Closure of skin incision after thyroidectomy through a supraclavicular approach: a comparison between tissue adhesive and staples

Abstract

Background: The objective of this study was to compare the effectiveness and cosmetic results of tissue adhesive or surgical staples in thyroidectomy through a supraclavicular incision.Methods: This was a prospective, randomized study of consecutive patients undergoing thyroidectomy by a supraclavicular approach. Eligible patients were randomized into two groups: one group had the incision closed with tissue adhesive (the experimental group) and the other with surgical staples (the control group). The main outcomes included operative time, early postoperative pain measured by visual Analog scale, incidence of wound dehiscence and infection, perceived cosmetic outcome, and overall patient satisfaction by using patient satisfaction Assessment form.Results: There were 151 consecutive patients assessed for eligibility, and 132 patients were enrolled over 22 months. The clinical characteristics of the patients in the two groups were similar. main outcomes were assessed in the first 24 h postoperatively, the first month, and the third month postoperatively. Operation time was longer in the experimental group (P = 0.027). mean visual Analog scale scores for pain were lower in the experimental group in the early postoperative period (P < 0.001). No patients developed surgical site infections or wound dehiscence. Lower scores for scar assessment and higher overall satisfaction levels at the first month after surgery were found in the experimental group compared to the control group (P < 0.001). There was no significant difference between the two groups at the third month postoperatively in perceived cosmetic result (P = 0.052) or overall satisfaction (P = 0.059).

Optimal wound closure techniques for thyroid and parathyroid surgery: A systematic review of cosmetic outcomes

“…One paper by Guarino et al was a retrospective cohort study. Three studies compared staples vs glue; three papers compared sutures vs staples; two papers compared suture vs steri‐strips; and two papers compared sutures vs glue . A total of 742 patients were included in this review.…”

“…With regards to surgical procedure, all but one, Vinay et al, included a description of the procedure performed, although to varying detail. Five papers described platysma closure, and four papers described subcutaneous closure prior to skin/epidermal closure. Pronio et al reported the use of ceftriaxone as prophylactic antibiotics.…”

“…Scar assessment tools were used by all, except Iqbal et al, who used a polar question of satisfaction with cosmesis or not. Five of these studies utilised validated scar assessment tools . Pronio et al, O'Leary et al and Selvadurai et al utilised more than one tool.…”

“…The authors' judgment of bias is summarised in Table . Four papers reported blinding, with three blinded to closure method, and one paper had patients blinded to treatment method prior to surgery. Only O'Leary et al followed an intention to treat principle in data analysis, and only Consorti et al presented data with confidence intervals.…”

Comparative study of steristrips and subcuticular suture for wound closure after thyroid surgery

“…In a study Yang YL et al, these patients were randomly divided into two groups (one experimental and one control group) of 70 patients each. 12 In the process of the study, 8 patients were excluded because of intraoperative findings. Therefore, there were 65 patients in the experimental group (tissue adhesive) and 67 patients in the control group (surgical staples).…”