Comparison of effects of suture and cyanoacrylate tissue adhesive on bacterial counts in contaminated lacerations

Abstract

We studied the effects of closing lacerations with suture or cyanoacrylate tissue adhesive on staphylococcal counts in inoculated guinea pig lacerations. Wounds closed with adhesive alone had lower counts than wounds containing suture material (P <0.05). The results of a time-kill study were consistent with a bacteriostatic adhesive effect of the adhesive against Staphylococcus aureus.Cyanoacrylate tissue adhesive is an organic polymer that effectively closes simple lacerations in humans and animals (1,7,9). However, the risk of wound sepsis for cyanoacrylate adhesive compared with that for suture material has not been quantified. One study used a well diffusion method to conclude that cyanoacrylate adhesive is bacteriostatic for gram-positive organisms (4). It is also known that suture material increases the risk of wound sepsis by serving as an adherent foreign body (4, 10). In contrast, Staphylococcus epidermidis adheres to cyanoacrylate adhesive, which may thus promote wound infection (8). To clarify this issue, we studied the difference in wound bacterial counts among the following wound closure methods (our terms are given in parentheses): use of a cyanoacrylate adhesive alone (glue), adhesive and subcutaneous suture (glue/SQ), skin suture alone (suture), and skin suture with subcutaneous suture (suture/SQ). Our null hypothesis was that no differences existed among these closure methods.We studied 11 male albino guinea pigs weighing between 650 and 800 g each. The technique was modified from an established animal model (2,3,5), and the experimental protocol was approved by the University Animal Care and Use Committee.Four dorsal lacerations 3 cm long were made parallel to the spine to deep fascia. After hemostasis with sterile gauze and pressure, 0.1 ml of a bacterial inoculum was placed in each laceration with a Selectapette (Becton Dickinson and Co., Parsippany, N.J.) sterile pipette system. The lacerations were inoculated with Staphylococcus aureus (ATCC 11632) adjusted to a spectrophotometric absorbance of 0.138 to 0.139. Inocula were quantified at approximately 10 8 CFU/ml by standard microbiological methods.Immediately after inoculation, the four wounds on each animal were approximated in one of four ways: (i) with Nexaband Liquid (n-butyl-2-cyanoacrylate and D and C violet number six dye; Veterinary Products Laboratories, Phoenix, Ariz.) (glue), (ii) with subcutaneous suture (i.e., intradermal stitches buried beneath the skin) followed by application of Nexaband Liquid (glue/SQ), (iii) with simple skin suture (suture), or (iv) with intradermal subcutaneous suture followed by simple skin suture (suture/SQ). In selected lacerations, wound edges were approximated manually and a thin line of adhesive was applied along the wound margin with a plastic applicator. Also in selected wounds, one intradermal stitch of 4-0 braided polyglactin 910 suture (Vicryl; Ethicon Inc., Somerville, N.J.) was placed. Similarly, two simple skin stitches were placed with 5-0 monofilament nylon (Dermalon; Ethicon Inc.). The o...

In-Vitro Analysis for Microbial Barrier Properties of 2-Octyl Cyanoacrylate-Derived Wound Treatment Films

“…8,12,13 A recent study by Davis et al 11 reports the faster healing of partial thickness wounds using a 2-octyl cyanoacrylate formulation.…”

Skin Glue Improves Outcome after Excision and Primary Closure of Sacrococcygeal Pilonidal Disease

“…They concluded that contaminated wounds closed with sutures had higher infection rates compared with those reported with topical tissue adhesive. Howell et al [22] studied the effects of closing lacerations with suture or cyanoacrylate tissue adhesive on staphylococcal counts in inoculated guinea pig lacerations. Wounds closed with adhesive alone had lower counts than wounds containing suture material.…”

Periorbital infections after Dermabond closure of traumatic lacerations in three children

“…( J AAPOS 2012;16: 168-172) I n previous studies authors have documented the benefits of wound closure with tissue adhesives compared with sutured wound closure. [1][2][3][4][5][6][7] The purpose of this report is to describe cases of periorbital cellulitis after wound closure of traumatic periorbital lacerations with 2-octyl cyanoacrylate (Dermabond; Ethicon, Inc, Somerville, NJ) and to evaluate the existing literature to identify a trend toward an increased infection rate with tissue adhesive closure.…”