Randomized Trial Tissue Adhesive/Staples in Thyroidectomy

Abstract

Objective Closure of thyroidectomy skin incision with tissue adhesive was compared to staples for the cosmetic appearance 3 months postoperatively, and proportion of wound infection as well as patient pain score. Methods A prospective randomized control trial, study conducted over 8 months. Disease/condition studied – Skin closure in thyroidectomy surgery. 43 patients undergoing thyroid surgery. The setting in which subjects were studied is a tertiary referral centre. Intervention – tissue adhesive and staples. Outcome measurements – cosmetic appearance 3 months postoperatively, using the Manchester Scar Assessment Tool, pain levels and wound infection. Statistical methods were Fisher exact test/paired t-test. Results 43 patients ranging in age between 16 to 72 years were included, of whom 34 (79%) were female and 9 (21%) were male; none developed wound infection. Pain level ranged between 0 and 6 on the 1st and 10th postoperative day with no significant different between the 2 modalities. Assessment using Manchester tool showed no statistically significant difference (P greater than 0.05). There was a statistically significant difference in patient satisfaction regarding ability to shower on the same day with dermabond compared to staples (p less than 0.05). Pain on removal of staples was reported by 91% of patients. There was no difference in patient rating of wound cosmesis. Conclusions Tissue adhesive is an acceptable method of skin incision closure in thyroid surgery, with the added advantage of ability to shower on the same day and avoidance of pain associated with staples removal.