Comparative trial of octyl-cyanoacrylate and silver sulfadiazine for the treatment of full-thickness skin wounds

A prospective, randomized, blinded, controlled experimental trial was perfo rmed in pigs to compare the rates of reepithelialization of 126 full-thickn ess cutaneous 4-mm punches treated with an octyl-cyanoacrylate spray, silve r sulfadiazine, or a dry gauze (controls). Full thickness biopsies were tak en 7, 14, or 30 days later for histopathological evaluation of hematoxylin and eosin stained tissue sections by a dermatopathologist. The primary outc ome measure was the proportion of wounds completely re-epithelialized at da ys 7 and 14. Secondary outcomes were the rates of infection, foreign body r eactions, and the depth of any resulting cutaneous dells measured with a mi crometer. Between-group comparisons were performed with ANOVA or Chi-square tests. Octyl-cyanoacrylate treated wounds re-epithelialized more slowly, a s fewer wounds treated with octyl-cyanoacrylate were re-epithelialized at d ay 7 in comparison with sliver sulfadiazine or control wounds (50% vs. 90% vs. 100%, p < 0.001). There were no infections or foreign body type reactio ns. Amounts of granulation tissue were similar among groups. Octyl-cyanoacr ylate wounds were more depressed than silver sulfadiazine wounds at days 7 and 14 yet had similar histopathological characteristics at day 30, We conc lude that treatment of small, full thickness cutaneous wounds with octyl-cy anoacrylate results in delayed re-epithelialization and dermal repair in co mparison with silver sulfadiazine, yet it does not result in any foreign bo dy-type reaction. However, by 30 days, histopathological wound characterist ics were similar in all groups.