Tissue Adhesive Versus Sutures in Oral Biopsy Closure

June 16, 2026 updated by: Omar Hamadah, Damascus University

Comparison of Tissue Adhesive and Surgical Sutures for Wound Closure After Oral Excisional Biopsies: A Randomized Controlled Clinical Trial

Excisional biopsies are commonly performed in the oral mucosa, and proper wound closure and hemostasis are critical for the success of the surgical procedure. Suturing remains the gold standard for closing surgical incisions; however, it has several drawbacks, including being time-consuming and requiring technical skill for proper placement. In addition, access to posterior areas of the oral cavity can be challenging. Suturing may also cause patient discomfort during needle penetration of tissues and can serve as a potential pathway for microbial contamination. Therefore, this randomized controlled clinical trial aims to evaluate one of the latest tissue adhesives from the cyanoacrylate group (PeriAcryl 90 HV) compared to conventional surgical sutures (Nylon 4-0) for wound closure following oral excisional biopsies. A total of 28 patients with oral fibroma will be randomly assigned to either the tissue adhesive group or the suture group (14 patients per group).

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Appropriate closure of the surgical wound is essential for achieving successful surgical outcomes and optimal wound healing. Although sutures are the most commonly used method for closing wounds in the oral mucosa, they may cause discomfort to patients, particularly in the buccal and labial mucosa. Furthermore, sutures require a second clinical visit for removal. These limitations highlight the clinical need for an alternative to conventional sutures that is easy to apply, does not require removal, and minimizes patient discomfort. This study will compare tissue adhesive (PeriAcryl 90 HV) versus surgical sutures (Nylon 4-0) for wound closure after oral fibroma excision in a randomized controlled trial design.

Study Type

Interventional

Enrollment (Estimated)

28

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Syria
    • Mazzh
      • Damascus, Mazzh, Syria
        • Recruiting
        • Damascus University ,Department of Oral Medicine, Faculty of Dentistry
        • Contact:
        • Contact:
        • Sub-Investigator:
          • Nour J Ibrahim, DDS _ MSc student

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

-Patients clinically diagnosed with oral fibroma located on the

labial mucosa (lip) or buccal mucosa (cheek).

  • Lesion requires excisional biopsy.
  • Lesion size greater than 3 mm and less than 3 cm in

greatest diameter.

Exclusion Criteria:

  • Pregnant or breastfeeding women.
  • Patients taking anticoagulant medications (blood thinners).
  • Patients with infectious diseases such as hepatitis, HIV, etc.
  • Patients taking immunosuppressants.
  • Patients with uncontrolled diabetes mellitus.
  • Patients taking medications that affect bleeding and wound healing.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Tissue adhesive(PeriAcryl90 HV)
Tissue adhesive (PeriAcryl 90 HV) will be applied directly to the wound surface after excisional biopsy.
Device: Tissue adhesive (PeriAcryl 90 HV)
After excisional biopsy of oral fibroma and achieving hemostasis by applying pressure with saline-soaked gauze, the wound surface will be gently dried. PeriAcryl 90 HV (high viscosity butyl cyanoacrylate) will be applied directly using a pipette to cover the entire wound surface . A second layer will be applied 10-15 seconds after the first layer to ensure adequate thickness and durability. The adhesive will polymerize upon contact with moist tissue within approximately 10-20 seconds.
Active Comparator: Surgical sutures(Nylon 4-0)
Surgical suture (Nylon 4-0) will be used to close the wound with interrupted stitches.
Device: Surgical suture (Nylon 4-0)
After excisional biopsy of oral fibroma and achieving hemostasis, the wound margins will be approximated using tissue forceps. Interrupted sutures using Nylon 4-0 will be placed to close the wound. Sutures will be removed on day 7 postoperatively.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Early Wound Healing Score (EHS)
Time Frame: Assessed at day 7 and day 14 postoperatively.
Wound healing will be assessed using the Early Wound Healing Score (EHS), a validated clinical index that evaluates three parameters: clinical signs of re-epithelialization (CSR, scored 0-6), clinical signs of haemostasis (CSH, scored 0-2), and clinical signs of inflammation (CSI, scored 0-2). The total score ranges from 0 (worst healing) to 10 (excellent healing).
Assessed at day 7 and day 14 postoperatively.
Operative time (minutes)
Time Frame: Measured intraoperatively using a stopwatch.
The time measured from the start of wound closure (immediately after excisional biopsy and hemostasis) to the complete wound closure. For the tissue adhesive group, this ends when the second layer polymerizes. For the suture group, this ends after the last interrupted suture is placed.
Measured intraoperatively using a stopwatch.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative pain measured by Visual Analogue Scale (VAS)
Time Frame: Measured at 24 hours, 3 days, and 7 days postoperatively.
Pain intensity will be assessed using a 10-cm Visual Analogue Scale (VAS), where 0 cm represents "no pain" and 10 cm represents "the worst possible pain". Patients will be asked to mark their pain level on the scale at each time point.
Measured at 24 hours, 3 days, and 7 days postoperatively.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Damascus University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

August 12, 2025

Primary Completion (Estimated)

December 1, 2026

Study Completion (Estimated)

December 1, 2027

Study Registration Dates

First Submitted

June 12, 2026

First Submitted That Met QC Criteria

June 12, 2026

First Posted (Actual)

June 17, 2026

Study Record Updates

Last Update Posted (Actual)

June 18, 2026

Last Update Submitted That Met QC Criteria

June 16, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • DN- 230226-649

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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