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

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.

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.

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.

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.