A Randomized Controlled Trial of Tissue Adhesive Versus Sutures in the Closure of Port-Site Incisions in Laparoscopic Surgery

Cyanoacrylates have been recognized since before the 1960s as excellent tissue adhesives. They are easy to use, cost-effective, and cosmetically favorable. There are no studies from India reporting the use of tissue adhesives in laparoscopic surgery. We carried out a prospective, interventional, randomized trial of non-absorbable simple interrupted sutures versus 2-octyl cyanoacrylate in the closure of skin incisions in laparoscopic surgery with the primary objective of assessing the efficacy (approximation achieved) of both methods. The secondary objectives were to compare the operative time for closure, post-operative pain, infection and cost. There were 20 participants, 10 in either arm. Consenting patients undergoing elective laparoscopic surgery in a single surgical unit were included. Descriptive statistics were used on demographic data. Comparisons between the two methods were made on the basis of Southampton Wound Assessment Scale-SWAS grade for healing, Visual Analogue Scale-VAS scores for pain, intra-operative time, and cost. Apart from cost which was significantly higher for adhesive group, the groups did not differ significantly in terms of pain, wound approximation, and infection. Octyl cyanoacrylate is comparable to non-absorbable simple interrupted sutures in terms of closure time, post-operative pain, wound approximation and infection. The cost of using octyl cyanoacrylate is substantially higher than traditional suture material.