203 posters, 14 topics, 5 sessions, 817 authors, 256 institutions

The AAPS 102nd Annual Meeting

May 18-21, 2024 | The Westin Copley Place, Boston, MA

Dermabond For Reduction Mammoplasty Revisited: Its Effects On Postoperative Wound Healing

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Poster Presenter

Stephanie Francalancia

Authors

Stephanie Francalancia, Mary Lou, Damon McIntire, Nikhil Sobti, Navya Baranwal, Elijah Persad-Paisley, Jesse Menville, Brooke Barrow, Josué Marquez, Rachel Sullivan, Paul Liu, Karl Breuing

Affiliations

Brown University Warren Alpert Medical School

Part of Topic

Aesthetic Breast/Body Contouring

Dermabond for Reduction Mammoplasty Revisited: Effects on Postoperative Wound Healing

Introduction:

• Wound dressing following reduction mammoplasty can be conducted using surface 2-Octyl cyanoacrylate (Dermabond; Ethicon, Inc., Somerville, N.J)1,2,3
• The effect on long-term wound healing in these patients is inconclusive4
• We present an updated review of Dermabond's safety and efficacy in reduction mammoplasty patients

Methods:

Retrospective analysis n = 554 patients (1068 breasts)
• All reductions done by the same senior surgeon
• March 2015–February 2023
• Uni- and bilateral reductions included

Surgical Technique: inferior or superomedial pedicle reduction approach with an inverted-T Wise pattern used for all patients
• Dermabond: Four vials (0.5mL/vial) Dermabond + sterile gauze dressing
• No Dermabond: Bacitracin + non-adherent gauze + sterile gauze dressing

Statistical Analysis: Demographic, operative time, and postoperative complication data collected from patient records and summarized with descriptive statistics
• Student's t-test or Wilcoxon rank sum test for continuous variables and Fisher's exact test for categorical variables to evaluate differences in demographics and postoperative outcomes between groups
• Univariate and multivariate logistic regression with Firth's correction to accommodate low frequencies of complications used to calculate odds ratios (ORs), adjusted odds ratios (aORs), and 95% confidence intervals (CIs).

Results:

Of 554 patients:
• Average age = 38 ± 15 years old
• Average pre-operative BMI = 30.9 ± 5.0
• All identified as female
• 16% had hypertension, 5.3% had diabetes,
2.4% were current smokers

Of their 1068 breasts:
529 (49.5%) got Dermabond
539 (50.5%) did not

Operative Characteristics:
• Dermabond use was consistent for reduction mammoplasty dressings from 2015 through early 2020.

• Due to lower costs and surgeon preferences, practice reverted to traditional dressings after 2020 (Figure 1).

Post-operative Characteristics:

After up to a 2-year follow-up:
• 114 (10.7%) breasts had nipple insensitivity
• 44 (4.1%) had wound dehiscence
• 21 (2.0%) had fat necrosis
• 1.0% or less had seroma, hematoma, hypertrophic scarring, or nipple necrosis

Dermabond alone was significantly predictive of increased rates of dehiscence, hypertrophic scarring, fat necrosis, and decreased rates of nipple insensitivity (Table 1). Dermabond a significant predictor of increased rates of dehiscence, hypertrophic scarring, and major complications (hematoma, dehiscence, nipple necrosis, or fat necrosis) after adjusting for baseline demographics (Table 1, Model 1). After adjusting for operative and post-op characteristics, Dermabond remained a significant predictor of dehiscence and major complications (Table 1, Models 2 & 3).

Conclusions: By conferring similar procedure time and higher rates of postoperative complications, Dermabond’s use as wound dressing following our institution’s reduction mammoplasty cases is not superior to the traditional dressing method.