USE OF OCTYL-2-CYANOACRYLATE FOR SKIN CLOSURE IN FACIAL PLASTIC-SURGERY

Octyl-2-cyanoacrylate is a long carbon chain cyanoacrylate derivative that is stronger and more pliable than its shorter chain derivatives. One hundred and eleven patients underwent elective surgical procedures by the same surgeon using either octyl-2-cyanoacrylate or sutures for skin closure at the University of Illinois at Chicago. Most patients underwent excision of benign skin lesions with a mean wound size of 11 2 mm(3). Patients were randomized into either control (vertical mattre ss suture closure) or test groups (closure with octyl-2-cyanoacrylate) . Surgical judgment was used to determine which wounds in each group r equired application of subcutaneous sutures to relieve tension and aid in skin edge eversion. Generally, full-thickness (through dermis) wou nds larger than 1 cm(3) required the use of subcutaneous sutures. The time required to close the epidermis with suture (mean, 3 minutes and 47 seconds) was about four times that of octyl-2-cyanoacrylate (mean, 55 seconds). Wounds were evaluated at 5 to 7 days for infection, wound dehiscence, or tissue reaction, and at 90 days using the modified Hol lander wound evaluation scale. At 1 year, photographs of the wounds we re evaluated by two facial plastic surgeons that graded the cosmetic o utcome using a previously validated visual analog scale. There were no instances of wound dehiscence, hematoma, or infection ill either grou p. Results of wound evaluation at 90 days determined by the modified H ollander scale revealed equivalent cosmetic results in both groups. Re sults of the visual analog scale ratings showed scores of 21.7 +/- 16. 3 for the 49 patients treated with octyl-2-cyanoacrylate and 29.2 +/- 17.7 for the 51 control patients treated with sutures. The lower visua l analog scale score represented a superior cosmetic outcome at 1 year with the octyl-2-cyanoacrylate as compared with sutures. This differe nce is statistically significant at p = 0.03. Additionally, patient sa tisfaction was very high in the group treated with octyl-2-cyanoacryla te.