A blinded, randomised, controlled trial of stapled versus tissue glue closure of neck surgery incisions.
BACKGROUND
Cosmetic acceptability of scar and neck mobility are important outcomes after collar line incision for neck surgery. This randomised, controlled trial compares these parameters in closures using tissue glue (Dermabond, Ethicon, UK) and skin staples.


METHODS
Patients requiring a collar line incision were randomised to receiving tissue glue or staples for skin closure. Time for closure to be completed was recorded. Mobility of the neck was assessed using a visual analogue scale at 48 h and 1 week after surgery. At 6 weeks, cosmetic appearance was assessed using a linear 1-10 visual analogue scale by the patient, surgeon and an independent blinded assessor. Results were compared using appropriate statistical tests.


RESULTS
Glued (n = 14) and stapled (n = 15) closures were performed for hemithyroidectomy (n = 8 versus 6), sub-total thyroidectomy (n = 2 versus 4), total thyroidectomy (n = 1 versus 4) and parathyroidectomy (n = 3 versus 1). Closure with tissue glue took significantly longer than with staples (mean, 95 versus 28 s; P < 0.001). Neck mobility scores were comparable at 48 h and 1 week (mean, 4.8 versus 4.4; P = 0.552: and 2.7 versus 2.6; P = 0.886). Cosmetic appearance at 6 weeks was comparable when patient (mean, 1.7 versus 1.8; P = 0.898), surgeon (mean, 2.6 versus 2.3; P = 0.633) and independent assessment (mean, 1.4 versus 1.9; P = 0.365) was performed.


CONCLUSIONS
The use of glued skin closure may increase the duration of surgery but acceptable neck mobility and wound cosmesis can be achieved by the more rapid application of stapled skin closure in cervicotomy incisions.
Ridgway
D M
DM
Scunthorpe General Hospital, Northern Lincolnshire and Goole Hospitals NHS Trust, Scunthorpe, UK.
Mahmood
F
F
Moore
L
L
Bramley
D
D
Moore
P J
PJ
D002921:Cicatrix / Q000209:etiology; D003487:Cyanoacrylates / Q000627:therapeutic use*; D004311:Double-Blind Method; D006801:Humans; D009333:Neck / Q000601:surgery*; D017060:Patient Satisfaction; D017792:Surgical Stapling; D013536:Suture Techniques; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
D003487:Cyanoacrylates; D014014:Tissue Adhesives; C100832:octyl 2-cyanoacrylate