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Closure of cutaneous incision after thyroid surgery: a comparison between metal clips and cutaneous octyl-2-cyanoacrylate adhesive. A prospective randomized clinical trial

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Abstract

Octyl-2-cyanoacrylate (Dermabond, Ethicon Inc.) has been introduced in clinical practice as an ideal system of closure of wounds, but no studies have confirmed the advantages of wound closure performed with Dermabond compared to skin staples (Proximate, Ethicon Inc.) in thyroid surgery. The objective of this study is to evaluate the short- and long-term results of wound closure in thyroid surgery performed with Dermabond (DERM) versus Proximate (PROX). Seventy patients after thyroidectomy were randomly assigned into the two groups (DERM vs PROX). The postoperative and the long-term outcomes were clinically evaluated by physicians, and the Stony Brook scar evaluation scale has also been used. The patients' satisfaction with the early postoperative management and with the cosmetic outcomes has been assessed by a numerical scale ranging from 0 to 10. Results were compared using appropriate statistical tests. Thirty-two patients used DERM, while 38 patients used PROX. Immediate results showed difficult application in two cases DERM (6.2%) and hyperemia in one case DERM (3.1%). Early results showed edema in eight cases DERM (25%) vs two cases PROX (5.2%; p < 0.05); patients' satisfaction: optimum judgement in 100% DERM vs 15.7% PROX (p < 0.001); patients' self aesthetic evaluation: PROX higher percentage of excellent results vs DERM (p < 0.005). After one month, results showed edema in nine cases DERM (28.8%) vs two cases PROX (5.2%; p < 0.01), while after 6 months, DERM had lesser symptoms than PROX (p < 0.01). Octyl-2-cyanoacrylate has proven to be effective and reliable in the skin closure of cervical incision similar to suture with staples and yields similar final cosmetic outcomes. Because Dermabond offers the advantage of better management in the early postoperative phase, the patients’ satisfaction is clearly better.

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References

  1. Singer AJ, Arora B, Dagum A, Valentine S, Hollander JE (2007) Development and validation of a novel scar evaluation scale. Plast Reconstr Surg 120:1892–1897

    Article  PubMed  CAS  Google Scholar 

  2. Chughtai T, Chen LQ, Salasidis G, Nguyen D, Tchervenkov C, Morin JF (2000) Clips versus suture tecnique: is there a difference? Can J Cardiol 16(11):1403–1407

    PubMed  CAS  Google Scholar 

  3. dos Santos LR, Freitas CA, Hojaij FC, Araujo Filho VJ, Cernea CR, BrandaoLG FAR (1995) Prospective study using skin staplers in head and neck surgery. Am J Surg 170(5):451–452

    Article  PubMed  Google Scholar 

  4. Hocwald E, Sichel JY, Dano I, Meir K, Eliashar R (2003) Adverse reaction to surgical sutures in thyroid surgery. Head Neck 25(1):77–81

    Article  PubMed  Google Scholar 

  5. Lachachi F, Descottes B, Durand-Fontanier S, Sodji M, Pech de la Clause B, Vlleix D (2000) The value of fibrin sealant in thyroid surgery without drainage. Int Surg 85(4):344–346

    PubMed  CAS  Google Scholar 

  6. Lundblad R, Simensen HV, Wiig JN, Niels Gruner OP (1989) Skin closure. A prospective randomized study. Tidsskr Nor Laegeforen 109(12):1307–1309

    PubMed  CAS  Google Scholar 

  7. Matthews TW, Briant TD (1991) The use of fibrin tissue glue in thyroid surgery: resource utilization implications. J Otolaryngol 20(4):276–278

    PubMed  CAS  Google Scholar 

  8. Ong CC, Jacobsen AS, Joseph VT (2002) Comparing wound closure using tissue glue versus subcuticular suture for pediatric surgical incisions: a prospective, randomised trial. Pediatr Surg Int 18(5–6):553–555

    PubMed  CAS  Google Scholar 

  9. Selvadurai D, Wildin C, Treharne G, Choksy SA, Heywood MM, Nicholson ML (1997) Randomised trial of subcuticular suture versus metal clips for wound closure after thyroid and parathyroid surgery. Ann R Coll Surg Engl 79(4):303–306

    PubMed  CAS  Google Scholar 

  10. Singer AJ, Quinn JV, Clark RE, Hollander JE, TraumaSeal Study Group (2002) Closure of lacerations and incisions with octylcyanoacrylate: multicenter randomized controlled trial. Surgery 131(3):270–276

    Article  PubMed  Google Scholar 

  11. Singer AJ, Quinn JV, Hollander JE (2008) The cyanoacrylate topical skin adhesives. Am J Emerg Med 26(4):490–496

    Article  PubMed  Google Scholar 

  12. Stagnitti F, Schillaci F, De Pascalis M, Mongardini M, Patrizi V, Cilurso F, Costantini A, Dall’Olio D, Priore F, Tiberi R, Natalizi E (2001) Use of adhesives in emergency surgery. G Chir 22(8–9):309–312

    PubMed  CAS  Google Scholar 

  13. van’t Riet M, Steyerberg EW, Nellensteyn J, Bonjer HJ, Jeekel J (2002) Meta-analysis of techniques for closure of midline abdominal incisions. Br J Surg 89(11):1350–1356

    Article  Google Scholar 

  14. Silvestri A, Brandi C, Grimaldi L, Nisi G, Brafa A, Calabrò M, D’Aniello C (2006) Octyl-2-cyanoacrylate adesive for skin closure and prevention of infection in plastic surgery. Aesthet Plast Surg 30(6):695–699

    Article  Google Scholar 

  15. Blondeel PN, Murphy JW, Debrosse D, Nix JC 3rd, Puls LE, Theodore N, Coulthard P (2004) Closure of long surgical incisions with a new formulation of 2-octylcyanoacrylate tissue adesive versus commercially available methods. Am J Surg 188(3):307–313

    Article  PubMed  CAS  Google Scholar 

  16. Laccourreye O, Cauchois R, El Sharkawy L, Menard M, De Mones E, Brasnu D, Hans S (2005) Octylcyanoacrylate (Dermabond®) for skin closure at the time of head and neck surgery: a longitudinal prospective study. Ann Chir 130(10):624–630

    Article  PubMed  CAS  Google Scholar 

  17. Nitsch A, Pabyk A, Honig JF, Verheggen R, Merten H-A (2005) Cellular, histomorphologic, and clinical characteristics of a new octyl-2-cyanoacrylate skin adhesive. Aesthet Plast Surg 29(1):53–58

    Article  Google Scholar 

  18. Quinn J, Wells G, SutcliffeT JM, Maw J, Stiell I, Johns P (1997) A randomized trial comparing octylcyanoacrylate tissue adhesive and sutures in the management of lacerations. JAMA 277(19):1527–1530

    Article  PubMed  CAS  Google Scholar 

  19. Sattonet C, Allouch C, Brunel P, Dudeck F, Robert V, Legall P, Perry D, Petit J-L (2001) Urgence Pratique 46:51–53

    Google Scholar 

  20. Bernard L, Doyle J, Friedlander SF, Eichenfield LF, Gibbs NF, Cunningham BB (2001) A prospective comparison of octyl cyanoacrylate tissue adhesive (dermabond) and suture for the closure of excisional wounds in children and adolescentes. Arch Dermatol 137(9):1177–1180

    PubMed  CAS  Google Scholar 

  21. Gennari R, Rotmensz N, Ballardini B, Scevola S, Perego E, Zanini V, Costa A (2004) A prospective, randomized, controlled clinical trial of tissue adhesive (2-octylcyanoacrylate) versus standard wound closure in breast surgery. Surgery 136(3):593–599

    Article  PubMed  CAS  Google Scholar 

  22. Hollander JE, Singer AJ (1998) Application of tissue adhesives: rapid attainment of proficien Stony Brook Octylcyanoacrylate Study Group. Acad Emerg Med 5(10):1012–1017

    Article  PubMed  CAS  Google Scholar 

  23. Quinn J, Wells G, Sutcliffe T, Jarmuske M, Maw J, Stiell I, Johns P (1998) Tissue adhesive versus suture wound repair at 1 year: random clinical trial correlating early, 3-month, and 1-year cosmetic outcome. Ann Emerg Med 32(6):645–649

    Article  PubMed  CAS  Google Scholar 

  24. Singer AJ, Hollander JE, Valentine SM, Turque TW, McCuskey CF, Quinn JV (1998) Prospective, randomized, controlled trial of tissue adhesive (2-octylcyanoacrylate) vs standard wound closure techniques for laceration repair. Stony Brook Octylcyanoacrylate Study Group. Acad Emerg Med 5(2):94–99

    Article  PubMed  CAS  Google Scholar 

  25. Switzer EF, Dinsmore RC, North JH Jr (2003) Subcuticular closure versus Dermabond: a prospective randomized trial. Am Surg 69(5):434–436

    PubMed  Google Scholar 

  26. Toriumi DM, O’Grady K, Desai D, Bagal A (1998) Use of octyl-2-cyanoacrylate for skin closure in facial plastic surgery. Plast Reconstr Surg 102(6):2209–2219

    Article  PubMed  CAS  Google Scholar 

  27. Ridgway DM, Mahmood F, Moore L, Bramley D, Moore PJ (2007) A blinded, randomised, controlled trial of stapled versus tissue glue closure of neck surgery incisions. Ann R Coll Surg Engl 89:242–246

    Article  PubMed  CAS  Google Scholar 

  28. Ubbink DT, Legemate DA (2004) Evidence-based surgery. Br J Surg 91(9):1091–1092

    Article  PubMed  CAS  Google Scholar 

  29. Maw JL, Quinn JV, Wells GA, Ducic Y, Odell PF, Lamothe A, Brownrigg PJ, Sutcliffe T (1997) A prospective comparison of octylcyanoacrylate tissue adhesive and suture for the closure of head and neck incision. J Otolaryngol 26(1):26–30

    PubMed  CAS  Google Scholar 

  30. Singer AJ, Thode HC Jr (2004) A review of the literature on octylcyanoacrylate tissue adhesive. Am J Surg 187(2):238–248

    Article  PubMed  CAS  Google Scholar 

  31. Coulthard P, Worthington H, Esposito M, Elst M, Waes OJ (2004) Tissue adhesives for closure of surgical incision. Cochrane Database Syst Rev (2):CD004287

  32. Wolfram D, Tzankov A, Pülzl P, Piza-Katzer H (2009) Hypertrophic scar and keloids—a review of their pathophysiology, risk factors, and therapeutic management. Dermatol Surg 35(2):171–181

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Annalisa Di Filippo.

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Pronio, A., Di Filippo, A., Narilli, P. et al. Closure of cutaneous incision after thyroid surgery: a comparison between metal clips and cutaneous octyl-2-cyanoacrylate adhesive. A prospective randomized clinical trial. Eur J Plast Surg 34, 103–110 (2011). https://doi.org/10.1007/s00238-010-0477-6

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  • DOI: https://doi.org/10.1007/s00238-010-0477-6

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