Comparison of conventional suturing and tissue adhesive (2-octyl cyanoacrylate) for port site skin closure in laparoscopic surgeries

Abstract

Background: Today there are numerous methods available for closure of wounds like tissue adhesives, staplers, adhesive tapes and obviously the age old conventional suturing, all of which have their own pros and cons. The aim was to study the complications and results of use of 2-octyl cyanoacrylate on wound healing and compare them without those of conventional suturing. Methods: Study comprised of 100 patients undergoing clean or clean contaminated elective laparoscopic surgery. After randomization 50 patients had their port site skin incision closed using 2-octyl cyanoacrylate. In the rest the port site skin incision was sutured using 3-0 polyamide. The scar was assessed using the stony brook scar evaluation scale. Results: The average Stony Brooke scar evaluation scale score was 4.2±1.03 (95% CI: 3.90 - 4.49) in the 2-octyl cyanoacrylate group and 3.12±1.04 (95% CI: 2.82-3.41) in the suturing group. The score was significantly higher in the 2-Octyl Cyanoacrylate group (p value≤ 0.001). 4 of 50 (8%) patients from the tissue adhesive group developed breaking of adhesive film. 8% and 4% developed wound infection from the suturing and 2-octyl cyanoacrylate group respectively(p value - 0.65). None of the patients showed any hypersensitivity to the product. Conclusions: 2-octyl cyanoacrylate is a safe and effective method for closure of skin incisions without any toxicity to the product. There is no difference in early complications such as breaking of film, wound dehiscence and wound infection when compared with conventional suturing. According to the Stony Brooke scar evaluation scale laparoscopic port sites closed using 2-octyl cyanoacrylate have better short term cosmetic appearance.