Primary and Revision Cleft Lip Repairs Using Octyl-2-Cyanoacrylate

Abstract

The purpose of our retrospective review is to examine our method and outcomes for the application of octyl-2-cyanoacrylate for the repair of primary and revision cleft lips in both pediatric and adult patients. Records and photographs were reviewed and analyzed for patient age, type of cleft, revision or primary repair, complications, length of follow-up, and aesthetic outcomes. Eighteen patients, both children and adults, who underwent cleft lip repairs using tissue adhesive performed by a single surgeon between 1999 and 2003 were included. Twelve patients underwent primary repair and 6 patients underwent revision repair. Repairs were performed using the Millard rotation advancement technique and the Mohler variant. The lateral advancement flap was kept long and redundant in its transverse dimension to create a pressure fit everting the skin edges with minimal sutures to set up the closure for application of the tissue adhesive. Seventeen of eighteen patients had excellent cosmetic outcomes. One patient had minor necrosis of the tip of the advancement flap. No allergic reactions, wound infections, or dehiscences occurred. The use of octyl-2-cyanoacrylate for the skin closure of primary and revision cleft lip repairs in both children and adults results in excellent cosmetic outcomes. Employing our pressure-fit technique for skin eversion prior to application of the tissue adhesive may be advantageous. The lack of suture removal in the pediatric population and decreased operative time are additional benefits.