Singer Adam J, Quinn James V, Clark Robert E, Hollander Judd E
Department of Emergency Medicine, State University of New York, Stony Brook, NY.
Surgery. 2002 Mar;131(3):270-6. doi: 10.1067/msy.2002.121377.
Most lacerations and surgical incisions are closed with sutures or staples. Octylcyanoacrylate tissue adhesive (OCA) was recently approved for use in the United States. We compared the cosmetic appearance of lacerations and incisions repaired with OCA versus standard wound closure methods (SWC).
A multicenter randomized clinical trial including patients with simple lacerations or surgical incisions was conducted at 10 clinical sites. Patients were randomly assigned to treatment with OCA or SWC. Follow-up was performed at 1 week and at 3 months to determine infection rates and cosmetic outcome.
Eight hundred fourteen patients with 924 wounds (383 traumatic lacerations, 235 excisions of skin lesions or scar revisions, 208 minimally invasive surgeries, and 98 general surgical procedures) were enrolled. Groups were similar in baseline characteristics. Wound closure with OCA was faster than with SWC (2.9 vs 5.2 minutes, P <.001). At 1 week infection rates were similar (OCA, 2.1% vs SWC, 0.7%; P =.09) and fewer OCA wounds were erythematous (18% vs 36%, P <.001). There were no differences in wound dehiscence rates (OCA, 1.6% vs SWC, 0.9%; P =.35). At 3 months there was no difference in the percent of wounds with optimal appearance (OCA, 82% vs SWC, 83%; P =.67).
Repair of traumatic lacerations and surgical incisions with OCA is faster than with SWC, and cosmetic outcome is similar at 3 months.
大多数撕裂伤和手术切口通过缝合或钉合进行闭合。氰基丙烯酸辛酯组织粘合剂（OCA）最近在美国被批准使用。我们比较了用OCA修复的撕裂伤和切口与标准伤口闭合方法（SWC）的美容效果。
在10个临床地点进行了一项多中心随机临床试验，纳入了患有单纯撕裂伤或手术切口的患者。患者被随机分配接受OCA或SWC治疗。在1周和3个月时进行随访，以确定感染率和美容效果。
纳入了814例患者的924处伤口（383处外伤性撕裂伤、235处皮肤病变切除或瘢痕修复、208例微创手术和98例普通外科手术）。两组在基线特征方面相似。用OCA进行伤口闭合比SWC更快（2.9分钟对5.2分钟，P<.001）。在1周时，感染率相似（OCA为2.1%，SWC为0.7%；P=.09），且OCA伤口出现红斑的较少（18%对36%，P<.001）。伤口裂开率没有差异（OCA为1.6%，SWC为0.9%；P=.35）。在3个月时，外观最佳的伤口百分比没有差异（OCA为82%，SWC为83%；P=.67）。
用OCA修复外伤性撕裂伤和手术切口比SWC更快，且3个月时的美容效果相似。
