Jl. Maw et al., A PROSPECTIVE COMPARISON OF OCTYLCYANOACRYLATE TISSUE ADHESIVE AND SUTURE FOR THE CLOSURE OF HEAD AND NECK INCISIONS, Journal of otolaryngology, 26(1), 1997, pp. 26-30
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.