The Use of Octyl-2-Cyanoacrylate (Dermabond™) Tissue Adhesive for Skin Closure in Head and Neck Surgery

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.

Response of head and neck epithelial cells to a DNA damage-differentiation checkpoint involving polyploidization

BACKGROUND

Squamous epithelia of the head and neck undergo continuous cell renewal and are continuously exposed to mutagenic hazard, the main cause of cancer. How they maintain homeostasis upon cell cycle deregulation is unclear.

METHODS

To elucidate how head and neck epithelia respond to cell cycle stress, we studied human keratinocytes from various locations (oral mucosa, tonsil, pharynx, larynx, and trachea). We made use of genotoxic or mitotic drugs (doxorubicin [DOXO], paclitaxel, and nocodazole), or chemical inhibitors of the mitotic checkpoint kinases, Aurora B and polo-like-1. We further tested the response to inactivation of p53, ectopic cyclin E, or to the chemical carcinogen 7,12-dimethylbenz[a]anthracene (DMBA).

RESULTS

All treatments provoked DNA damage or mitosis impairment and strikingly triggered squamous differentiation and polyploidization, resulting in irreversible loss of clonogenic capacity.

CONCLUSION

Keratinocytes from head and neck epithelia share a cell-autonomous squamous DNA damage-differentiation response that is common to the epidermis and might continuously protect them from cancer.

A Pilot Study of 2-Octyl Cyanoacrylate (Dermabond™) versus Conventional Suture Skin Closures for Caesarean Sections

Introduction:

2-octyl cyanoacrylate (Dermabond™, Ethicon, USA) has been available as an alternative skin closure since 1997. There are no reports on keloid formation with 2-octyl cyanoacrylate (2OC) closure for Caesarean section. Our study aims to assess keloid formation after Caesarean sections, as well as the safety and efficacy of 2OC for skin closure in Caesarean sections.

Methods:

A pilot study of 97 cases of Caesarean section performed by a single surgeon was done — 50 2OC closure versus 47 suture closure. Keloid formation, average operating time, wound infection, wound dehiscence and adverse peri-wound conditions were compared. Proportions across the two series were compared using chi-square/fisher exact test. Average operating time was compared using unpaired t-test.

Results:

Keloid formation was not statistically significant (2OC 24.0% versus S 14.9%, p=0.382). Mean operating time was similar (2OC 34.1±7.2 minutes versus S 32.7±7.2 minutes, p=0.33). Wound infection rate was similar (2OC 2.0% versus S 2.1%, p=0.939). More women experienced adverse peri-wound conditions with suture closure (2OC 2.0% versus S 6.4%, p=0.303). No woman experienced wound dehiscence.

Conclusion:

2-octyl cyanoacrylate has similar efficacy to suture skin closure in terms of keloid formation, operating time, wound infection and adverse peri-wound conditions. It can be a safe alternative for Caesarean section skin closure.

Identification of host genes involved in geminivirus infection using a reverse genetics approach

Geminiviruses, like all viruses, rely on the host cell machinery to establish a successful infection, but the identity and function of these required host proteins remain largely unknown. Tomato yellow leaf curl Sardinia virus (TYLCSV), a monopartite geminivirus, is one of the causal agents of the devastating Tomato yellow leaf curl disease (TYLCD). The transgenic 2IRGFP N. benthamiana plants, used in combination with Virus Induced Gene Silencing (VIGS), entail an important potential as a tool in reverse genetics studies to identify host factors involved in TYLCSV infection. Using these transgenic plants, we have made an accurate description of the evolution of TYLCSV replication in the host in both space and time. Moreover, we have determined that TYLCSV and Tobacco rattle virus (TRV) do not dramatically influence each other when co-infected in N. benthamiana, what makes the use of TRV-induced gene silencing in combination with TYLCSV for reverse genetic studies feasible. Finally, we have tested the effect of silencing candidate host genes on TYLCSV infection, identifying eighteen genes potentially involved in this process, fifteen of which had never been implicated in geminiviral infections before. Seven of the analyzed genes have a potential anti-viral effect, whereas the expression of the other eleven is required for a full infection. Interestingly, almost half of the genes altering TYLCSV infection play a role in postranslational modifications. Therefore, our results provide new insights into the molecular mechanisms underlying geminivirus infections, and at the same time reveal the 2IRGFP/VIGS system as a powerful tool for functional reverse genetics studies.

Efficacy of octyl-2-cyanoacrylate in type I tympanoplasty

OBJECTIVE

To evaluate the safety and efficacy of octyl-2-cyanoacrylate for type I tympanoplasty.

METHODS

This study involved 23 patients (14 females and 9 males) with chronic otitis media who underwent type I tympanoplasty. During surgery, the temporal fascia is placed underlying the eardrum remnant, and octyl-2-cyanoacrylate was dropped over the temporal fascia. The mean air-bone gap (ABG) at the 4 frequencies (500, 1000, 2000, and 4000) was calculated for each patient before and after surgery. These data were compared by Student t test.

RESULTS

The mean follow-up was 10 months (range, 6-12 mo). Successful tympanic membrane grafting occurred in 21 patients (91.3%). Graft failure was seen in 2 patients. The mean preoperative ABG of the 23 patients was 19.3 (SD, 5.7) dB, and the postoperative ABG improved to a mean value of 8.2 (SD, 5.9) dB (P ≤ 0.0001).

CONCLUSIONS

Octyl-2-cyanoacrylate is effective and safe in using as a compound on temporalis muscle fascia in type I tympanoplasty and can be used more widely in tympanoplasty.