Randomized study of the effectiveness of closing laparoscopic trocar wounds with octylcyanoacrylate, adhesive papertape or poliglecaprone.
BACKGROUND
Several methods for skin closure are used, i.e. sutures, adhesive papertape and tissue adhesives. Little is known about the efficacy of these techniques in laparoscopic surgery. This study was performed to analyse the efficacy of octylcyanoacrylate, a new tissue adhesive, adhesive papertape and poliglecaprone for wound closure in laparoscopy.


METHODS
From May 2000 to September 2001, 140 patients were included in a prospective randomized trial. Wounds were closed with octylcyanoacrylate (n = 48), adhesive papertape (n = 42) or poliglecaprone (n = 50). Closing time, wound infection, cosmetic results and costs were evaluated. A time-motion analysis was also performed.


RESULTS
The patients in the three groups were well matched for age, gender and body mass index. Closing times per wound were 26, 33 and 65 s respectively for adhesive papertape, octylcyanoacrylate and poliglecaprone (P < 0.001). Cosmetic results, as scored by the patients, were no different. The number of actions required to close each wound was 5.7, 8.3 and 21.0 for octylcyanoacrylate, adhesive papertape (P = 0.05 versus octylcyanoacrylate) and poliglecaprone (P < 0.01 versus octylcyanoacrylate and adhesive papertape) respectively. Octylcyanoacrylate was significantly more expensive than poliglecaprone and adhesive papertape.


CONCLUSIONS
Closure with adhesive papertape was the fastest method. The smallest number of actions required to close a wound was with octylcyanoacrylate. Adhesive papertape was the most cost-effective.
Maartense
S
S
Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
Bemelman
W A
WA
Dunker
M S
MS
de Lint
C
C
Pierik
E G J M
EG
Busch
O R C
OR
Gouma
D J
DJ
D000704:Analysis of Variance; D003362:Cost-Benefit Analysis; D003487:Cyanoacrylates / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000209:etiology; D014014:Tissue Adhesives / Q000191:economics / Q000627:therapeutic use*; D016896:Treatment Outcome; D014945:Wound Healing
D003487:Cyanoacrylates; D014014:Tissue Adhesives; C119247:octylcyanoacrylate