Ann R Coll Surg Engl 2007; 89: 242-246 242Acceptable wound cosmesis and neck mobility are important outcomes following cervicotomy. Methods of skin closure vary in published series and are largely the result of surgeon choice based upon the need for a rapid, economic and reproducible technique of skin apposition. Recent advances in skin closure include the use of skin staples and tissue glues. Though each of these modalities has been evaluated against standard sutured methods in randomised clinical trials, no such comparison between these methods has been performed following cervicotomy. This blinded, randomised, controlled trial seeks to address this by comparing the speed and cosmetic results of cervicotomy closure using tissue glue or skin staples.
Patients and MethodsThe trial protocol was reviewed and approved by local research ethics committee. The study population comprised patients undergoing primary cervicotomy for thyroid or parathyroid surgery at a single district general hospital. Primary outcome measure was time taken to complete skin closure. A power calculation yielded that 30 participants were required based on a halving of closure time with 80% power, an allocation ratio of 1:1 to glue and staple groups and a two-sided significance test at the 5% level. Secondary outcomes were neck mobility, scar cosmesis score and perioperative adverse event rates. Inclusion criteria were planned primary thyroid or parathyroid surgery in patients of the age and ability to give informed consent, with no known allergies to the products to be used and agreeing to randomisation procedure. Exclusion criteria were secondary neck surgery, history of poor compliance with medical treatments, allergy to products to be used or inability to give informed consent for inclusion or randomisation. Potential participants were identified at outpatient visits when the decision for surgical excision was Cosmetic acceptability of scar and neck mobility are important outcomes after collar line incision for neck surgery. This randomised, controlled trial compares these parameters in closures using tissue glue (Dermabond™, Ethicon, UK) and skin staples.
HEAD AND NECK