Sutureless closure of the upper eyelids in blepharoplasty: use of octyl-2-cyanoacrylate.

BACKGROUND Skin adhesives provide an alternative to sutures for skin closure. The use of octyl-2-cyanoacrylate in blepharoplasty has been reported by some authors, but difficulties in applying the product and the real benefits of its use are still controversial. OBJECTIVE The purpose of this study is to show a simple technique for closing the upper incision in blepharoplasty with octyl-2-cyanoacrylate instead of sutures and to discuss its benefits. METHODS Eight female patients who underwent blepharoplasty had the upper incision closed with octyl-2-cyanoacrylate, for a total of 16 eyelids studied. Temporary stitches were placed along the incision and pulled by traction to approximate the skin borders. After apposition of the skin borders, high viscosity octyl-2-cyanoacrylate (Dermabond; Johnson & Johnson, New Brunswick, NJ) was used to close the incision. The stitches were removed immediately after glue crust formation, leaving the incision without sutures. The procedure was timed and a Hollander wound scale was used to evaluate the aesthetic results. RESULTS Approximation of the skin borders with temporary stitches made it easier to apply octyl-2-cianoacrylate. The average gap between the skin borders was 1.0 cm. No major complications were encountered, although minor wound dehiscence occurred in 2 eyelids (12.5%). The closure time averaged 6.9 minutes and the aesthetic results were considered very good or excellent. CONCLUSIONS Closure of the upper eyelids using octyl-2-cianoacrylate and temporary stitches removed immediately after glue crust formation is a safe and easily reproduced technique, with no differences in aesthetic outcome compared with suture closure.