Comparison of 2-Octylcyanoacrylate Versus 5-0 Fast-Absorbing Gut During Linear Wound Closures and the Effect on Wound Cosmesis

Abstract

BACKGROUND Although the use of 2-octylcyanoacrylate (OCA) in cutaneous surgery offers increased efficiency, there is scant data comparing scar outcomes achieved with OCA versus 5-0 fast-absorbing gut suture (FG). OBJECTIVE To compare scar cosmesis achieved with OCA versus FG for surgical wound closure. MATERIALS AND METHODS A total of 44 patients with postoperative defects of at least 3 cm were included. Half of each wound was randomized to receive closure with either OCA or FG. At 3 months, patients and 2 blinded observers evaluated each scar using the Patient and Observer Scar Assessment Scale (POSAS). RESULTS The total observer POSAS score (mean [SD]) for the side repaired with OCA (12.3 [4.72]) and the side that received FG (11.6 [4.36]) did not differ significantly (p = .40). There was no significant difference in the total patient POSAS scores between closure with OCA (14.9 [8.67]) and FG (14.6 [8.90]) (p = .70). Based on observer POSAS scores, scar pigmentation was significantly worse on the scar half repaired with OCA (1.98 [0.91]) compared with FG (1.79 [0.80]) (p = .05). CONCLUSION With the exception of inferior scar pigmentation with OCA, there was no statistically significant difference in wound cosmesis after linear wound closure with OCA versus FG.

Comparing Cosmetic Outcomes of Straight-Line Versus W-Plasty Techniques for Linear Postauricular Wound Closure: A Randomized Evaluator Blind Split-Scar Trial

“…Split-scar models have been used in the past to assess cuticular suturing techniques. [8][9][10][11][12][13][14][15][16][17] Enrolment and follow-up were conducted from June 6, 2018, to September 25, 2020, at the UC Davis Department of Dermatology. This study was approved by the University of California, Davis Institutional Review Board and the ClinicalTrials.gov Identifier: NCT05074199.…”

Fast Absorbing Gut Sutures in Dermatologic Surgery - A Systematic Review and Meta-Analysis

“…18,19 Three studies which were included in the nal analysis compared the use of fast-gut sutures to cyanoacrylate adhesive, two studies compared FG to traditional PP sutures, and one compared different sized (5-0 and 6-0) FG sutures together. 8,9,[20][21][22][23] Risk of bias was considered low across all studies with regards to the randomization process, deviations from the intended result, outcome data, and selection of the desired result (Supplementary 1). Although overall risk was believed to be low, some concerns were present with measurement of outcome data as patients were unable to be blinded during the randomization process and were aware of their treatment group in 3 manuscripts.…”

“…9,23 Two studies reported data related to patient opinion of nal cosmetic outcome and there was no difference between closures using FG vs. CA (Table 3). 22,23 Complications A total of 40 complications were reported across all wound closures (Table 4). The most common complication noted with FG sutures was infection (n=8, 3.3% of overall cases, Table 4).…”

“…Although overall risk was believed to be low, some concerns were present with measurement of outcome data as patients were unable to be blinded during the randomization process and were aware of their treatment group in 3 manuscripts. [21][22][23] Concurrent grading by blinded physicians during these studies was thought to minimize the potential impact of this bias.…”

Undermining during cutaneous wound closure for wounds less than 3 cm in diameter: a randomized split wound comparative effectiveness trial

“…The total score ranges from 6 to 60 with a lower score representing more normal appearing skin on the scale. The POSAS has been validated when 2 independent observers are used [18] and has been used in numerous surgical studies [12,13,17,[19][20][21][22][23][24][25]. The scar outcome was evaluated in person by the patient and 2 blinded observers who were not present during the intervention.…”