A prospective comparison of octyl cyanoacrylate tissue adhesive (Dermabond) and suture for the closure of excisional wounds in children and adolescents
L. Bernard et al., A prospective comparison of octyl cyanoacrylate tissue adhesive (Dermabond) and suture for the closure of excisional wounds in children and adolescents, ARCH DERMAT, 137(9), 2001, pp. 1177-1180
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.