Safety and Efficacy of Octyl 2-Cyanoacrylate (Dermabond) in Breast Surgery: A Systematic Review

Background/Objectives: Effective wound closure in breast surgery achieves a compromise between safety and aesthetic outcomes. This systematic review evaluates the effect of 2-octyl cyanoacrylate (2-OCA) tissue adhesive (Dermabond) as a primary means of skin closure compared with traditional sutures. Methods: The study protocol was registered in PROSPERO (CRD42023420595). A systematic search of PubMed, Embase, and Web of Science databases identified ten studies (n = 1870) comparing 2-OCA with standard suturing techniques in breast reduction, reconstruction, and oncological procedures. The methodological quality was assessed using Cochrane RoB 2.0 and the Newcastle-Ottawa Scale. Results: Using the Synthesis Without Meta-analysis (SWiM) framework, the results indicate that 2-OCA offers a safety profile comparable to sutures in terms of the incidence of infection and hematoma. Although a higher incidence of wound dehiscence was observed with glue, 2-OCA showed better operative efficacy and greater patient satisfaction, which is attributed to its immediate water resistance and elimination of the need for suture removal. Conclusions: The analysis suggests that 2-OCA is a feasible structural alternative to skin sutures in appropriately selected patients, with the proper management of deep skin layer tension.