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Reply: Seasonal Impact on Surgical-Site Infections in Body Contouring Surgery: A Retrospective Cohort Study of 602 Patients over a Period of 6 Years

Duscher, Dominik M.D., Ph.D.; Zaussinger, Maximilian M.D.; Wenny, Raphael M.D.; Huemer, Georg M. M.D., M.B.A., M.Sc.

Author Information
Plastic and Reconstructive Surgery: April 2019 - Volume 143 - Issue 4 - p 891e-892e
doi: 10.1097/PRS.0000000000005462
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Sir:

We appreciate the comments by Pierazzi et al. regarding our study demonstrating the seasonal impact of surgical-site infections in body contouring surgery.1 As the authors point out, the ultimate goal in body contouring surgery is patient safety, which implies decreased complication and infection rates. To fulfill this purpose, they suggest the use of cyanoacrylate skin adhesive for reducing surgical-site infections.

It has been shown that liquid 2-octyl cyanoacrylate adhesive provides stable wound closure and spares a significant amount of time for closure of long cutaneous incisions.2 However, based on our experiences, the application of tissue glue increase the potential for intense local allergic reactions.3,4 In body contouring, multistage procedures are often necessary to achieve satisfactory results. The repeated use of tissue glue allows the patients to acquire sensitivity to the substance, which can lead to significant atopic reactions in subsequent operations. These reactions could be conclusively linked to the octyl-2 cyanoacrylate adhesive.3,4 As a consequence, we decided to renounce the use of any cyanoacrylate adhesive to ensure patient safety.

In the 8-year experience with octyl-2-cyanoacrylate adhesive cited by the authors, unfortunately, seasonal impact on wound infections was not considered.2 We suspect that higher temperatures influence the potential risk of surgical-site infections either with or without tissue glue. Because there are no conclusive data regarding this matter, we feel that this might be a fruitful future field of study.

DISCLOSURE

The authors have no financial interest to declare in relation to the content of this communication. No funding was received for this work.

Dominik Duscher, M.D., Ph.D.
Maximilian Zaussinger, M.D.
Section of Plastic, Aesthetic, and Reconstructive Surgery
Medcampus III
Kepler University Hospital
Johannes Kepler University
Linz, Austria
Department of Plastic Surgery and Hand Surgery
Klinikum rechts der Isar
Technical University Munich
Munich, Germany

Raphael Wenny, M.D.
Section of Plastic, Aesthetic, and Reconstructive Surgery
Medcampus III
Kepler University Hospital
Johannes Kepler University
Linz, Austria

Georg M. Huemer, M.D., M.B.A., M.Sc.
Section of Plastic, Aesthetic, and Reconstructive Surgery
Medcampus III
Kepler University Hospital
Johannes Kepler University
Linz, Austria
Department of Plastic Surgery and Hand Surgery
Klinikum rechts der Isar
Technical University Munich
Munich, Germany

REFERENCES

1. Duscher D, Kiesl D, Aitzetmüller MM, et al. Seasonal impact on surgical-site infections in body contouring surgery: A retrospective cohort study of 602 patients over a period of 6 years. Plast Reconstr Surg. 2018;142:653–660.
2. Grimaldi L, Cuomo R, Brandi C, Botteri G, Nisi G, D’Aniello C. Octyl-2-cyanoacrylate adhesive for skin closure: Eight years experience. In Vivo 2015;29:145–148.
3. Huemer GM, Schmidt M, Helml GH, Shafighi M, Dunst-Huemer KM. Effective wound closure with a new two-component wound closure device (Prineo) in excisional body-contouring surgery: Experience in over 200 procedures. Aesthetic Plast Surg. 2012;36:382–386.
4. Dunst KM, Auboeck J, Zahel B, Raffier B, Huemer GM. Extensive allergic reaction to a new wound closure device (Prineo). Allergy 2010;65:798–799.

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