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Laurie Bernard, MD; Julie Doyle, MD; Sheila Fallon Friedlander, MD; Lawrence F. Eichenfield, MD; Neil F. Gibbs, MD; Bari B. Cunningham, MD

Arch Dermatol. 2001;137:1177-1180.

Background  Recent studies suggest that the use of octyl cyanoacrylate tissue adhesive for closure of both traumatic lacerations and incisional surgical wounds results in a cosmetic outcome comparable to that achieved with conventional sutures. To date, no studies have looked at the use of tissue adhesive for higher-tension wounds, such as those created during cutaneous excisional procedures.

Objective  To compare the tissue adhesive octyl cyanoacrylate with standard suture for the closure of excisional wounds in children and adolescents.

Design  A prospective comparison with blinded assessment of cosmetic outcome. Twenty-eight wounds were closed with monofilament suture and 24 were closed with tissue adhesive. At approximately 2 months, photographs of the incisions were evaluated by 2 dermatologists blinded to the method of skin closure.

Subjects  Forty-two consecutive patients undergoing excisional dermatologic procedures at Children's Hospital, San Diego, Calif. These 42 patients had a total of 52 wounds that were evaluated.

Main Outcome Measures  The cosmetic appearance of the wounds at 2 months, based on 2 validated wound scales: the Hollander Wound Evaluation Scale and a visual analog scale.

Results  There were no differences in early complications between the groups. The suture group scored higher on the visual analog scale (63.3 mm for suture vs 47.8 mm for tissue adhesive), and this difference was statistically significant (P = .02). The suture group also had a higher median score on the Hollander Wound Evaluation Scale, but this difference was not statistically significant (P = .09).

Conclusion  The cosmetic outcome of cutaneous excisional surgery wounds closed with standard suturing was found to be superior to that of wounds closed with octyl cyanoacrylate.

From the Children's Hospital and Health Center, San Diego, Calif, Division of Pediatric and Adolescent Dermatology, University of California, San Diego, Departments of Pediatrics and Medicine (Dermatology) (Drs Bernard, Friedlander, Eichenfield, Gibbs, and Cunningham), and the Division of Emergency Medicine, University of California, San Diego (Dr Doyle).

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