Allergic contact dermatitis to Dermabond™: A case and review of the literature

Allergic Contact Dermatitis to Octyl Cyanoacrylate Skin Glue After Surgical Wound Closure: A Systematic Review

The rising incidence of allergic contact dermatitis (ACD) after cyanoacrylate adhesive use necessitates a comprehensive understanding of its clinical presentations, risk factors, and management. In this systematic review, we conducted an exhaustive search following PRISMA guidelines within Medline and PubMed databases to identify studies reporting cases of ACD resulting from cyanoacrylate adhesive application in wound closure. A total of 47 studies, covering 193 ACD cases, were included in our analysis. These cases involved 35 male, 120 female patients, and 38 cases without gender information (M:F ratio = 1:3.43), with ages ranging from 7 to 92 years (mean age 43.9 years). The majority of cases (n = 140) were part of 6 orthopedic studies, focusing on joint replacements (n = 68), orthopedic surgeries (n = 38), and breast surgeries (n = 29). The remaining 58 cases encompassed various surgical procedures. Common clinical manifestations included swelling, pruritic rash, erythema, vesicles, and itching around the surgical sites, typically appearing around 10 days post-adhesive application (within a range of 6 hours to 6 weeks). Patients with prior exposure to 2-octyl cyanoacrylate tended to exhibit earlier symptoms. Similar rates of dermatitis were observed across different adhesive brands, suggesting brand independence. Treatment strategies involved adhesive removal, administration of steroids and antihistamines, meticulous wound care, and, in some cases, surgical intervention. Notably, 3.1% of the 193 cases required surgical intervention. Risk factors, including a history of atopic dermatitis, high body mass index, diabetes, prior adhesive exposure, and surgical history, were identified in the studies. Patch tests confirmed 2-octyl cyanoacrylate as the allergen in 21 studies. Our review aims to enhance health care professionals' understanding of ACD resulting from the use of cyanoacrylate adhesive, facilitating improved postsurgical management and prevention strategies. Recognizing diverse risk factors, understanding varying clinical presentations, distinguishing ACD from infection, and employing appropriate treatment approaches are essential for achieving optimal outcomes in such cases.

Complications associated with Dermabond® during head and neck surgery: MAUDE and literature review

INTRODUCTION

Dermabond® is a liquid surgical sealant containing 2-octyl-cyanoacrylate that has been widely used during head and neck surgeries. This study aims to provide a summary of adverse events related to Dermabond® in head and neck procedures as reported in the MAUDE database, and to report a complete overview of all documented adverse events related to Dermabond® use in current literature.

METHODS

The US Food and Drug Administration's Manufacturer and User Facility Device Experience (MAUDE) database was queried for reports of adverse events related to Dermabond® use from January 1, 2010, to February 1, 2020. Data were extracted from reports pertaining to head and neck procedures. In addition, literature review was performed from January 1970 to January 2021. Various adverse events related to Dermabond® were included in the study.

RESULTS

We identified 32 adverse events, from which 29 (90.6%) were patient-related events and 3 (9.4%) were operator-related events. Of the patient-related events, contact dermatitis (CD) (20 [69.0%]) was the most common, followed by wound dehiscence (4 [13.8%]). All of the operator-related events were from inadvertent cut injury (3 [100%]). Following the literature review, adverse events of Dermabond® were categorized into CD, wound dehiscence, infection, and cut injury.

CONCLUSION

Dermabond® demonstrated utility in various surgical procedures including head and neck surgeries but are associated with risks. This study identified adverse events associated with Dermabond®. Further studies are needed to establish the causation of contact dermatitis in certain populations.

Histotopographic and morphometric characteristics of the oral mucosa postoperative wounds healing, depending on the method of connecting the wound edges

Implementation of high-quality tissue connections and hemostasis in oral surgery is an urgent problem of modern dentistry, due to the lack of available universal methods that would help to facilitate the work of oral surgeon and reduce wound healing time. The aim of the research. To investigate and study the regeneration processes in the oral mucosa after high-frequency electric welding, suturing and medical adhesive composition. Materials and methods. This study compared the effect of three connection methods and hemostasis: high-frequency electric welding (EKVZ-300M1 “PATONMED®”, Ukraine), suture method (nylon 5/0 “PIRUS®”, China), adhesive composition (“Histoacryl®”, Germany). 72 rabbits were involved in experiment. An incision of the soft tissues of the vestibulum of the oral cavity of the maxilla with a length of 1.3–1.5 cm was made. On days 3, 7, 14 and 21, tissue samples were excised, histological and morphometric examination of the material were performed. Results. By statistical data processing of 72 rabbits was found that the reliability of differences in the levels of morphometric parameters between groups on each day is very high, as evidenced by the calculated values ​​of the U-test. In 38 cases (90.5 %), the significance level was p≤0.01, in the other 4 cases – p≤0.05. The lowest value level of neutrophilic granulocytes was in rabbits of group No.1 (electric welding). In rabbits of group No. 1 GFBC were not observed in the 8 fields of view throughout the experiment. Conclusions. High-frequency electric welding of soft tissues can be used for effective intraoperative hemostasis and connection of the intraoral wound edges. Due to the absence of a foreign body (adhesive masses, filaments) and moderate alterative effect, histological examination indicates accelerated activation of regenerative processes in the early stages of observation in rabbits of group No. 1.