Adhesive bonds or percutaneous absorbable suture for closure of surgical wounds in children. Results of a prospective randomized trial.
BACKGROUND
Surgeons have become increasingly interested in replacing conventional sutures by means of adhesive bonds for the closure of skin wounds. There are several advantages to the use of adhesive bonds compared with the conventional sutures.


METHODS
Between January and August 2001, all the wounds in children after groin surgery were closed with an adhesive, N-butylcyanoacrylate (Indermil, Locite Corp, 's-Hertogenbosch, The Netherlands), or with a suture, polyglactin 5-0 (Vicryl), intracutaneously. Fifty Inguinal wounds were treated with Indermil and 50 with Vicryl. Wounds were evaluated for hematoma, infection, dehiscence, or formation of granuloma. A scale from 1 to 10 expressed the cosmesis by patient and surgeon.


RESULTS
The most remarkable difference in wound healing was dehiscence of the wound in 26% of cases in the adhesive group and no dehiscence in the suture group. The cosmesis of the wounds was marked with an 8.6 in the suture group and in the adhesive group with a 6.8.


CONCLUSIONS
Wound dehiscence was seen significantly more frequent in the patients in whom the wound was closed with N-butylcyanoacrylate. The cosmesis of wounds closed with tissue glue was significantly lower then the cosmesis after suturing. Therefore, the authors advise, on the basis of this prospective randomized trial, that surgical wounds in children should be closed with a intracutaneous absorbable suture.
Department of Pediatric Surgery, Red Cross Hospital, The Hague, The Netherlands.
E D
ED
van den Ende
P W H E
PW
Vriens
J H
JH
Allema
P J
PJ
Breslau
D020341:Absorbable Implants; D002675:Child, Preschool; D004659:Enbucrilate / Q000627:therapeutic use*; D004954:Esthetics; D005260:Female; D006099:Granuloma / Q000453:epidemiology / Q000209:etiology; D006406:Hematoma / Q000453:epidemiology / Q000209:etiology; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D010342:Patient Acceptance of Health Care; D011098:Polyglactin 910; D011446:Prospective Studies; D013529:Surgical Wound Dehiscence / Q000453:epidemiology*; D013530:Surgical Wound Infection / Q000453:epidemiology; D013537:Sutures; D014014:Tissue Adhesives / Q000627:therapeutic use*; D014945:Wound Healing
D014014:Tissue Adhesives; D011098:Polyglactin 910; D004659:Enbucrilate