Postoperative Nasal Septal Abscess Following Use of 2-Octylcyanoacrylate and Polydioxanone Plate in Open Septorhinoplasty: A Case Series

Abstract

We present an original case series on our limited, though impactful experience with PDS plate reconstruction using Dermabond to facilitate caudal septal graft placement in open septorhinoplasty. In conjunction with previously reported case series, which demonstrated elevated risk of prolonged inflammation and infection, we would recommend avoidance of subcutaneous Dermabond as an adjunct, particularly in combination with PDS plate utilization.

A Prospective Randomized Trial of N-butyl-cyanoacrylate + Metacryloxysulfolane Adhesive versus Suture Alone for Grafting in Rhinoplasty: 9 year Follow-up

“…We did not observe any statically significant difference in the prevalence of short and long-term postsurgical complications among our patients; this result was discordant with a case series published in 2017, in which the authors showed an increased risk of developing a septal nasal abscess [6] by using a pure 2-Octyl-Cyanoacrylate (OCA). We think that the increased risk of developing an infection was related to the use of specific adhesive as proposed by Gall et al, 6 rather than to a general use of the glue. In our study, conducted on a large sample (>100 patients), we did not observe differences in infection prevalence between the groups.…”

“…4 CA glues are extremely useful for vascular anastomosis because they are simpler to use than traditional suture and they offer comparable results in term of outcome. 5 CA glues, despite generally safe, can sometimes cause infection in the site where they are applied 6 or dermatitis. 7 An adverse event could be due to subject's sensitivity to the active principle or to one of the excipients contained in the glue.…”

“…12,13 Some authors have reported an increased risk of developing infection especially when CA glues are used to fix graft in rhinoplasty. 6 A new type of glue that combine N-butyl-cyanoacrylate (NBCA) and Metacryloxysulfolane (MS) has been used to close oroantral fistulae after functional endoscopic sinus surgery (FESS). 14 The compound has strong hemostatic, bacteriostatic and adhesive properties, and was used in place of traditional sutures during cleft palate surgery to prevent fistulae and to reduce the risk of infection.…”

Cartilage Framework Fixation with 2-Octyl Cyanoacrylate in a Prelaminated Radial Forearm Free Flap Total Auricular Reconstruction

“…Gall et al reported postoperative septal abscess following use of Dermabond in septorhinoplasty [1]. They, however, used a polydioxanone plate secured with both Dermabond and suture in their repair, which may confound any attribution of infection to the use of adhesive alone.…”

“…Steel wire can extrude. Rhinoplasty surgeons have cautioned against using bioadhesives to stabilize cartilage grafts due to prolonged inflammation and infection, although data have actually been mixed or confounded by other variables [1]. We report successfully employing 2-octyl cyanoacrylate (Dermabond, Ethicon, Somerville, NJ) as the sole fixation method of a costal cartilage auricular framework in a prelaminated radial forearm free flap (RFFF) without complication.…”