Comparative trial of octyl-cyanoacrylate and silver sulfadiazine for the treatment of full-thickness skin wounds.
A prospective, randomized, blinded, controlled experimental trial was performed in pigs to compare the rates of reepithelialization of 126 full-thickness cutaneous 4-mm punches treated with an octyl-cyanoacrylate spray, silver sulfadiazine, or a dry gauze (controls). Full thickness biopsies were taken 7, 14, or 30 days later for histopathological evaluation of hematoxylin and eosin stained tissue sections by a dermatopathologist. The primary outcome measure was the proportion of wounds completely re-epithelialized at days 7 and 14. Secondary outcomes were the rates of infection, foreign body reactions, and the depth of any resulting cutaneous dells measured with a micrometer. Between-group comparisons were performed with ANOVA or Chi-square tests. Octyl-cyanoacrylate treated wounds re-epithelialized more slowly, as fewer wounds treated with octyl-cyanoacrylate were re-epithelialized at day 7 in comparison with silver sulfadiazine or control wounds (50% vs. 90% vs. 100%, p < 0.001). There were no infections or foreign body type reactions. Amounts of granulation tissue were similar among groups. Octyl-cyanoacrylate wounds were more depressed than silver sulfadiazine wounds at days 7 and 14 yet had similar histopathological characteristics at day 30. We conclude that treatment of small, full thickness cutaneous wounds with octyl-cyanoacrylate results in delayed re-epithelialization and dermal repair in comparison with silver sulfadiazine, yet it does not result in any foreign body-type reaction. However, by 30 days, histopathological wound characteristics were similar in all groups.
Singer
A J
AJ
Department of Emergency Medicine, State University of New York at Stony Brook, USA.
Berrutti
L
L
McClain
S A
SA
D000818:Animals; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D003487:Cyanoacrylates / Q000627:therapeutic use*; D005069:Evaluation Studies as Topic; D005260:Female; D006097:Granulation Tissue; D011897:Random Allocation; D012837:Silver Sulfadiazine / Q000627:therapeutic use*; D013552:Swine; D014945:Wound Healing / Q000502:physiology
D000891:Anti-Infective Agents, Local; D003487:Cyanoacrylates; D012837:Silver Sulfadiazine