Repair of cutaneous wounds with the use of low cost surgical glue

Abstract

BACKGROUND: The advantages of the cyanoacrylates in cutaneous synthesis have been often demonstrated in the literature. However, these products have been underutilized in Brazil due to the high costs of the 2-octil-cyanoacrylate. Besides, few studies have been done with the more economically accessible form, the 2-etil-cyanoacrylate, as a cutaneous tissue adhesive. OBJECTIVE: To evaluate the effectiveness of the closing of cutaneous lesions using ECA. METHOD: This was a prospective study in which 46 wounds were occluded using the low cost ECA as an alternative to intradermal suture. RESULTS: Excisions (97,8%) and traumatic wounds (2,2%) were treated with 2-etil-cyanoacrylate and deep relaxed sutures as synthesis method. Unaesthetic scars (22%), infection (2,1%), dehiscence (2,1%) and contact allergic dermatitis (2,1%) were the problems we found. There were no cases of necrosis or keloids. The results were considered satisfactory in most cases (97,3%). CONCLUSIONS: The use of 2-etil-cyanoacrylate was shown to be safe and with satisfactory cosmetic results in this group of patients. Keywords: Cyanoacrylates; Suture techniques; Tissue adhesives Resumo: FUNDAMENTOS: As vantagens dos cianoacrilatos em síntese cutânea têm sido sobejamente mostradas na literatura. Entretanto, estes produtos têm sido subutilizados no Brazil devido aos elevados custos do 2-octilcianoacrilato. Ademais, a forma mais economicamente acessível, o 2-etilcianoacrilato, tem sido pouco estudada como adesivo cutâneo. OBJETIVO: Avaliação da eficácia do fechamento de lesões cutâneas usando o 2-etilcianoacrilato. MÉTODO: Estudo prospectivo no qual 46 feridas foram ocluídas usando o 2-etilcianoacrilato de baixo custo como alternativa a sutura intradérmica. RESULTADOS: Feridas excisionais (97,8%) e traumática (2,2%) foram tratadas com 2-etilcianoacrilato e suturas profundas relaxadoras como método de síntese. Cicatrizes inestéticas (22%), infecção (2,1%), deiscência (2,1%) e dermatite alér-gica de contato (2,1%) foram os problemas encontrados. Não houve casos de necrose ou quelóides. Os resultados foram considerados satisfatórios na grande maioria dos casos (97,3%). Conclusões: O uso do ECA mostrou-se seguro e com resultados cosméticos satisfatórios neste grupo de pacientes.

Comparison of Different Suture Techniques

“…Previous studies have shown that stapling is 5-7 times quicker than suturing [1]; [10]; [11]. Souza et al demonstrated that tissue adhesives were 3 times quicker than suture [12]. In contrast, Coulthard et al reported that suture was quicker than tissue adhesive [12].…”

“…Souza et al demonstrated that tissue adhesives were 3 times quicker than suture [12]. In contrast, Coulthard et al reported that suture was quicker than tissue adhesive [12]. Comparison of the time to treatment in different modalities demonstrated that Group 2 and 3 were significantly quicker compared to Group 1, a condition which was due to absence of need for local anesthesia and ease of application with staplers or tissue adhesives.…”

“…However, Kanegaye et al [1] reported a lower complication rate in stapling than suturing. Souza et al reported that complications of tissue adhesives for wound closure included infection 2.1% and dehiscence 22.1% [12]. Coulthard et al reported that sutures were better than tissue adhesives with respect of dehiscence [13].…”

“…In addition, we also think that a widespread use of tissue adhesives and the competition among the manufacturing companies would reduce their cost. Souza et al reported a patient satisfaction of 97.3% for tissue adhesives [12]. Coulthard et al reported a higher patient satisfaction for sutures than tissue adhesives [13].…”