title: Postoperative outcomes associated with topical skin adhesives among women having hysterectomies.
abstract: BACKGROUND
  Multiple options are available for closure of hysterectomy incisions. This study compared postoperative clinical and economic outcomes using topical skin adhesive (2-octyl cyanoacrylate; OCA) vs. conventional skin closure in women undergoing total abdominal hysterectomy.
  
  
  METHODS
  A multi-hospital administrative database was used to identify women discharged in 2005 who had undergone total abdominal hysterectomy. Patients, classified by skin closure as suture (n = 21,201), staples (n = 23,441), OCA (n = 880), or staples + OCA (n = 489), were compared on length of inpatient stay (LOS), total inpatient cost, and non-prophylactic antibiotic treatment after day four.
  
  
  RESULTS
  The unadjusted mean LOS was 3.9, 4.5, 3.7, and 5.2 days for suture, staples, OCA, and staples + OCA, respectively; and the percentages of patients having antibiotic treatment were 12.93, 17.51, 11.14, and 23.72. There were overall differences in adjusted mean LOS, mean total cost, and antibiotic treatment (p < 0.0001). Pairwise comparisons indicated no difference between sutures and OCA, whereas the outcomes for each of the non-staple groups were more favorable than those for the staple group (p < 0.01). Results were similar in adjusted comparisons, with pairwise comparisons between OCA and staples at or near the threshold for significance.
  
  
  CONCLUSIONS
  2-octyl cyanoacrylate appears to be a safe and cost-effective alternative to topical sutures for patients having total abdominal hysterectomy. There were less favorable outcomes in groups receiving staples.
authors.affiliation: Department of Obstetrics & Gynecology, University of Tennessee , Memphis, TN, USA.
authors.forename: Susan G
authors.initials: SG
authors.lastname: Murrmann
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Markowitz
authors.forename: Elane M
authors.initials: EM
authors.lastname: Gutterman
authors.forename: Glenn
authors.initials: G
authors.lastname: Magee
mesh_terms: D058107:Abdominal Wound Closure Techniques / Q000009:adverse effects / Q000191:economics*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D008875:Middle Aged; D053832:Surgical Tape / Q000009:adverse effects / Q000191:economics*; D016896:Treatment Outcome; D055815:Young Adult