TITLE:
2-Octyl Cyanoacrylate Skin Adhesive for Topical Skin Incision Closure in Female Pelvic Surgery
AUTHORS:
Rebecca L. James, Marilyn Alejandro-Rodriquez, Elba Adriana Perez, Jeffrey Mangel
KEYWORDS:
Female Pelvic Surgery, Gynecologic Surgery, Octyl Cyanoacrylate, Surgical Incision, Skin Closure
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.5 No.5,
May
27,
2015
ABSTRACT: Background: 2-octyl cyanoacrylate
(2OCA) high viscosity tissue adhesive (Medline Industries, Inc., Mundelein, IL)
is a liquid topical skin adhesive. 2OCA offers the same design features and
clinical utility in terms of flexibility, strength, and low complication rate
as the commercially available 2OCA tissue adhesives. Additionally, 2OCA
features high viscosity allowing for better control during the application
process, polymerization without the use of an external activator, and a
distinctive violet color for ease of application visualization. Objective: The
aim of this prospective case series is to descriptively report clinical data
with the application of 2OCA as a topical incision closure system in female
pelvic surgery. The primary outcomes included: incisional pain, incisional
dehiscence, and post-operative bleeding. The secondary outcome included drying
times of the adhesive with regard to incision length. Methods: A prospective
open-label observational case series study was conducted to evaluate the use of
2OCA in surgical wound closure of the topical skin in adult patients undergoing
gynecologic surgical procedures. A total of 50 adult women undergoing
gynecologic surgery were enrolled. 2OCA was applied only by surgeons who had
undergone product training to the incisions in a standardized, protocol-defined
fashion. Drying times for the adhesive and photography were recorded
intraoperatively. Post treatment follow-up was conducted with queries of pain
level, incisional dehiscence, and incisional bleeding immediately
post-operatively, 48 hours, 5 - 10 days and 14 days post-treatment. Adverse
events were documented. Results: 2OCA was applied to a total of 154 incisions
from the 50 patients enrolled to the study. The procedures included: 16
laparoscopic total hysterectomies, 4 diagnostic laparoscopies, 2 laparoscopic
myomectomies, 2 laparoscopic bilateral or unilateral salpingo-oophorectomies, 5
total robotic-assisted laparoscopic surgeries (2 total hysterectomies, 1
supracervical hysterectomy, 1 sacrocolpopexy, and one excision of
endometriosis), 7 sacral neuromodulation procedures, and 18 midurethral slings.
The overall rate of incisional dehiscence was 3% (4/154). The rate of reported
incisional bleeding was 3% (4/154). There was 1 incisional infection. The pain
reports based on a 10-point scale had a mean of 4.96 immediately
post-operatively, which decreased to a mean score