A prospective comparison of octyl cyanoacrylate tissue adhesive (Dermabond) and suture for the closure of excisional wounds in children and adolescents

Background: Recent studies suggest that the use of octyl cyanoacrylate tiss ue adhesive for closure of both traumatic lacerations and incisional surgic al wounds results in a cosmetic outcome comparable to that achieved with co nventional sutures. To date, no studies have looked at the use of tissue ad hesive for higher-tension wounds, such as those created during cutaneous ex cisional procedures. Objective: To compare the tissue adhesive octyl cyanoacrylate with standard suture for the closure of excisional wounds in children and adolescents. Design: A prospective comparison with blinded assessment of cosmetic outcom e. Twenty-eight wounds were closed with monofilament suture and 24 were clo sed with tissue adhesive. At approximately 2 months, photographs of the inc isions were evaluated by 2 dermatologists blinded to the method of skin clo sure. Subjects: Forty-two consecutive patients undergoing excisional dermatologic procedures at Children's Hospital, San Diego, Calif. These 42 patients had a total of 52 wounds that were evaluated. Main Outcome Measures: The cosmetic appearance of the wounds at 2 months, b ased on 2 validated wound scales: the Hollander Wound Evaluation Scale and a visual analog scale. Results: There were no differences in early complications between the group s. The suture group scored higher on the Visual analog scale (63.3 mm for s uture vs 47.8 mm for tissue adhesive), and this difference was statisticall y significant (P=.02). The suture group also had a higher median score on t he Hollander Wound Evaluation Scale, but this difference was not statistica lly significant (P=.09). Conclusion: The cosmetic outcome of cutaneous excisional surgery wounds clo sed with standard suturing was found to be superior to that of wounds close d with octyl cyanoacrylate.