Comparing Cyanoacrylate Tissue Adhesive and Conventional Subcuticular Skin Sutures for Maxillofacial Incisions-A Prospective Randomized Trial Considering Closure Time, Wound Morbidity, and Cosmetic Outcome

Purpose: To compare octyl-2-cyanoacrylate (2-OCA) tissue adhesive with subcuticular suture for the closure of incisions in the maxillofacial region to determine 1) whether it is faster than traditional subcuticular suturing, 2) whether the number and length of incisions affect closure time, 3) wound morbidity, 4) patient satisfaction outcome, and 5) cosmetic outcome. Material and Methods: In a prospective randomized clinical trial, 29 patients were allocated to 1 of 2 groups for the closure of skin incisions using 2-OCA or conventional subcuticular skin sutures. Postoperative follow-up evaluated wound healing at 5 to 10 days and at 3 months. Assessment of cosmetic outcome was performed by a plastic surgeon using a modified Hollander Wound Evaluation Scale and a validated visual analog scale. Comparisons between groups were performed using the Student t test and chi(2) test. Results: Twenty incisions in 14 patients were closed with 2-OCA and 20 incisions in 15 patients were closed with subcuticular sutures. Mean time of closure was significantly (P<.005) faster with 2-OCA at 69.50 +/- 33.39 seconds compared with 379.00 +/- 75.39 seconds in the suture group. There was no significant difference in wound complications between the 2 groups; also, there was no significant difference in patient satisfaction and cosmetic outcome of scars at the 3-month follow-up between the 2 groups. Conclusions: 2-OCA tissue adhesive is an excellent alternative to sutures for effective, reliable, and faster skin closure of maxillofacial incisions. (C) 2013 American Association of Oral and Maxillofacial Surgeons