A Randomised Study On Skin Closure in Laparoscopic Living Donor Nephrectomy: Modern Tissue Adhesive (Cyanoacrylate) Versus Conventional Intracutaneous Suture.

Abstract

Purpose: The aim of the present study was to compare the modern tissue adhesive cyanoacrylate (Liquiband) to conventional, intracut. suture and dressing, with regard to wound characteristics, time consumption, patients' self-satisfaction and cost. Material & Methods: 64 donors, subjected to laparoscopic hand-ass. nephrectomy, were randomized to skin closure either with tissue adhesive (n=32) or suture (n=32). The follow-up assessments were carried out on postop. days 2, 4 and at departure; evaluated by the use of a previously set numerical scale for rubor, secretion, gaps, oedema and blisters. Infections and complications/reinterventions were recorded, as well as skin closure time and costs. Results:Table: No Caption available.There were significant results in favour of tissue adhesive regarding wound closure time and the wound characteristics ‘rubor’, ‘blisters’ and ‘oedema’ (t-test **: p<0.05; *: p<0.10; with the *- indicated group demonstrating favourable results). Whereas, the wound parameters ‘secretion’ and ‘gaps’ altogether showed a rather evident tendency in favour of suture, partially at significant levels. A low rate of complications/reop./infections did not give rise to any significant differences.Figure: No Caption available.Top: Liquiband glued Pfannenstiel incision Bottom: Conventionally intracut. sutured incision; Both at postop. day 6. Conclusion: Our study concludes that gluing is significantly faster, less traumatic by avoiding needle penetrations and seems particularly suitable for small, laparoscopic/trocar incisions.