An open study of tissue adhesive in full-thickness skin grafting.
BACKGROUND
Securing full-thickness skin grafts (FTSG) by suturing is a time-consuming procedure, even in experienced hands. The advent of tissue adhesives has led to their use in a variety of surgical procedures, providing an acceptable alternative to conventional suturing.


OBJECTIVE
Our purpose was to identify whether the tissue adhesive n-butyl-2-cyanoacrylate (NBCA) can be used to secure FTSG and to compare the outcome with conventional suturing.


METHODS
Twenty-one patients with defects after Mohs micrographic surgery were enrolled into the study. An initial pilot study of 8 patients compared NBCA and sutures within individual grafts; the subsequent 13 patients had grafts secured with between 4 and 8 cardinal sutures and NBCA alone.


RESULTS
No differences in healing, complications, or cosmetic appearance were observed between the sides secured with NBCA and with sutures in the pilot study. Of the grafts in the subsequent 13 patients, 2 patients experienced superficial necrosis with subsequent healing and a good cosmetic outcome, the remainder healed in place without complications, with excellent cosmetic outcome.


CONCLUSIONS
NBCA is suitable for securing selected FTSG and provides a significant time-saving over the traditional approach of suturing such grafts into place.
Craven
N M
NM
Mohs Micrographic Surgery Unit, Dermatology Centre, Hope Hospital, Manchester, UK.
Telfer
N R
NR
D000368:Aged; D000369:Aged, 80 and over; D004659:Enbucrilate / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005153:Facial Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D010865:Pilot Projects; D016038:Skin Transplantation / Q000379:methods*; D014014:Tissue Adhesives; D014945:Wound Healing / Q000187:drug effects
D014014:Tissue Adhesives; D004659:Enbucrilate