Sutureless skin closure in varicose vein surgery: Preliminary results

OBJECTIVE. To describe the preliminary results of a special method of wound closure in varicose vein surgery using the tissue adhesive butyl-2-cyanoac rylate. METHODS. Eighteen consecutive young women (mean age 23 years) underwent par tial stripping of the greater saphenous vein for varicose veins of the lowe r limbs by an external phleboextractor, Their wounds were closed without su tures by means of the adhesive butyl-2-cyanoacrylate. The cutaneous edges w ere drawn together by linear traction between forceps and the adhesive was applied and allowed to set. Less than 0.5 mi of adhesive was required to co mplete the entire procedure. Wounds were evaluated at 7 days for infection, dehiscence, and tissue reactions, At 6 months all wounds were rated for co smesis using a validated visual analog scale, that is, a 100 mm line with " worst scar" at the right end of the line and "best scar" at the left end. A ll patients were interviewed about their acceptance of tissue adhesive skin closure. RESULTS. The mean time required to close the epidermis with the adhesive wa s 117 seconds. All patients were followed up for 6 months. At 7 days no adv erse outcomes had occurred. Results of wound evaluation at 6 months by the visual analog scale showed scores of 22.2 +/- 13.8 mm (optimal). The percen tage of optimal scores was 94.4%, and only one patient (5.6%) had a subopti mal score. Inquiry into the patient's opinions suggested that this procedur e was very acceptable. CONCLUSION. Preliminary results with sutureless skin closure in varicose ve in surgery have been very encouraging, This fast and cosmetic method of wou nd repair can replace the need for skin sutures in varicose vein surgery.