Evaluating the use of octyl-2-cyanoacrylate in unilateral cleft lip repair

Vijaylaxmy Malhotra, J K Dayashankara Rao, Varun Arya, Shalender Sharma, Sushil Singh, Payal Luthra, Vijaylaxmy Malhotra, J K Dayashankara Rao, Varun Arya, Shalender Sharma, Sushil Singh, Payal Luthra

Abstract

Background: Facial cosmetic results are one of the most concerning issues for the parents who get their children operated for cleft lip. Moreover, the postoperative care of the surgical site, the discomfort associated with the suture removal, and additional visit for suture removal are other reasons which encourages one to use any new technologies that may replace the need for suture placement. In this study, we used octyl-2-cyanoacrylate, a tissue adhesive which offers a viable alternative to traditional techniques without compromising optimal wound closure.

Objective: To perform a comprehensive comparison of the outcomes from the use of Dermabond in patients undergoing primary repair of congenital cleft lip ± palate anomalies.

Materials and methods: Twenty patients, in the age group of 3-18 months were treated surgically for unilateral cleft lip deformity using Millard rotation-advancement flap. Pre- and post-operative photographs of the patients were taken at 1 week, 2 week, 1 month, 6 months, and 1 year postoperatively and were evaluated using Vancouver scar scale which was given by Sullivan in 1990. Paired t-test was used for statistical analysis.

Results: Increased vascularity (hyperemia) was seen in the 1st and 2nd week in 35% and 30% patients, respectively which gradually reduced to normal in subsequent follow-ups. The scar was flat in 85% of patients in 1st week, and the number decreased to 10% at the end of 1 year. No wound dehiscence was found in any patients. Statistical analysis showed that among all the follow-ups, only the difference between the first and second follow-ups. Comparison of the results of 1 week with all other follow-ups yielded no significant results.

Conclusion: Octyl-2-cyanoacrylate can be used for cleft lip closure effectively. The procedure is relatively painless and quick. Added to this are benefits of protection from wound infection since the material is bacteriostatic.

Keywords: Congenital cleft lip; Dermabond; sutures; tissue adhesive.

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Preoperative photograph showing unilateral complete cleft of left upper lip
Figure 2
Figure 2
Intraoperative photograph showing modified Millard incision
Figure 3
Figure 3
Intraoperative photograph showing application of cyanoacrylatescore
Figure 4
Figure 4
Photograph showing follow-up after 2 weeks
Figure 5
Figure 5
Photograph showing follow-up after 1 month
Figure 6
Figure 6
Photograph showing follow-up after 1 year

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