BACKGROUND: While a variety of epidermal wound closure techniques are utilized, there are few evidence based studies comparing techniques in head-to-head studies. OBJECTIVE: To compare the aesthetic outcomes and wound healing properties of 2 epidermal closure mechanisms: 2-octylethylcyanoacrylate adhesive and rapid absorbing gut suture in skin closures. METHODS: A total of 8 patients were enrolled in this randomized right-left comparative trial. Patients were randomized for epidermal closure with one half of their wounds (chest [n=6] and upper extremities [n=2]) with tissue adhesive and the contralateral with rapid absorbing gut suture. RESULTS: Three months following wound closure, overall cosmetic outcome was slightly greater on the half closed with rapid absorbing gut suture (mean=3.56) relative to the tissue adhesive (mean=3.19, P=.05). For dyspigmentation, the half of the scar treated with the suture had a better outcome (mean=3.50) relative to tissue adhesive (mean=2.75) (P<.05). All other variables (i.e., scar thickness, wound approximation, patient outcome, and preference) were highly equivalent. CONCLUSION: Both rapid absorbing gut suture and tissue adhesive appear to be highly efficacious techniques for epidermal closure. It appears that tissue adhesive may not be as effective in achieving optimal cosmesis for defects after Mohs micrographic surgery on the trunk and extremities in follow-up at 3 months.
RCT Entities:
BACKGROUND: While a variety of epidermal wound closure techniques are utilized, there are few evidence based studies comparing techniques in head-to-head studies. OBJECTIVE: To compare the aesthetic outcomes and wound healing properties of 2 epidermal closure mechanisms: 2-octylethylcyanoacrylate adhesive and rapid absorbing gut suture in skin closures. METHODS: A total of 8 patients were enrolled in this randomized right-left comparative trial. Patients were randomized for epidermal closure with one half of their wounds (chest [n=6] and upper extremities [n=2]) with tissue adhesive and the contralateral with rapid absorbing gut suture. RESULTS: Three months following wound closure, overall cosmetic outcome was slightly greater on the half closed with rapid absorbing gut suture (mean=3.56) relative to the tissue adhesive (mean=3.19, P=.05). For dyspigmentation, the half of the scar treated with the suture had a better outcome (mean=3.50) relative to tissue adhesive (mean=2.75) (P<.05). All other variables (i.e., scar thickness, wound approximation, patient outcome, and preference) were highly equivalent. CONCLUSION: Both rapid absorbing gut suture and tissue adhesive appear to be highly efficacious techniques for epidermal closure. It appears that tissue adhesive may not be as effective in achieving optimal cosmesis for defects after Mohs micrographic surgery on the trunk and extremities in follow-up at 3 months.