Skin Adhesive vs Skin Sutures for Wound Closure in Hernia Repair: A Randomized Controlled Trial

Abstract

 Background: Wound closure is an important step in all sorts of surgeries, whether elective or emergency. Wound closure techniques vary from conventional skin suturing to natural glues, skin staples, and tapes. A good wound closure is one that ensures optimal healing. There are several aspects of wound closure technique that can render it either good or bad. This study is designed to investigate the outcomes of skin adhesives. The technique which leads to a better outcome is recommended moving forward so that we can reduce associated complications and costs in terms of post-surgical infection. Methods: A randomized controlled trial was conducted in Surgical Unit-3, Civil Hospital Karachi from 9th Feb 2018 to 8th Aug 2018. A total of 130 patients undergoing open inguinal hernia mesh repair (i.e., hernioplasty) were randomly allocated to two groups. Patients in Group A were treated with skin adhesive, patients in and Group B were treated with subcuticular sutures. All patients were operated on in the usual manner using Lichtenstein’s technique, and mesh was applied. In the post-operative period, all patients were observed for signs of wound infection according to the Southampton Score. Scar cosmesis was calculated using the Hollander Score at six weeks. Results: The average age of the patients was 45.42±8.70 years. There were 105(80.8%) males and 25(19.2%) females. The rate of wound infection and dehiscence was not statistically significant between both groups. The mean application time of skin closure was significantly lower in Group A than Group B. Conclusion: From this study, it can be concluded that the use of tissue adhesives has an advantage of saving time when compared to conventional suturing.