Martin Jonathan G, Hollenbeck Scott T, Janas Gemini, Makar Ryan A, Pabon-Ramos Waleska M, Suhocki Paul V, Miller Michael J, Sopko David R, Smith Tony P, Kim Charles Y
Department of Radiology, Division of Vascular and Interventional Radiology, Duke University Medical Center, Box 3808, 2301 Erwin Road, Durham, NC 27710.
Department of Surgery, Division of Plastic, Maxillofacial, and Oral Surgery, Duke University Medical Center, Box 3808, 2301 Erwin Road, Durham, NC 27710.
J Vasc Interv Radiol. 2017 Jan;28(1):111-116. doi: 10.1016/j.jvir.2016.08.009. Epub 2016 Nov 9.
To compare early outcomes of skin closure with octyl cyanoacrylate skin adhesive versus subcuticular suture closure.
Over a 7-month period, 109 subjects (28 men and 81 women; mean age, 58.6 y) scheduled to undergo single-lumen implantable venous port insertion for chemotherapy were randomly assigned to skin closure with either octyl cyanoacrylate skin adhesive or absorbable subcuticular suture after suturing the deep dermal layer. Subjects were followed for episodes of infection or dehiscence within 3 months of port implantation. At 3 months, photographs of the healed incision were obtained and reviewed by a plastic surgeon in a blinded fashion who rated cosmetic scar appearance based on a validated 10-point cosmesis score.
Of subjects, 54 were randomly assigned to skin adhesive, and 55 were randomly assigned to subcuticular suture. No subjects had incision dehiscence. Infection rates at 3 months were similar between groups (2.1% vs 4.0%; P = 1.0). The mean cosmesis scores were 4.40 for skin adhesive and 4.46 for subcuticular suture (P = .898). The superficial skin closure time was 8.6 minutes for suture versus 1.4 minutes for skin adhesive (P < .001).
Scar cosmesis and patient outcomes did not significantly vary between skin adhesive versus subcuticular suture, although skin closure time was significantly less with skin adhesive.
比较使用氰基丙烯酸正辛酯皮肤粘合剂与皮下缝合进行皮肤闭合的早期效果。
在7个月的时间里,将计划接受单腔植入式静脉化疗端口插入术的109名受试者(28名男性和81名女性;平均年龄58.6岁)在缝合深层真皮层后随机分配为使用氰基丙烯酸正辛酯皮肤粘合剂或可吸收皮下缝线进行皮肤闭合。对受试者进行随访,观察端口植入后3个月内的感染或切口裂开情况。在3个月时,获取愈合切口的照片,并由一名整形外科医生以盲法进行评估,该医生根据经过验证的10分美容评分对瘢痕外观进行评级。
受试者中,54人被随机分配至使用皮肤粘合剂组,55人被随机分配至皮下缝合组。没有受试者出现切口裂开。两组在3个月时的感染率相似(2.1%对4.0%;P = 1.0)。皮肤粘合剂组的平均美容评分为4.40,皮下缝合组为4.46(P = 0.898)。缝合的浅表皮肤闭合时间为8.6分钟,而皮肤粘合剂为1.4分钟(P < 0.001)。
尽管使用皮肤粘合剂的皮肤闭合时间明显更短,但在瘢痕美容效果和患者结局方面,皮肤粘合剂与皮下缝合之间没有显著差异。