A PROSPECTIVE COMPARISON OF OCTYLCYANOACRYLATE TISSUE ADHESIVE AND SUTURE FOR THE CLOSURE OF HEAD AND NECK INCISIONS

Objective: To compare the tissue adhesive octylcyanoacrylate with subc uticular suture for the closure of head and neck incisions. Design: A prospective comparison with a blinded assessment of cosmetic outcome. Subjects: Fifty consecutive patients undergoing head and neck procedur es at two University of Ottawa teaching hospitals. Methods: Twenty-six patients underwent skin closure with monofilament suture and 24 were closed with tissue adhesive. At 4 to 6 weeks the incisions were evalua ted with a validated wound scale. Photographs of the incisions were ra ted using a visual analogue scale by two facial-plastic otolaryngologi sts who were blinded to the method of skin closure. Results: The adhes ive provided faster skin closure (29.7 seconds vs 289.0 seconds, p < . 0001), and there were no differences in complications between the two groups. The primary outcome measure was the cosmetic appearance of the incision at 4 to 6 weeks. Although the adhesive group scored higher o n both cosmesis scales, the visual analogue scale (octylcyanoacrylate 58.7 mm vs suture 53.2 mm) and the wound evaluation scale (57% vs 50% optimal wound scores), there were no statistical or clinically signifi cant differences on either scale. The two facial-plastic otolaryngolog ists had good intraobserver and interobserver agreement when rating th e cosmetic outcomes (0.87 and 0.71 respectively). Conclusions: Octylcy anoacrylate was found to be an effective method of skin closure in cle an head and neck incisions. The practical advantages of tissue adhesiv es are reviewed.