Should We Stick With Surgical Glues?

The Incidence of Dermatitis after 2-Octyl Cyanoacrylate Exposure in 102 Consecutive Breast Cases

Lauren C. Nigro, M.D.; Jamie Parkerson, B.F.A., M.S.; Julia Nunley, M.D.; Nadia Blanchet, M.D.

Disclosures

Plast Reconstr Surg. 2020;145(1):32-37. 

In This Article

Results

One hundred two patients undergoing breast-related procedures completed the questionnaire. Patients ranged in age from 19 to 82 years (mean, 51 years); all were female (Table 1). Prior exposure to glues, tapes, and/or cosmetic lashes or nails was self-reported in 60 patients (59 percent)(Table 1).

A cyanoacrylate reaction was observed in 14 patients (14 percent) (Table 1 and Figure 1). Allergy to cyanoacrylate was confirmed by scratch testing in all 14 patients demonstrating or noting a reaction. Every patient who was allergic to Dermabond also reacted to LiquiBand at the time of the scratch test. Of the 14 patients noted to have a reaction, four demonstrated reaction at the time of their surgical delay procedure 2 weeks before their mastectomies and first-stage reconstruction. Two patients with known allergies to surgical glue did not receive glue intraoperatively, but had their allergy confirmed by scratch testing.

Figure 1.

Acute dermatitis 1 week after breast augmentation along incisions covered with cyanoacrylate glue.

Comparing patients who reacted to cyanoacrylate with those that did not demonstrated a slight trend in which those who self-reported a prior exposure were more likely to react to cyanoacrylate than those who did not report a prior exposure (Table 2). No clear trends are observed among the other variables, including number of surgical exposures, procedure type, or patient age (Table 2). Multivariate logistic regression model statistical testing supported this trend toward significance when comparing cyanoacrylate reaction between those with a prior exposure versus those without a prior exposure; however, this did not reach statistical significance (p = 0.0732). The remaining variables were not statistically significant predictors of cyanoacrylate reaction (Table 3).

The majority of reactions were observed within the first week of surgery, at which time the glue was removed in the office and patients were treated with over-the-counter or prescription strength hydrocortisone cream (1 to 2.5%). Steroid dose packs were reserved for patients whose symptoms did not improve in a few days, and were necessary in three patients (Figure 2).

Figure 2.

Resolving dermatitis 3 weeks postoperatively after a steroid dose pack.

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