Maw J L, Quinn J V, Wells G A, Ducic Y, Odell P F, Lamothe A, Brownrigg P J, Sutcliffe T
Department of Otolaryngology, University of Ottawa Faculty of Medicine, Ontario.
J Otolaryngol. 1997 Feb;26(1):26-30.
To compare the tissue adhesive octylcyanoacrylate with subcuticular suture for the closure of head and neck incisions.
A prospective comparison with a blinded assessment of cosmetic outcome.
Fifty consecutive patients undergoing head and neck procedures at two University of Ottawa teaching hospitals.
Twenty-six patients underwent skin closure with monofilament suture and 24 were closed with tissue adhesive. At 4 to 6 weeks the incisions were evaluated with a validated wound scale. Photographs of the incisions were rated using a visual analogue scale by two facial-plastic otolaryngologists who were blinded to the method of skin closure.
The adhesive provided faster skin closure (29.7 seconds vs 289.0 seconds, p < .0001), and there were no differences in complications between the two groups. The primary outcome measure was the cosmetic appearance of the incision at 4 to 6 weeks. Although the adhesive group scored higher on both cosmesis scales, the visual analogue scale (octylcyanoacrylate 58.7 mm vs suture 53.2 mm) and the wound evaluation scale (57% vs 50% optimal wound scores), there were no statistical or clinically significant differences on either scale. The two facial-plastic otolaryngologists had good intraobserver and interobserver agreement when rating the cosmetic outcomes (0.87 and 0.71 respectively).
Octylcyanoacrylate was found to be an effective method of skin closure in clean head and neck incisions. The practical advantages of tissue adhesives are reviewed.
比较组织黏合剂氰基丙烯酸辛酯与皮下缝合用于头颈部切口闭合的效果。
一项前瞻性比较研究，对美容效果进行盲法评估。
渥太华大学两所教学医院连续50例接受头颈部手术的患者。
26例患者采用单丝缝线进行皮肤缝合，24例采用组织黏合剂闭合。在4至6周时，使用经过验证的伤口量表对切口进行评估。两名面部整形耳鼻喉科医生在不知道皮肤闭合方法的情况下，使用视觉模拟量表对切口照片进行评分。
黏合剂实现皮肤闭合的速度更快（29.7秒对289.0秒，p <.0001），两组并发症无差异。主要观察指标是4至6周时切口的美容外观。尽管黏合剂组在两个美容量表上得分更高，即视觉模拟量表（氰基丙烯酸辛酯58.7 mm对缝线53.2 mm）和伤口评估量表（最佳伤口评分分别为57%对50%），但在任何一个量表上均无统计学或临床显著差异。两名面部整形耳鼻喉科医生在评估美容效果时，观察者内和观察者间的一致性良好（分别为0.87和0.71）。
发现氰基丙烯酸辛酯是清洁头颈部切口皮肤闭合的有效方法。对组织黏合剂的实际优势进行了综述。
