title: Cosmetic outcome of skin adhesives versus transcutaneous sutures in laparoscopic port-site wounds: a prospective randomized controlled trial.
abstract: In an elective laparoscopic surgery, the cosmetic outcome becomes increasingly important. We conducted a study to evaluate the cosmetic outcome 3 months after a laparoscopic procedure and compared skin adhesive (SA) versus transcutaneous suture (TS).
  
  
  
  A randomized, controlled, prospective study was conducted at a single study centre in Hamburg, Germany. Seventy-seven patients undergoing laparoscopic surgery with two lower abdominal port sites met the study requirements. It was decided randomly which port site would be closed with SA. The opposite site was closed with TS. Wounds were assessed after 7-12 days and after 3 months. Cosmetic outcome was measured by a visual analogue scale (VAS) completed by the patient, by the Hollander wound evaluation scale (HWES) and by the judgement of blinded investigators.
  
  
  
  Seventy-seven subjects were randomized. Complete data from the 3-month follow-up visit were available from 56 patients (72.7 %). The VAS scale ranged from 0 to 100 mm with "0" representing the best possible cosmetic outcome. Median satisfaction was 2 mm in the TS group and 3 mm in the SA group. The mean was high in both groups 4.6 (s = 13.1) versus 3.8 mm (s = 4.6). The outcome was neither clinically nor statistically significant. Cosmetic outcome was assessed by an investigator, and the HWES showed no difference. In regard to complications, no difference was found between SA and TS, either.
  
  
  
  In conclusion this study demonstrated that closure of laparoscopic port-site wounds leads to equivalent outcomes whether SAs or TSs are used. Complications are rare in both methods. Thus, SAs seem to be a valid alternative to sutures in laparoscopic surgery. Registration site: www.clinicaltrials.gov .
  
  
  
  NCT02179723.
authors.affiliation: Tagesklinik Altonaer Strasse, Altonaer Str. 57-61, 20357, Hamburg, Germany. olafbuchweitz@aol.com.|Department of Gynecology and Obstetrics, University Hospital, Münster, Germany. olafbuchweitz@aol.com.
authors.forename: Olaf
authors.initials: O
authors.lastname: Buchweitz
authors.affiliation: Wound Market Consulting, Heyford, Oxfordshire, UK.
authors.forename: Christian
authors.initials: C
authors.lastname: Frye
authors.affiliation: Tagesklinik Altonaer Strasse, Altonaer Str. 57-61, 20357, Hamburg, Germany.
authors.forename: Claus Peter
authors.initials: CP
authors.lastname: Moeller
authors.affiliation: Tagesklinik Altonaer Strasse, Altonaer Str. 57-61, 20357, Hamburg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Nugent
authors.affiliation: Tagesklinik Altonaer Strasse, Altonaer Str. 57-61, 20357, Hamburg, Germany.
authors.forename: Eckart
authors.initials: E
authors.lastname: Krueger
authors.affiliation: Tagesklinik Altonaer Strasse, Altonaer Str. 57-61, 20357, Hamburg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Nugent
authors.affiliation: Tagesklinik Altonaer Strasse, Altonaer Str. 57-61, 20357, Hamburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Biel
authors.affiliation: Tagesklinik Altonaer Strasse, Altonaer Str. 57-61, 20357, Hamburg, Germany.|Department of Gynecology and Obstetrics, University Hospital, Cologne, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Juergens
mesh_terms: D000328:Adult; D003487:Cyanoacrylates / Q000627:therapeutic use*; D004954:Esthetics; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013537:Sutures; D014014:Tissue Adhesives / Q000627:therapeutic use*; D064232:Visual Analog Scale; D014945:Wound Healing
chemical_list: D003487:Cyanoacrylates; D014014:Tissue Adhesives
keywords: Cosmetic outcome; Laparoscopy; Octyl-cyanoacrylate; Port-site incisions; Skin adhesive