Clinical Paper
Trauma
A prospective comparison of octyl-2-cyanoacrylate and suture in standardized facial wounds

https://doi.org/10.1016/j.ijom.2005.10.003Get rights and content

Abstract

Regarding the cosmetic results of wound closure using tissue adhesives as opposed to sutured wounds, most published studies are performed on children and with non-standardized lacerations, which makes it difficult to transfer the results to facial incisional wounds in adults. There are also conflicting conclusions about the cosmetic results. The purpose of this randomized prospective study was to compare the cosmetic outcomes of wound closure with sutures and octyl-2-cyanoacrylate in standardized facial wounds in adults. To compare very similar facial wounds, the infraorbital cut (lower eyelid incision) was used in 45 patients. The assessment was performed by patients and surgeons blind to the data. Phase-shifting profilometry was used to measure the profile of the scars. No early complications were observed in any group. The wound depth in the tissue adhesive group was significantly greater than in the suture group. There were no differences in the overall cosmetic results among all patients in the two groups. Interestingly, in the younger patients the result of the sutured wounds was superior to that of the adhesive-treated patients. The Dermabond® skin adhesive provides a means of closure of facial surgical wounds without early complications, but adjustment of the edges of the wound and the cosmetic result in younger patients are less successful than with thin sutures.

Section snippets

Material and methods

To compare very similar facial wounds of nearly equal length, localization and shape, the infraorbital cut (lower eyelid) was used. Forty-five Caucasian patients with an orbital floor fracture were included in this investigation. Patients were eligible for inclusion in the study if they were of generally good health without significant systemic abnormalities, had the medical indication for a surgical orbital floor reconstruction and provided informed consent. The study report meets the criteria

Results

A total of 45 patients met the previously defined inclusion criteria and were examined about 3 months after surgery. In 19 patients, wound closure was performed with a skin adhesive (Dermabond®) and in 26 patients with a monofilament suture (Ethilon®). The two treatment groups were similar regarding age, duration of surgery and follow-up time. The mean age of the patients in the adhesive group was 47 years against 42 years in the suture group. The total surgical procedure took 63 min (skin

Discussion

Tissue adhesives are an area of tremendous interest and research. The use of skin adhesives has become very popular, particularly for paediatric patients. Cyanoacrylates used as skin adhesives are liquid monomers that polymerize into a solid material forming a thin film that causes the opposite edges of a wound to adhere. While the short-chain cyanoacrylates (methyl and ethyl forms) have been associated with tissue toxicity as a result of rapid degradation, the higher chain derivatives (such as

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