Koonce Stephanie L, Eck Dustin L, Shaddix Kyle K, Perdikis Galen
From the *Mayo Clinic Florida Department of General Surgery, and †Division of Plastic Surgery, Mayo Clinic Florida, Jacksonville, FL.
Ann Plast Surg. 2015 Jan;74(1):107-10. doi: 10.1097/SAP.0b013e318289856f.
The use of tissue adhesives for the closure of surgical incisions is increasing. Few studies directly compare tissue adhesives to one another or focus on the difference in wound closure time between tissue adhesives. We compared the use of N-butyl-2 cyanoacrylate (Histoacryl), octyl cyanoacrylate (Dermabond), or subcuticular suture in incisions resulting from reduction mammoplasty, mastopexy, panniculectomy, and abdominoplasty.
A 2-armed prospective randomized controlled trial was performed. Part 1 compared closure of surgical incisions with N-butyl-2 cyanoacrylate and octyl cyanoacrylate. Part 2 compared the closure of surgical incisions with N-butyl-2 cyanoacrylate and subcuticular suture. End points were closure time, scar width, and satisfaction ratings.
Both study arms revealed significantly faster closer times with N-butyl-2 cyanoacrylate [9/10 in part 1 (P = 0.022) and 10/10 in part 2 (P = 0.002)]. Scar width difference did not reach statistical significance, and there was no difference in surgeon, independent reviewer, or patient satisfaction among the materials.
Our results demonstrate a decreased time required for wound closure using N-butyl-2 cyanoacrylate compared to both suture and octyl cyanoacrylate regardless of incision type with no significant difference in scar width or satisfaction ratings.
用于手术切口闭合的组织粘合剂的使用正在增加。很少有研究直接比较不同的组织粘合剂,或关注组织粘合剂之间伤口闭合时间的差异。我们比较了在乳房缩小成形术、乳房固定术、腹壁成形术和腹部整形术后的切口使用正丁基-2-氰基丙烯酸酯(Histoacryl)、辛基氰基丙烯酸酯(Dermabond)或皮下缝合的情况。
进行了一项双臂前瞻性随机对照试验。第一部分比较了使用正丁基-2-氰基丙烯酸酯和辛基氰基丙烯酸酯闭合手术切口的情况。第二部分比较了使用正丁基-2-氰基丙烯酸酯和皮下缝合闭合手术切口的情况。终点指标为闭合时间、瘢痕宽度和满意度评分。
两个研究组均显示,使用正丁基-2-氰基丙烯酸酯时闭合时间显著更快[第一部分为9/10(P = 0.022),第二部分为10/10(P = 0.002)]。瘢痕宽度差异未达到统计学显著性,且在不同材料之间,外科医生、独立评审员或患者的满意度没有差异。
我们的结果表明,与缝合和辛基氰基丙烯酸酯相比,无论切口类型如何,使用正丁基-2-氰基丙烯酸酯进行伤口闭合所需的时间减少,且瘢痕宽度或满意度评分没有显著差异。