The use of Indermil (n-butyl cyanoacrylate) in otorhinolaryngology and head and neck surgery. A preliminary report on the first 33 patients

Abstract

The authors present their initial experience of a new sterile medical grade cyanoacrylate adhesive (Indermil) in otolaryngeal and head and neck surgery.Thirty-three patients who underwent a variety of head and neck operations consented to have their skin incisions closed using the adhesive and 10 of those also underwent repair of the tympanic membrane, either as part of tympanoplasty or mastoid surgery. The history of the use of this class of adhesive is presented with an explanation of the chemical properties of these compounds. Advantages of using cyanoacrylate adhesives and future possible applications in otolaryngology and head and neck surgery are discussed.

A Comparison of Dermabond Tissue Adhesive and Sutures in the Primary Repair of the Congenital Cleft Lip

“…12 Initial formulations using short-side-chain alkyl groups, such as ethyl or methyl groups, suffered from rapid degradation of the compounds into toxic metabolites, such as cyanoacetate and formaldehyde, causing significant tissue toxicity and inflammation. Subsequently, longer-chain derivatives have been developed which degrade more slowly, causing less local toxicity and decreased inflammation.…”

The Comparison of Histological Results of Experimentally Created Facial Nerve Defects Repaired by 2 Different Anastomosis Techniques

“…The potential for foreign body reaction caused by the suture material is accepted as a common handicap for nerve regeneration in these cases. 1,2 The alternative techniques to overcome this problem are still under investigation. Theoretically, the new biocompatible materials that promise lesser foreign body reactions and other procedure-related problems may be an ideal option to replace conventional suture techniques.…”

“…Currently, the longer-chain N-butyl-2-cyanoacrylate and 2-octylcyanoacrylate are widely used as the ideal nontoxic forms. 1,2 Despite its relatively early description by 1949, their clinical application for closure of surgical wounds was almost a decade later. 1 In recent years, cyanoacrylate application for surgical wound closure or tissue approximation has gained increasing interest in a variety of surgical cases, as well as in head and neck surgical procedures.…”

“…1 In recent years, cyanoacrylate application for surgical wound closure or tissue approximation has gained increasing interest in a variety of surgical cases, as well as in head and neck surgical procedures. 2,3 In this study, our hypothesis was that application of small amounts of N-butyl-2-cyanoacrylate solution to anastomosis lines may eliminate tissue reaction caused by needle trauma and suture material. For comparison, we used electron microscopic evaluation of histological regeneration characteristics of the nerve fibers at the line of anastomosis performed by either microsurgical suture or N-butyl-2-cyanoacrylate solution.…”

Evaluation of the long-term outcome of wounds closed with ”Indermil" adhesive

“…Cyanoacrylates are used for a variety of medical and surgical conditions [1,2,3,4]. Coover, in 1959, first noted their adhesive properties and their potential applications [5].…”