Dr. Mahesh Dhotre,
ABSTRACT
BACKGROUND There are several concerns while selecting the mode of wound closure after surgery, whether major or minor procedure. One of the concerns is how fast and comfortable will be the recovery. A new technology is surgical adhesives, cyanoacrylates, 2-octyl cyanoacrylate is easier to use and provides a flexible, water resistant, sealed skin closure, 2 octyl cyanoacrylate provides a needle free method of wound closure, an important consideration because of blood borne viruses (e.g. HIV). The objectives of the study are- 1) To compare isoamyl-2-cyanoacrylate with subcuticular polyamide suture for skin closure in elective surgical procedures for the following characters. 2) To compare the cosmetic outcome. 3) To compare wound dehiscence & wound infection. MATERIALS AND METHODS This is a comparative study conducted on 50 patients in two groups at Bapuji Hospital and Chigateri General Hospital, Davangere in Department of General Surgery between 1st of January 2010 and 1st of July 2011. Cases undergoing clean elective surgical procedure were randomly selected and put into two groups. 1) Skin closure was done with 3-0 polyamide subcuticular sutures in one group. 2) Skin closure was achieved with 2–octyl cyanoacrylate in the other group. RESULTS Wound cosmesis assessment on day 7, the mean score for adhesive glue group was 5.84 which was slightly higher than the mean cosmesis score of 5.68 for subcuticular skin suturing (p=0.3). The cosmesis assessment at 1 month, the mean score for adhesive glue group was 5.9 and was 5.68 for subcuticular skin suturing group which was again not statistically significant (p=0.1). The mean wound ASEPSIS scores on day 3 for adhesive glue group was 0.28 and the same for subcuticular skin suturing group was 0.36 (p=0.7). The same score on day 5 for adhesive glue group was 0.12 and that of subcuticular skin suturing group was 0.28 (p=0.4). The results in both the groups were comparable in terms of wound infection rate. CONCLUSION Octyl cyanoacrylate provides an effective and reliable means of skin closure and yields similar cosmetic results as with subcuticular skin sutures. The incidence of infection and wound complications are comparable in both the groups. In addition, octyl cyanoacrylate provides certain practical advantages to the patients. The advice as to which method is used for closure of wound may come down to economics and operator preference.
