Soni Abhishek, Narula Ravi, Kumar Anil, Parmar Monika, Sahore Manish, Chandel Mohinder
Lecturer, Department of Oral and Maxillofacial Surgery, Himachal Pradesh Government Dental College and Hospital, Shimla, Himachal Pradesh, India.
J Oral Maxillofac Surg. 2013 Dec;71(12):2152.e1-8. doi: 10.1016/j.joms.2013.08.029.
To compare octyl-2-cyanoacrylate (2-OCA) tissue adhesive with subcuticular suture for the closure of incisions in the maxillofacial region to determine 1) whether it is faster than traditional subcuticular suturing, 2) whether the number and length of incisions affect closure time, 3) wound morbidity, 4) patient satisfaction outcome, and 5) cosmetic outcome.
In a prospective randomized clinical trial, 29 patients were allocated to 1 of 2 groups for the closure of skin incisions using 2-OCA or conventional subcuticular skin sutures. Postoperative follow-up evaluated wound healing at 5 to 10 days and at 3 months. Assessment of cosmetic outcome was performed by a plastic surgeon using a modified Hollander Wound Evaluation Scale and a validated visual analog scale. Comparisons between groups were performed using the Student t test and χ(2) test.
Twenty incisions in 14 patients were closed with 2-OCA and 20 incisions in 15 patients were closed with subcuticular sutures. Mean time of closure was significantly (P < .005) faster with 2-OCA at 69.50 ± 33.39 seconds compared with 379.00 ± 75.39 seconds in the suture group. There was no significant difference in wound complications between the 2 groups; also, there was no significant difference in patient satisfaction and cosmetic outcome of scars at the 3-month follow-up between the 2 groups.
2-OCA tissue adhesive is an excellent alternative to sutures for effective, reliable, and faster skin closure of maxillofacial incisions.
比较辛酯-2-氰基丙烯酸酯(2-OCA)组织粘合剂与皮下缝合用于颌面区域切口闭合的效果,以确定:1)其是否比传统皮下缝合更快;2)切口数量和长度是否影响闭合时间;3)伤口发病率;4)患者满意度结果;5)美容效果。
在一项前瞻性随机临床试验中,29例患者被分配至两组中的一组,分别使用2-OCA或传统皮下皮肤缝线闭合皮肤切口。术后随访在5至10天及3个月时评估伤口愈合情况。由整形外科医生使用改良的霍兰德伤口评估量表和经过验证的视觉模拟量表对美容效果进行评估。组间比较采用学生t检验和χ²检验。
14例患者的20处切口用2-OCA闭合,15例患者的20处切口用皮下缝线闭合。2-OCA组的平均闭合时间显著更快(P <.005),为69.50±33.39秒,而缝线组为379.00±75.39秒。两组间伤口并发症无显著差异;此外,两组在3个月随访时患者满意度和瘢痕美容效果也无显著差异。
2-OCA组织粘合剂是用于颌面切口有效、可靠且更快皮肤闭合的缝线的极佳替代品。