Prospective randomised study to evaluate the use of DERMABOND ProPen (2-octylcyanoacrylate) in the closure of abdominal wounds versus closure with skin staples in patients undergoing elective colectomy.
BACKGROUND
Topical 2-octylcyanoacrylate tissue (OCA) adhesive has been used as an alternative to close wounds with a comparable cosmetic outcome. The use of 2-OCA in the closure of abdominal laparotomy wounds has not been thoroughly evaluated. Our aim was to compare 2-OCA with conventional skin stapling devices in colorectal surgery.


METHODS
A prospective randomised study was conducted in which 74 consecutive patients above the age of 21 undergoing open elective colectomies for benign or malignant indications were allocated to skin closure with 2-OCA or skin staples. Cosmetic outcome as assessed with the Hollander Cosmesis Scale with a single assessor, complication rates, and patient satisfaction were recorded at discharge (4-10POD) 2 weeks after discharge and then at 3 months.


RESULTS
Of the 74 patients, 38 were randomised to skin staples and 36 to 2-OCA. There was no significant difference in cosmetic outcomes between the two groups as assessed with a visual analogue scale or the Hollander Cosmesis Scale but showed a trend to better cosmetic outcomes in the 2-OCA group. Patient satisfaction scores were higher but did not reach statistical significance. The time taken to close a wound with 2-OCA was significantly longer than with skin staples. There was no statistical difference in rates of wound infection.


CONCLUSIONS
2-OCA is a safe and effective means of skin closure in patients undergoing elective colectomies with a good and at least equivalent outcome to traditional methods of closure.
Ong
Julian
J
Department of Colorectal Surgery, Singapore General Hospital, Singapore, Singapore.
Ho
Kok-Sun
KS
Chew
Min-Hoe
MH
Eu
Kong-Weng
KW
D000005:Abdomen / Q000601:surgery*; D000368:Aged; D003082:Colectomy / Q000191:economics / Q000379:methods*; D003487:Cyanoacrylates / Q000191:economics / Q000627:therapeutic use*; D003710:Demography; D062109:Dermatologic Surgical Procedures; D017558:Elective Surgical Procedures / Q000191:economics / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D011446:Prospective Studies; D012867:Skin / Q000187:drug effects; D017792:Surgical Stapling / Q000191:economics / Q000379:methods*; D014014:Tissue Adhesives / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
D003487:Cyanoacrylates; D014014:Tissue Adhesives; C100832:octyl 2-cyanoacrylate