Skin Closure in Laparoscopic Living Donor Nephrectomy: Modern Tissue Adhesive versus Conventional Intracutaneous Suture—A Randomized Study

Purpose. To compare the modern tissue adhesive cyanoacrylate (Liquiband) to conventional, intracutaneous suture and dressing, with regard to wound characteristics, time consumption, donors’ self-satisfaction, and cost. Methods. Sixty-four kidney donors, subjected to laparoscopic hand-assisted nephrectomy, were randomly assigned to skin closure either with tissue adhesive (n=32) or suture (n=32). The follow-up assessments were carried out on postoperative 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 operative/skin closure time and costs. The donors’ self-satisfaction was evaluated by means of a questionnaire. Results. There were significant results in favour of tissue adhesive regarding wound closure time and the wound characteristics “rubor,” “blisters,” and “oedema.” Although, 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/reoperations/infections did not give rise to any significant differences. Conclusion. Our study concludes that gluing is significantly faster, less traumatic by avoiding needle penetrations, but associated with an increased rate of secretion and gaps—presumably depending on gluing technique. Glue seems particularly suitable for small, laparoscopic/trocar incisions.

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Surgical glue- a promising technology for wound healing

International Journal of Research in Pharmaceutical Sciences and Technology ◽

10.33974/ijrpst.v1i1.18 ◽

2018 ◽

Vol 1 (1) ◽

pp. 9-11

Author(s):

K. V. Swathi Krishna ◽

L. S. Uma Maheswari ◽

G Rajeswari

Keyword(s):

Wound Healing ◽

Cost Effectiveness ◽

Wound Closure ◽

Cost Effective ◽

Daily Basis ◽

Skin Closure ◽

Tissue Glue ◽

Closure Time ◽

Anesthesia Awareness ◽

Long Time

Wound closure is one of the important steps of surgical dressing and suturing is the most commonly used method of wound closure. The process of suturing takes very long time for surgery and increases the patient’s risk of anesthesia awareness. Skin glues are a safe and effective method to close selected wounds. They are also cost-effective and help prevent infection. Ideally, wounds should be less than 4 cm, not contaminated or infected and have skin edges that are not under tension. Wounds should be closed within 12 hours. Novel methods of wound closure have been introduced to address these issues, most notably cyanoacrylate tissue glues. The evidence would suggest that the use of cyanoacrylate tissue glue is associated with a reduction in closure time and costs. On a daily basis, dermasurgeons are facing different kinds of wounds that have to be closed. With a plethora of skin closure materials currently available, choosing a solution that combines excellent and rapid cosmetic results with practicality and cost-effectiveness is preferred.

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A Single Blind, Prospective, Randomized Trial Comparing N-Butyl 2-Cyanoacrylate Tissue Adhesive (Indermil) and Sutures For Skin Closure in Hand Surgery

Journal of Hand Surgery (European Volume) ◽

10.1054/jhsb.2001.0572 ◽

2001 ◽

Vol 26 (3) ◽

pp. 264-265

Author(s):

S. SINHA ◽

M. NAIK ◽

V. WRIGHT ◽

J. TIMMONS ◽

A. C. CAMPBELL

Keyword(s):

Randomized Trial ◽

Wound Closure ◽

Hand Surgery ◽

Demographic Characteristics ◽

Tissue Adhesive ◽

Skin Closure ◽

Tissue Viability ◽

Treatment Groups ◽

Suture Group ◽

Single Blind

Fifty patients underwent a variety of hand operations and were randomized for wound closure either with tissue adhesive (Indermil) or sutures. The two treatment groups had similar demographic characteristics and similar outcomes at the 2 and 6 week postoperative assessments which were performed by a designated tissue viability nurse blinded to the method of closure. Five minor wound dehiscences occurred: three in the adhesive group and two in the suture group. No infection occurred in either group. In conclusion, the study demonstrates tissue adhesive is as effective as suture in this type of hand surgery.

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Which is better for pfannensteil skin incision closure in caesarean section? Interrupted mattress suture or continuous subcuticular suture

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20203844 ◽

2020 ◽

Vol 9 (9) ◽

pp. 3711

Author(s):

Shridevi A S. ◽

Madhusoodana R. Bhovi ◽

Prema Prabhudeva ◽

Renuka . ◽

Camelia Maitra

Keyword(s):

Patient Satisfaction ◽

Caesarean Section ◽

Caesarean Delivery ◽

Wound Closure ◽

Wound Dehiscence ◽

Skin Wound ◽

Wound Complications ◽

Skin Closure ◽

Pain Level

Background: Caesarean delivery is one of the most commonly performed operations in obstetrics. Postoperative comfort of the woman largely depends on the method of skin closure. Wound complications from caesarean delivery such as dehiscence or infection cause a significant emotional and economic burden in obstetric care. There are many methods and techniques for skin wound closure in caesarean section. Each technique has its own advantages and disadvantages. The aim and objective of this study was to compare the wound outcomes in Pfannensteil incisions closed with mattress sutures using nonabsorbable suture and subcuticular sutures using absorbable sutures in caesarean deliveries.Methods: It is a prospective observational study done on 216 consecutive pregnant women who were admitted to labor room for elective or emergency caesarean section. Patients undergoing caesarean section with Pfannensteil incision between February 2019 to October 2019 were included in this study. Among 216 women, 108 women had mattress sutures and 108 women had subcuticular sutures for skin wound closure. The primary outcome studied was wound complications including erythema, wound dehiscence, burst abdomen, infection and pain which was studied on postoperative day 3-7. The secondary outcome was assessed at 6 weeks follow-up in terms of pain, cosmetic appearance of scar and patient satisfaction about scar.Results: A total of 216 pregnant women undergoing caesarean section were studied who had similar baseline characteristics and risk factors. However, women with previous caesarean section were more in mattress group. The overall incidence of erythema, surgical site infection, wound dehiscence, resuturing and pain was more in mattress group and was statistically significant. During follow-up at 6 weeks, women with subcuticular sutures had cosmetically better scar and more satisfied with their scars than women with mattress sutures but the pain level was same in both groups.Conclusions: Authors conclude that compared to mattress sutures, subcuticular sutures cause significantly fewer wound complications and pain in postoperative period. Also, subcuticular sutures are associated with cosmetically appealing scars and higher patient satisfaction. But there was no difference in pain level at 6 weeks in both methods of skin closure.

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Comparison of tissue adhesive (N-butyl-2-cyanoacrylate) versus conventional suturing in umbilical hernia surgeries

International Surgery Journal ◽

10.18203/2349-2902.isj20211291 ◽

2021 ◽

Vol 8 (4) ◽

pp. 1165

Author(s):

Atul Dua ◽

Nawaz Shariff A. ◽

K. Krishna Prasad

Keyword(s):

Postoperative Pain ◽

Surgical Site Infection ◽

Umbilical Hernia ◽

Tissue Adhesive ◽

Tissue Loss ◽

Skin Closure ◽

Site Infection ◽

Closure Time ◽

Group A ◽

Group B

Background: Umbilical hernia is a common problem encountered mostly in women. Conventional suturing is used as a traditional method for closure of skin in umbilical hernia surgeries. N-butyl-2-cyanoacrylate glue can be used as an alternative where tissue loss is minimal, minimal scarring, no significant bacterial infection and less postoperative pain. The aim of this study was to determine the effectiveness of tissue adhesive in the closure of umbilical skin incisions compared to conventional sutures.Methods: A prospective study was conducted including 30 patients with umbilical hernia. Patients were allocated into two groups using odd and even method: group A and B. Patients of group A underwent skin closure with topical tissue adhesive and that of group B underwent skin closure with conventional sutures. Skin closure time, postoperative pain, scar assessment using Vancouver scar scale and surgical site infection were recorded. IBS-statistical package for the social sciences (SPSS) 22 version was used to analyse the data.Results: 57% females and 43% males were included in the study. The age of the patients ranged between 18 and 60 years in both the groups. All patients had chief complaint of swelling in the umbilical area. Group A (tissue adhesive) patients had lesser skin closure time and cosmetically better scar than group B (conventional suturing) patients. Surgical site infection was seen in 2 patients in group B and 1 patient in group A.Conclusions: Tissue adhesive is superior as compared to conventional suture in terms of skin closure time, cosmesis, postoperative pain and postoperative surgical complications.

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Skin stapler versus sutures in abdominal wound closure

International Surgery Journal ◽

10.18203/2349-2902.isj20173888 ◽

2017 ◽

Vol 4 (9) ◽

pp. 3062

Author(s):

Fobin Varghese ◽

Jose Gamalial ◽

John S. Kurien

Keyword(s):

Wound Infection ◽

Wound Closure ◽

Visual Analogue Score ◽

P Value ◽

Skin Closure ◽

Chi Square ◽

Skin Staples ◽

Suture Group ◽

Study Population

Background: Wound closure is as important as any other action performed by the surgeon. Apart from the need for producing a healthy and strong scar, it is the surgeon’s responsibility to ensure its aesthetically pleasing physical appearance. Skin staples are an alternative to regular sutures in offering this advantage. The present study has helped to highlight the benefits of skin stapler.Methods: Out of the 120 participants, 60 underwent skin closure with Stainless steel skin staples and the remaining 60 with non-absorbable Polyamide mattress sutures randomly. They all received one mandatory dose of pre-operative parenteral antibiotic 1 hour prior to the incision. On the 3rd postoperative day, the wound was evaluated for inflammation, infection and wound gape. Participants were re-evaluated for infection/gape/inflammation during follow-up on 7th day. The wounds were evaluated at 1 months follow up which were rated for cosmesis by Visual Analogue Score. The data was coded and entered in Microsoft excel and then analysed using statistical software SSPS.Results: Study population consisted of 79 males (65.8%) and 41 females (34.2%). Mean age of the study population was 49.35 with an SD 16.739. Wound infection was found to be higher in stapler group (30%) when compared to conventional suture group (11.7%)which was found to be statistically significant with chi-square value 6.114 and p value 0.013. Mean time for closure was significantly shorter in stapler group 4.55 minutes, when compared to suture group (11.22 minutes). Better cosmetic outcome was observed in conventional suture group.Conclusions: Preventing wound infection, especially in abdominal wounds, is of importance as it may lead to wound gaping. Incidence of post-operative wound infection was more with skin staples. Cosmesis is essential and important aspect in this day and age. A cosmetic scar not only gives satisfaction to the patient but also mental ease to the surgeon. Conventional sutures provided better cosmetic result when compared with skin staplers.

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

Transplantation Journal ◽

10.1097/00007890-201407151-02045 ◽

2014 ◽

Vol 98 ◽

pp. 604-605

Author(s):

S. Vormdal ◽

M. Skauby ◽

S. Lonar ◽

O. Oyen

Keyword(s):

Living Donor ◽

Donor Nephrectomy ◽

Tissue Adhesive ◽

Skin Closure ◽

Randomised Study ◽

Living Donor Nephrectomy

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A novel skin-stretching device for closing large skin-soft tissue defects after soft tissue sarcoma resection

World Journal of Surgical Oncology ◽

10.1186/s12957-020-02022-3 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Qiang Wu ◽

Zengwu Shao ◽

Yubin Li ◽

Saroj Rai ◽

Min Cui ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Pulmonary Metastasis ◽

Wound Closure ◽

Skin Closure ◽

Soft Tissue Defects ◽

Skin Stretching ◽

Large Skin ◽

Tissue Defects

Abstract Background Closure of large skin-soft tissue defects following soft tissue sarcoma (STS) resection has been a great challenge. The objective of this study was to evaluate the effectiveness of a novel, simple, and cheap skin-stretching device (bidirectional regulation-hook skin closure system, BHS) for closing large skin-soft tissue defects resulting from the removal of STS and the complications associated with the use of the BHS. Methods From January 2017 to September 2018, 25 patients with STS underwent BHS therapy after tumor resection. BHS was used for two main clinical applications: securing wound closure after high-tension suture closure and delayed wound closure. We described a detailed reconstruction procedure regarding this therapy. Wound closure and complications associated with BHS therapy were recorded. We also analyzed tumor recurrence and metastases. Results All patients were observed for 16–36 months with an average follow-up of 25.6 months. During the follow-up period, no significant functional restriction was observed and the final scar was aesthetically acceptable. Superficial wound infection occurred in six patients, wound edge ischemia in two patients, and small skin tears in two patients. Two patients developed pulmonary metastasis, two patients had a local recurrence, and one patient died of pulmonary metastasis. Conclusions BHS therapy can effectively close large skin-soft tissue defects following STS resection and obtain acceptable functional results, without severe complications. However, larger studies are required to further evaluate the effectiveness, indications, and complications of BHS therapy.

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