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Ruth Hill Yeilding, Denis M. O'Day, Louise A. Mawn; Periorbital Infections after Dermabond® Closure of Traumatic Lacerations in Three Children: a Case Series and Review of the Literature. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1589.
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Previous studies have documented the benefits of wound closure with tissue adhesives over sutured wound closure. The purpose of this report is to describe the development of preseptal cellulitis after Dermabond® wound closure of traumatic periorbital lacerations in three children, including one case of necrotizing fasciitis
We retrospectively reviewed the charts of the three patients referred consecutively to the Vanderbilt University Eye Institute. The main measures were history and hospital course including presentation, workup, treatment, and clinical outcome. In addition, a systematic literature review was performed through September 2010. All studies involving Dermabond® were retrieved and reviewed. The Vanderbilt Emergency Department was contacted to identify additional cases. The Eye Drug Registry and the World Health Organizations's Data Base were also queried. Results: All three cases were children less than two years old who developed preseptal cellulitis within 24 hours of wound closure of periorbital lacerations with tissue adhesive. Broad spectrum IV antibiotic therapy was instituted in all cases. Cultures were taken in two of three cases, and both grew Strep Pyogenes. Two cases required surgical
The development of preseptal cellulitis following closure of periorbital lacerations should alert the physician to the possibility of an uncommon, but serious periorbital infection. The etiology of the three Dermabond® associated infections presented in this case series remains to be ascertained. We believe the most likely mechanism of infection in this cases series to be from contamination secondary to incomplete sterilization prior to Dermabond® application. We encourage the reporting of other Dermabond® associated infections. Additionally, we emphasize the importance of meticulous wound sterilization before closure.
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