Meta-analysis of skin adhesives versus sutures in closure of laparoscopic port-site wounds

Sajid, M. S.; Siddiqui, Muhammed R; Khan, Muhammad Nisar; Baig, Mirza

doi:10.1007/s00464-009-0373-y

Cited by 22 publications

(12 citation statements)

References 26 publications

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“…Sutures compared to 2OCATI showed no difference in length of inpatient stay, mean total cost, or antibiotics treatment [4]. Laparoscopic port site incisions were closed faster by surgical adhesive than sutures in a metaanalysis of seven trials [5]. Among general surgery laparoscopic procedures, a randomized controlled trial of n-butyl cyanoacrylate tissue adhesive versus sutures showed significantly shorter incision closure times and no differences in wound complications or cosmesis at either 4 to 6 weeks or at 3 months [6].…”

Section: Discussionmentioning

confidence: 98%

2-Octyl Cyanoacrylate Skin Adhesive for Topical Skin Incision Closure in Female Pelvic Surgery

James

Alejandro-Rodriquez²,

Perez³

et al. 2015

OJOG

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Background: 2-octyl cyanoacrylate (2OCA) high viscosity tissue adhesive (Medline Industries, Inc., Mundelein, IL) is a liquid topical skin adhesive. 2OCA offers the same design features and clinical utility in terms of flexibility, strength, and low complication rate as the commercially available 2OCA tissue adhesives. Additionally, 2OCA features high viscosity allowing for better control during the application process, polymerization without the use of an external activator, and a distinctive violet color for ease of application visualization. Objective: The aim of this prospective case series is to descriptively report clinical data with the application of 2OCA as a topical incision closure system in female pelvic surgery. The primary outcomes included: incisional pain, incisional dehiscence, and post-operative bleeding. The secondary outcome included drying times of the adhesive with regard to incision length. Methods: A prospective open-label observational case series study was conducted to evaluate the use of 2OCA in surgical wound closure of the topical skin in adult patients undergoing gynecologic surgical procedures. A total of 50 adult women undergoing gynecologic surgery were enrolled. 2OCA was applied only by surgeons who had undergone product training to the incisions in a standardized, protocol-defined fashion. Drying times for the adhesive and photography were recorded intraoperatively. Post treatment follow-up was conducted with queries of pain level, incisional dehiscence, and incisional bleeding immediately post-operatively, 48 hours, 5-10 days and 14 days post-treatment. Adverse events were documented. Results: 2OCA was applied to a total of 154 incisions from the 50 patients enrolled to the study. The procedures included: 16 laparoscopic total hysterectomies, 4 diagnostic laparoscopies, 2 laparoscopic myomectomies, 2 laparoscopic bilateral or unilateral salpingo-oophorectomies, 5 total roboticassisted laparoscopic surgeries (2 total hysterectomies, 1 supracervical hysterectomy, 1 sacrocolpopexy, and one excision of endometriosis), 7 sacral neuromodulation procedures, and 18 midurethral slings. The overall rate of incisional dehiscence was 3% (4/154). The rate of reported incisional bleeding was 3% (4/154). There was 1 incisional infection. The pain reports based on a * Corresponding author. 10-point scale had a mean of 4.96 immediately post-operatively, which decreased to a mean score < 1 (0.2) by post-op day (POD) 14. The mean drying times for the various lengths of incisions included the following: 1.28 minutes for incisions ≤ 5 mm, 1.53 minutes for 6-8 mm, 1.66 minutes for 10 mm-20 mm, and 1.57 minutes for the 40-50 mm incisions. In 23% (36/154) of incisions 2OCA was the sole method of skin closure. Conclusion: This study demonstrates that 2OCA is safe to use in gynecologic surgical incisions with low rates of post-operative incisional bleeding and incisional dehiscence. Post-operative reports of pain maintained expected levels for recovery. 2OCA is a practical alternative or augmentation to...

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Section: Discussionmentioning

confidence: 98%

2-Octyl Cyanoacrylate Skin Adhesive for Topical Skin Incision Closure in Female Pelvic Surgery

James

Alejandro-Rodriquez²,

Perez³

et al. 2015

OJOG

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“…1,2 A study with a large retrospective questionnaire on 262,000 arthrograms reported a complication rate of 3.6% and 0.03% of these complications were severe. 1 Another study reported sterile chemical synovitis as the most common adverse reaction following arthrography. Figure 1 Plain radiography demonstrating an intracapsular air ring following air arthrography…”

Section: Discussionmentioning

confidence: 99%

Air arthrography to confirm intra-articular positioning for hip injections

Wani

Bali

Shahid

et al. 2014

annals

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ses the underlying subcutaneous tissue (not the subdermal space). The same steps are repeated on the ipsilateral skin edge (Fig 1B). Both the ends are pulled caudally (Fig 1C) to attain adequate skin approximation (Fig 1D) that finishes with a secure 'figure-of-eight' configuration ( Fig 1E). DISCUSSIONIn this method, the end result of the transversely (rather than longitudinally) configured coaptation of the skin edges tends to achieve the original anatomical elevation of the umbilical mound. Moreover, the firmly suture approximated wound edges are likely to decrease the rate of wound dehiscence. Although supplementary studies are needed, we encountered no wound complications in 1,853 patients over the last 3 years. Thus, it may be proposed as a standard technique for umbilical port closure. Reference 1.Sajid MS, Siddiqui MR, Khan MA, Baig MK. Meta-analysis of skin adhesives versus sutures in closure of laparoscopic port-site wounds.

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“…A metananlysis based on four clinical trials encomassing 404 patients showed that there is insufficient evidence that port-site wound closure technique by tissue adhesives is superior to traditional suture closure technique in terms of wound infection, wound dehiscence, and patient satisfaction. 20 Finally the Cochrane review in which eight RCTs (630 patients) on comparison of tissue adhesives and sutures were included no statistically significant difference was found for dehiscence, infection or cosmetic appearance. However a statistically significant difference was found for surgeons' assessment of cosmetic appearance with mean difference 13 (95% CI 5 to 21), the higher mean rating for the tissue adhesive group.…”

Section: Discussionmentioning

confidence: 99%

Comparison of conventional suturing and tissue adhesive (2-octyl cyanoacrylate) for port site skin closure in laparoscopic surgeries

2017

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Meta-analysis of skin adhesives versus sutures in closure of laparoscopic port-site wounds

Cited by 22 publications

References 26 publications

2-Octyl Cyanoacrylate Skin Adhesive for Topical Skin Incision Closure in Female Pelvic Surgery

2-Octyl Cyanoacrylate Skin Adhesive for Topical Skin Incision Closure in Female Pelvic Surgery

Air arthrography to confirm intra-articular positioning for hip injections

Comparison of conventional suturing and tissue adhesive (2-octyl cyanoacrylate) for port site skin closure in laparoscopic surgeries

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