Cyanoacrylate adhesive versus fast-absorbing gut suture for cutaneous closure in upper blepharoplasty: a systematic review
Keywords:
blepharoplasty, surgical adhesive, surgical closure technique, cyanoacrylate, catgutAbstract
Background: the choice of suture material for upper blepharoplasty remains highly variable and is often influenced by individual surgeon preferences. Absorbable sutures and cyanoacrylate adhesives offer distinct advantages due to their biodegrading ability, namely increased patient comfort and convenience. However, the current literature lacks direct comparative studies on these materials, and questions persist regarding their strength, durability, and wound-healing characteristics. Aim: this review assesses the functional and cosmetic effectiveness of absorbable sutures and cyanoacrylate for cutaneous closure in upper blepharoplasty. Methods: the review focuses on studies published since 2000 that compare absorbable sutures and cyanoacrylate use in upper blepharoplasty. A systematic search was conducted using several databases. Inclusion criteria encompassed clinical trials or case series assessing cutaneous closure in upper blepharoplasties. Results: five studies met the inclusion criteria and presented various outcomes. In some cases, cyanoacrylate closure demonstrated the potential for superior cosmetic results and reduced closure time. However, a closure with gut sutures alone tended to show a higher dehiscence risk than non-absorbable sutures, though cosmetic results may have been equivalent. No papers were found evaluating synthetic absorbable sutures. Conclusion: the included studies were limited by their design, small sample sizes, and limited follow-up durations. The lack of objective measures in the assessment of cosmetic outcomes made it challenging to form direct cross-comparisons. In summary, while absorbable gut suture and cyanoacrylate present satisfactory results in upper blepharoplasty closure, cyanoacrylate primary closure may provide enhanced cosmesis in addition to inherent practical advantages. Surgeons may consider these alternatives over non-absorbable sutures, considering their resource-saving potential and patients’ comfort.
References
1. Kouba DJ, Tierney E, Mahmoud BH, Woo D. Optimizing closure materials for upper lid blepharoplasty: a randomized, controlled trial. Dermatol Surg. 2011; 37(1)19-30.
2. Kim H, Hwang K, Mi Yun S. Catgut and its use in plastic surgery. J Craniofac Surg. 2020; 31(3):876-878.
3. Jaggi R, Hart R, Taylor MS. Absorbable suture compared with nonabsorbable suture in upper eyelid blepharoplasty closure. Arch Facial Plast Surg. 2009; 11(5):349-352.
4. Joshi AS, Janjanin S, Tanna N, Geist C, Lindsey C. Does suture material and technique matter? Lessons learned from 800 consecutive blepharoplasties. Laryngoscope. 2007; 117(6):981-4.
5. Perin LF, Helene Jr A, Fraga MF. Sutureless closure of the upper eyelids in blepharoplasty: use of octyl-2-cyanoacrylate. Aesthet Surg J. 2009; 29(2):87-92.
6. Quinn J, Maw J, Ramotar K, Wenckebach G, Wells G. Octylcyanacrylate tissue adhesive versus suture wound repair in a contaminated wound model. Surgery. 1997; 122(1):69-72.
7. Suriano MM, Stirbu O, Perez DM, Serra Segarra M. [Blepharoplasty: to suture or to use cyanoacrylate]. Arch Soc Esp Oftalmol. 2011; 86(3):81-84.
8. Homer NA, Zhou S, Watson AH, Durairaj VD, Nakra T. Wound dehiscence following upper blepharoplasty: a review of 2376 cases. Ophthalmic Plast Reconstr Surg. 2021; 37(3S):S66-S69.
9. Guyuron B, Vaughan C. A comparison of absorbable and nonabsorbable suture materials for skin repair. Plast Reconstr Surg. 1992; 89(2)234-236.
10. Scaccia FJ, Hoffman JA, Stenick DW. Upper eyelid blepharoplasty. A technical comparative analysis. Arch Otolaryngol Head Neck Surg. 1994; 120(8):827-830.
11. Toriumi DM, O’Grady K, Desai D, Bagal A. Use of octyl-2-cyanoacrylate for skin closure in facial plastic surgery. Plast Reconstr Surg. 1998; 102(6):2209-2219.
12. Greene D, Koch RJ, Goode RL. Efficacy of octyl-2-cyanoacrylate tissue glue in blepharoplasty. A prospective controlled study of wound-healing characteristics. Arch Facial Plast Surg. 1999; 1(4):292-296.
13. Aydemir E, Kiziltoprak H, Aydemir G. Comparison of Clinical Outcomes of Upper Eyelid Blepharoplasty Using Two Different Suture Techniques. Beyoglu Eye J. 2022; 7(1):18-24.
14. Kashkouli MB, Jamshidian-Tehrani M, Sharzad S, Sanjari MS. Upper blepharoplasty and lateral wound dehiscence. Middle East Afr J Ophthalmol. 2015; 22(4):452-456.
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