Octyl-2-cyanoacrylate tissue adhesive in external dacryocystorhinostomy

Purpose: To review our experience using octyl-2-cyanoacrylate for closing the cutaneous incision in external dacryocystorhinostomy (DCR). Methods: A retrospective review was performed of all cases of external DCR with cyanoacrylate wound closure performed during a 12-month period. At the completion of the DCR, octyl-2-cyanoacrylate was used to close the incision. No subcutaneous sutures were placed to approximate the wound edges. Fifteen seconds of drying time elapsed before a second application of the adhesive was applied. Follow-up consisted of examinations at 1 week, 1 month, and 3 months after surgery. Results: Twenty-one cases of wound closure using octyl-2-cyanoacrylate in external DCR were performed on 19 patients. Cyanoacrylate was applied to the wound without complications, and all patients had excellent closure of the wound with the cyanoacrylate at the end of the case. No wound infections were noted during the follow-up period. One patient had a wound dehiscence that was treated with forceps debridement of residual cyanoacrylate and reapplication of additional oetyl-2-cyanoacrylate. One patient had hypertrophic sear formation that resolved with daily massage. In all patients, the incision was believed to be aesthetically equivalent to the expected appearance Of Suture closed DCR incisions. Conclusions: Closure of the DCR incision with cyanoacrylate is safe, quick, does not compromise wound integrity, and provides an aesthetic result that is equivalent to suture wound closure. Additional benefits could potentially include safer operative environment and postoperative convenience for patient and surgeon.