Surgical Corner: A Prospective Randomized Evaluation of Cyanoacrylate Glue Devices in the Closure of Surgical Wounds
July 2013 | Volume 12 | Issue 7 | Original Article | 810 | Copyright © 2013
Joseph Maloney BA,a Gary S. Rogers MD,b,c and Mitesh Kapadia MD PhDd
aBeverly Hospital Oncology Care Center, Beverly, MA
bTufts University School of Medicine, Departments of Dermatology and Surgery, Boston, MA
cDermatologic Surgery & Oncology, Beverly Hospital, Beverly, MA
dTufts University School of Medicine, Department of Ophthalmology, Boston, MA
BACKGROUND: The use of medical adhesives for topical wound closure is gaining in popularity over conventional wound closure
materials such as sutures and staples. Adhesives provide advantages in both wound closure and patient management with good
cosmetic outcome and surgeon and patient satisfaction reported.
OBJECTIVE: To compare the use of two currently marketed medical adhesives; LiquiBand® Flow Control and High Viscosity Dermabond ™ for the topical closure of surgical incisions.
METHODS: In a prospective blinded manner, subjects were randomly assigned LiquiBand® or DermabondTM for topical closure of a surgical incision. Variables compared included ease of use, time taken to close wound, subject and surgeon satisfaction with device and wound closure, cosmetic outcome at 90 days, and complication rates.
RESULTS: Use of both devices resulted in effective wound closure with similar high levels of cosmesis subject and surgeon satisfaction, with only minor complications reported. There was no statistically significant difference between the devices for all the parameters studied, with the exception that the Liquiband device was found to significantly reduce the amount of time required for closure.
CONCLUSION: As the two devices appear substantially equivalent in terms of key surgeon and patient variables, product cost should be the primary determinant in selection of the tissue glue device.
J Drugs Dermatol. 2013;12(7):810-814.
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The ability to heal wounds is an ever-evolving skill documented throughout human history. Without medical intervention, most traumatic and surgical wounds heal on their own, although it may take a significant amount of time and can result in esthetically unacceptable scarring. Thus, the desire to repair wounds quickly and with less scarring continues to push advances in wound closure technology. Sutures have played a role in wound closure for roughly 4,000 years and have evolved from various man-made materials such as wire fashioned from iron, gold, and silver, as well as many organic materials, including tree bark fibers, silk, dried animal intestine, and horse hair.1 Today, sutures fabricated from synthetic polymers such as nylon, polypropylene, braided polyester, and polybutester are the mainstays of wound closure.2 Sutures, while excellent for approximating tissue edges and providing tensile strength, can often lead to inflammation, foreign body reactions, and cross-hatching along the incision line eventuating in a less attractive scar. Significant wound care of the surgical site is often required for several days following conventional closure because the wound is not sealed from water or pathogens and additional visits to the healthcare facility are required for suture removal. In order to mitigate potentially cosmetically unattractive outcomes, slow speed of wound closure, inconvenience, and expense for a repeat patient visit, many providers have begun using skin adhesives as an alternative to sutures for topical skin closure.
Adhesives themselves have also had an interesting evolution. In fact, the oldest adhesive discovered to date was approximately 8,000 years old, about twice as old as the first sutures, and was made from animal collagen. It’s not surprising that