An open study of tissue adhesive in full-thickness skin grafting

Background: Securing full-thickness skin grafts (FTSG) by suturing is a tim e-consuming procedure, even in experienced hands. The advent of tissue adhe sives has led to their use in a variety of surgical procedures, providing a n acceptable alternative to conventional suturing, Objective: Our purpose was to identify whether the tissue adhesive n-butyl- 2-cyanoacrylate (NBCA) can be used to secure FTSG and to compare the outcom e with conventional suturing. Methods: Twenty-one patients with defects after Mohs micrographic surgery w ere enrolled into the study. An initial pilot study of 8 patients compared NBCA and sutures within individual grafts; the subsequent 13 patients had g rafts secured with between 4 and 8 cardinal sutures and NBCA alone. Results: No differences in healing, complications, or cosmetic appearance w ere observed between the sides secured with NBCA and with sutures in the pi lot study. Of the grafts in the subsequent 13 patients, 2 patients experien ced superficial necrosis with subsequent healing and a good cosmetic outcom e, the remainder healed in place without complications, with excellent cosm etic outcome. Conclusion: NBCA is suitable for securing selected FTSG and provides a sign ificant time-saving over the traditional approach of suturing such grafts i nto place.