title: Evaluation of octylcyanoacrylate for wound repair of clinical circumcision and human skin incisional healing in a nude rat model.
abstract: OBJECTIVE
  Alternative methods of circumcision wound closure have been studied to decrease repair time and complications, and improve cosmesis. This study includes a clinical and a laboratory research portion. Clinical parameters, wound outcome, closure time and operative time were compared for octylcyanoacrylate and suture approximation of circumcision incisions. An in vivo incisional model using human foreskin was used to compare the wound breaking strength of octylcyanoacrylate and suture repair.
  
  
  METHODS
  Circumcision incisions were closed with suture or octylcyanoacrylate. Wound closure time and operating room time were recorded. Patients were evaluated 1 and 12 weeks postoperatively. Foreskin samples from another group of patients were engrafted to an immunodeficient rat and allowed to heal. Incisions were made in the human skin and the wounds were repaired with sutures or octylcyanoacrylate. After 7 days breaking stress was tested and healing was evaluated by histological testing.
  
  
  RESULTS
  Optimal wound healing was noted in all patients 1 week after surgery. Scarring was absent in the octylcyanoacrylate group. Octylcyanoacrylate closure time was significantly shorter than suture time (p <0.001). Mean total operating room time for octylcyanoacrylate plus or minus standard deviation was shorter than for suture (19.4 +/- 0.51 versus 26.9 +/- 0.94 minutes, p <0.001). Octylcyanoacrylate wound breaking stress was equivalent to suture on tensiometry. Histological testing revealed normal healing in all wounds.
  
  
  CONCLUSIONS
  Circumcision wounds may be closed by octylcyanoacrylate with shorter wound closure and operative time than by suture. In an animal model of human skin healing, wound breaking stress after octylcyanoacrylate closure was equivalent to suture repair. Octylcyanoacrylate may be a useful alternative to suture closure for circumcision incisions.
authors.affiliation: Center for Pediatric Urology and Laboratory for Minimal Invasive Urologic Surgery, Children's Hospital of New York, Weill Medical College of Cornell University, New York, New York, USA.
authors.forename: Peter B
authors.initials: PB
authors.lastname: Petratos
authors.forename: G Bino
authors.initials: GB
authors.lastname: Rucker
authors.forename: Robert A
authors.initials: RA
authors.lastname: Soslow
authors.forename: Diane
authors.initials: D
authors.lastname: Felsen
authors.forename: Dix P
authors.initials: DP
authors.lastname: Poppas
mesh_terms: D000293:Adolescent; D000818:Animals; D002648:Child; D002675:Child, Preschool; D002944:Circumcision, Male; D003487:Cyanoacrylates / Q000627:therapeutic use*; D005240:Feasibility Studies; D006801:Humans; D007223:Infant; D008297:Male; D051381:Rats; D011923:Rats, Nude; D013536:Suture Techniques; D013718:Tensile Strength; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D003487:Cyanoacrylates; C119247:octylcyanoacrylate