Prospective randomized comparative study of skin adhesive glue (2- methyl -2- cyanopropionate or cyanoacrylate) versus conventional skin suturing by suture material/skin stapler in clean surgical cases

Abstract

Background: To compare cosmetic appearance of skin closure wound by three methods -sutures, staples and skin adhesive glue. Traditional skin closure using sutures causes more pain, infection, needs its removal, time consuming and leaves behind bad scar. Nowadays, good cosmetic appearance of operated site is appealing among patients. Surgeons are looking for faster, comfortable and cosmetically best technique for skin closure. Newer techniques need to be evaluated which are better than suture and staples. 2-octylcyanoacrylate is easier to use, flexible, water resistant, pain free sealed skin closure without its need for removal and has better cosmesis.Methods: This study is conducted from July 2010 to April 2013 in 90 patients at LTMG Hospital. Wounds of clean surgeries closed with suture material, skin staples and skin adhesive glue were studied in 30 patients each. Patients were randomized using standardized methods. Patients followed up over period of 28 days and their scars were assessed according to the modified Hollander cosmesis scale(MHCS) and cosmetic visual analogue scale(VAS). Patient allotment was done using random number table.Results: Mean MHCS score for skin adhesive group on day 7 was 4.83 which was significantly more than 3.90for suture and 3.97 for stapler. Mean VAS score for skin adhesive group on day 7 was 67.67 which was significantly more than 61.67 for suture and stapler each. Mean MHCS and VAS score for skin adhesive group on day 7, 14 and 28 were significantly more than suture and stapler groups.Conclusions: Octylcyanoacrylate can be used for skin closure in clean elective surgeries with better cosmetic outcome as compared to staples and sutures.