Use of cyanoacrylate tissue adhesive under a diaper.
OBJECTIVE
To examine the utility of cyanoacrylate tissue adhesive (Dermabond, Ethicon, Somerville, NJ, USA; an effective means of epithelial skin closure) under a diaper (i.e. constantly exposed to bodily fluids) in 25 children (not toilet-trained) undergoing inguinal surgery.


METHODS
A retrospective review of charts between July 1998 and July 2000 was used to identify children who were not toilet-trained and who had undergone inguinal surgery (e.g. orchidopexy, hernia and hydrocele repair). In addition to the type of surgery, the method of closure was also assessed; in all cases reported the subcutaneous tissues were approximated with 4/0 polyglactin suture. From July 1998 to October 1999 all epithelial skin was closed with 5/0 poliglecaprone, benzoin, sterile strips and collodion; from October 1999 to July 2000 all skin was closed with cyanoacrylate tissue adhesive.


RESULTS
The chart review identified 45 boys (mean age 15.3 months, range 1-26) of whom 26 (57%) had undergone either inguinal hernia or hydrocele repair, and 19 (42%) who had undergone orchidopexy. These procedures resulted in a total of 52 incisions in the 45 children. Of the 52 incisions, 27 were closed with suture and 25 with cyanoacrylate adhesive. All patients were followed up at 2 weeks; there were no instances of infection or wound dehiscence in either group. The incisions were cosmetically identical at 3 months of follow-up.


CONCLUSIONS
Cyanoacrylate adhesive is a safe and effective method of skin closure that can be used under a diaper.
Ferlise
V J
VJ
Division of Urology, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Ankem
M K
MK
Barone
J G
JG
D002648:Child; D002675:Child, Preschool; D003487:Cyanoacrylates / Q000627:therapeutic use*; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D007223:Infant; D007224:Infant Care; D008297:Male; D009919:Orchiectomy / Q000379:methods; D012189:Retrospective Studies; D013733:Testicular Diseases / Q000601:surgery; D006848:Testicular Hydrocele / Q000601:surgery; D014945:Wound Healing / Q000187:drug effects*
D003487:Cyanoacrylates