Fast Absorbing Gut Suture versus Cyanoacrylate Tissue Adhesive in the Epidermal Closure of Linear Repairs Following Mohs Micrographic Surgery

June Kim, Harjot Singh Maan, Alicia J Cool, Allison M Hanlon, David J Leffell, June Kim, Harjot Singh Maan, Alicia J Cool, Allison M Hanlon, David J Leffell

Abstract

Background: Cyanoacrylate topical adhesives and fast absorbing gut sutures are increasingly utilized by dermatologic surgeons as they provide satisfactory surgical outcomes while eliminating an additional patient visit for suture removal. To date, no head-to-head studies have compared the wound healing characteristics of these epidermal closure techniques in the repair of facial wounds after Mohs micrographic surgery.

Objective: To compare the cosmetic outcome of epidermal closure by cyanoacrylate topical adhesive with fast absorbing gut suture in linear repairs of the face following Mohs micrographic surgery.

Methods: Fourteen patients with wound length greater than 3cm who underwent Mohs micrographic surgery for nonmelanoma skin cancer of the face were enrolled in this randomized right-left comparative study. Following placement of dermal sutures, half of the wound was randomly selected for closure with cyanoacrylate and the contralateral side with fast absorbing gut suture. Using photographs from the three-month postoperative visit, six blinded individuals rated the overall cosmetic outcome.

Results: The present study shows no significant difference in cosmetic outcomes between cyanoacrylate and fast absorbing gut suture for closure of linear facial wounds resulting from Mohs micrographic surgery. Cyanoacrylate tissue adhesive may not be as effective in achieving optimal cosmesis for wounds on the forehead or of longer repair lengths. The majority of patients did not have a preference for wound closure techniques, but when a preference was given, cyanoacrylate was significantly favored over sutures.

Conclusion: Cyanoacrylate tissue adhesive and fast absorbing gut suture both result in comparable aesthetic outcomes for epidermal closure of linear facial wounds following Mohs micrographic surgery. Consideration should be given to factors such as need for eversion, hemostasis, and wound tension when selecting an epidermal wound closure method. (ClinicalTrials.gov, Identifier: NCT01298167, https://ichgcp.net/clinical-trials-registry/NCT01298167).

Figures

Figures 1A and 1B
Figures 1A and 1B
A 77-year-old man with a 3.4cm MMS closure on the right temple. (A) Immediate postoperative appearance with cyanoacrylate applied to the inferior half of the wound, and the superior half sutured with 5-0 fast absorbing gut. (B) Appearance of the wound at the three-month follow-up revealed a rating of 8.2±1.2 for cyanoacrylate and 8.8±0.7 for fast absorbing gut suture on a 10-point visual analog scale.
Figures 1A and 1B
Figures 1A and 1B
A 77-year-old man with a 3.4cm MMS closure on the right temple. (A) Immediate postoperative appearance with cyanoacrylate applied to the inferior half of the wound, and the superior half sutured with 5-0 fast absorbing gut. (B) Appearance of the wound at the three-month follow-up revealed a rating of 8.2±1.2 for cyanoacrylate and 8.8±0.7 for fast absorbing gut suture on a 10-point visual analog scale.
Figures 2A and 2B
Figures 2A and 2B
A 76-year-old man with a 4cm MMS closure on the mid upper forehead. (A) Immediate postoperative appearance with cyanoacrylate applied to the superior half of the wound, and the inferior half sutured with 5-0 fast absorbing gut. (B) Appearance of the wound at the three-month follow-up revealed a rating of 6.2±1.3 for cyanoacrylate and 7±1.8 for fast absorbing gut suture on a 10-point visual analog scale.
Figures 2A and 2B
Figures 2A and 2B
A 76-year-old man with a 4cm MMS closure on the mid upper forehead. (A) Immediate postoperative appearance with cyanoacrylate applied to the superior half of the wound, and the inferior half sutured with 5-0 fast absorbing gut. (B) Appearance of the wound at the three-month follow-up revealed a rating of 6.2±1.3 for cyanoacrylate and 7±1.8 for fast absorbing gut suture on a 10-point visual analog scale.
Figure 3
Figure 3
Patient preference for wound closure

Source: PubMed

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