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Adhesive versus Subcuticular Sutures for Epidermal Closure

Summary and Comment |
January 22, 2014

Adhesive versus Subcuticular Sutures for Epidermal Closure

  1. Murad Alam, MD, MSCI

Adhesive repairs remain attractive because they offer the prospect of healed skin without visible suture marks.

  1. Murad Alam, MD, MSCI

How effective is tissue glue for wound closure? These investigators compared cyanoacrylate adhesive and subcuticular skin sutures for closure of maxillofacial incisions. They evaluated time to closure, associated morbidity, patient satisfaction, and cosmetic outcome in 29 patients. Following similar placement of subcutaneous sutures, 20 approximated facial wounds in 14 patients received epidermal closure with octyl-2-cyanoacrylate adhesive, and 20 wounds in 15 patients were repaired with standard subcuticular sutures.

Cosmetic outcome was assessed after 3 months by an independent plastic surgeon using validated scales. Patient satisfaction was evaluated by a visual analog scale. Both expert-rated cosmetic outcome and patient satisfaction at 3 months were comparable for the two epidermal closure groups, but the application of adhesive required significantly less time than subcuticular sutures (slightly >1 minute vs. slightly >6 minutes). There was no significant difference in the dehiscence of wounds with either method.

Comment

There are now many articles comparing epidermal adhesive closures to epidermal suture closures. The primary parameters of comparison are function and aesthetics. Some studies suggest that adhesive closures may be slightly more susceptible to dehiscence, although that was not seen in this study. Adhesive repairs remain attractive because they offer the prospect of healed skin without visible suture marks, and because closures without epidermal sutures are less alarming for patients. Speed and costs are other considerations, which may vary based on circumstances, including operator technique. In dermatology, adhesives are still only used in a minority of repairs because they are perceived as less able to provide the precise approximation and eversion often needed for facial wounds.

  • Disclosures for Murad Alam, MD, MSCI at time of publication Grant / research support Medicis; OptMed; Valeant Editorial boards Archives of Dermatology; Dermatologic Surgery; Journal of Cosmetic Dermatology; Lasers in Medical Science; Skin Therapy Letter Leadership positions in professional societies American Academy Of Dermatology (Chair, Health Care Finance Committee); American College of Mohs Surgery (Board of Directors); American Society for Dermatologic Surgery (Board of Directors); American Society for Lasers in Medicine and Surgery (Chair, Scientific Program)

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