Use of cyanoacrylate tissue adhesives for wound closure in the head and neck region: A systematic review

Abstract

Wound closure in the head and neck region is challenging, primarily due to aesthetic concerns. Tissue adhesives have been prized for their ease of use. This study aimed to compare the effectiveness of tissue adhesives as a suitable alternative to other conventional wound closure techniques, in the head and neck region. A systematic review was conducted in line with PRISMA guidelines. Available English literature from 2009 to 2019 was reviewed from PubMed, Scopus and Google Scholar. Randomized controlled trials and controlled clinical trials with wounds in the head and neck region were included in this study. Sixteen articles were found to meet the inclusion criteria. Main outcomes assessed included the following: cosmesis, pain, swelling, bleeding, wound dehiscence, time and cost. There was significant heterogeneity in results for pain, swelling and bleeding. No significant difference was observed in wound dehiscence and long-term cosmetic outcome when tissue adhesives were compared with sutures and staples. The time taken for wound closure with tissue adhesives was faster than sutures but were conflicted when compared with staples. Cost was found to be similar. Overall, there is a consensus that there is no long-term difference in cosmetic outcome and wound dehiscence between tissue adhesives and other wound closure techniques. Tissue adhesives have the benefit of being easy and quick to use with excellent patient satisfaction levels. We recommend tissue adhesives as a suitable alternative for wound closure in low tension areas in the head and neck region.