Use of N-butyl-2-cyanoacrylate in elective surgical incisions--longterm outcomes.
BACKGROUND
Histoacryl Blue (N-butyl-2-cyanoacrylate) is a tissue adhesive that has been used clinically for more than 20 years. In the last decade, N-butyl-2-cyanoacrylate has been used for cutaneous closure of low-tension lacerations in children and adults and has become a preferred method for closure of pediatric facial lacerations in many emergency rooms outside the United States. Many pediatric elective surgical procedures are performed in tension-free areas and may be suitable for closure with a tissue adhesive. In order to assess this approach, a retrospective study was conducted to evaluate the cosmetic outcomes and complications of the application of N-butyl-2-cyanoacrylate for the approximation of elective surgical incisions in a pediatric population.


METHODS
Records of 1,098 patients, ages 1 month to 16 years, who, between January 1995 and December 1996, underwent one of the following: orchidopexy, inguinal hernia, umbilical hernia, or hydrocele repair were analyzed. In all patients, N-butyl-2-cyanoacrylate was applied to close the surgical incision. A 12-item questionnaire was created to assess the presence of complications and to determine shortterm and longterm cosmetic outcomes of the incision. Data were collected by conducting telephone interviews of family members.


RESULTS
Among the 1,033 children who were treated, 66% had inguinal hernias, 15% hydroceles, 15% undescended testis, and 4% umbilical hernias. Redness or tenderness at the incision site (5.5%), discharge from the surgical wound (1.9%), and wound dehiscence (1.1%) were the main immediate complications after surgery. Overall satisfaction with the cosmetic outcomes of the surgical scar was high, with an average score of 4.73 out of 5 (94.6%).


CONCLUSIONS
Our results demonstrate that administration of N-butyl-2-cyanoacrylate for the closure of small low-tension surgical incisions in the pediatric population is safe, has a low complication rate, and produces excellent cosmetic outcomes.
Department of Urology, Bnai Zion Medical Center, Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel.
G E
GE
Amiel
I
I
Sukhotnik
B
B
Kawar
L
L
Siplovich
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D004659:Enbucrilate / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome
D014014:Tissue Adhesives; D004659:Enbucrilate