Dermabond for reduction mammoplasty revisited: Its effects on postoperative wound healing

Abstract

Purpose: Wound dressing following reduction mammoplasty can be conducted using surface 2-octyl cyanoacrylate (Dermabond; Ethicon, Inc., Somerville, N.J), but its effect on long-term wound healing in these patients is inconclusive. We present an updated review of Dermabond's safety and efficacy in reduction mammoplasty patients.

Methods: An IRB-approved retrospective analysis was conducted on 532 patients (1048 breasts) who underwent reduction mammoplasty by a single surgeon between March 2015 and February 2023. Data on demographics, operative times, and postoperative complications were collected from patient records. Patient data were separated into Dermabond and non-Dermabond dressing groups. The Wilcoxon rank sum or student's t-tests for continuous variables and Pearson's chi-squared test for categorical variables were used to evaluate the differences between both groups. Univariate and multivariable logistic regression assessed the association of Dermabond application with complications.

Results: Among the 1048 total breasts, Dermabond was used in 525 (50.1%), while it was not used in 523 (49.9%). There were significantly increased rates of dehiscence (p < 0.001), hypertrophic scarring (p = 0.005), fat necrosis (p = 0.028), and major complications (p < 0.001) in the Dermabond cohort; however, no significant differences in rates of seroma, hematoma, infection, or nipple necrosis were observed. Dermabond was a significant predictor of higher rates of dehiscence (p < 0.001) and incidence of major complications (p < 0.001) with and without adjustment for demographic or intra- and postoperative characteristics.

Conclusions: Using Dermabond as wound dressing after reduction mammoplasty was associated with higher rates of dehiscence, hypertrophic scarring, and major complications, suggesting a negative impact on postoperative outcomes.

Keywords: Breast reduction; Outcomes studies; Reduction mammoplasty; Retrospective studies; Surgical wound infection; Wound dressing.