title: Subcuticular closure versus Dermabond: a prospective randomized trial.
abstract: 2-Octylcyanoacrylate tissue adhesive (Dermabond, Ethicon, Inc, Somerville, NJ) is being used successfully for closure of minor lacerations. To date, however, there have been no studies evaluating its use in the operating room for surgical incisions. We conducted a prospective randomized trial to compare the closure of inguinal herniorrhaphy incisions using 2-octylcyanoacrylate tissue adhesive (Dermabond) with closures using 4-0 Monocryl (Ethicon, Inc) in a running subcuticular closure. A total of 46 incisions were randomized at the time of closure. Of these incisions 24 were randomized to Dermabond closure (TA) and 22 were randomized to subcuticular closure (SC). Performance measures included: time for closure, wound complications, and cosmesis. Cosmesis was evaluated by blinded evaluation of photographs of the incisions taken 4 weeks after surgery. Closure times for the TA group were faster than in the SC group (mean of 155 vs 286 seconds; P < 0.001). Wound complications were higher in the TA group (P = 0.045). Cosmesis was also felt to be better in the SC group with a score of 4.2 versus 3.88, but this did not reach statistical significance. Although the use of Dermabond did result in faster wound cultures it also resulted in an increase in wound complications. The difference in mean cosmetic score for each group was not statistically significant but trended toward better scores in the SC group. Based on these findings we do not feel Dermabond is an acceptable alternative to subcuticular suture closure in inguinal herniorrhaphy incisions.
authors.affiliation: Department of Surgery, Eisenhower Army Medical Center, Fort Gordon, Georgia 30905, USA.
authors.forename: Erin F
authors.initials: EF
authors.lastname: Switzer
authors.forename: Robert C
authors.initials: RC
authors.lastname: Dinsmore
authors.forename: James H
authors.initials: JH
authors.lastname: North
mesh_terms: D000328:Adult; D000368:Aged; D003487:Cyanoacrylates; D004146:Dioxanes; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011091:Polyesters; D011183:Postoperative Complications; D011446:Prospective Studies; D013537:Sutures; D014014:Tissue Adhesives; D014945:Wound Healing
chemical_list: D003487:Cyanoacrylates; D004146:Dioxanes; D011091:Polyesters; D014014:Tissue Adhesives; C095495:glycolide E-caprolactone copolymer; C100832:octyl 2-cyanoacrylate