• J L Maw, J V Quinn, G A Wells, Y Ducic, P F Odell, A Lamothe, P J Brownrigg, and T Sutcliffe.
• Department of Otolaryngology, University of Ottawa Faculty of Medicine, Ontario.
• J Otolaryngol. 1997 Feb 1;26(1):26-30.

ObjectiveTo compare the tissue adhesive octylcyanoacrylate with subcuticular suture for the closure of head and neck incisions.DesignA prospective comparison with a blinded assessment of cosmetic outcome.SubjectsFifty consecutive patients undergoing head and neck procedures at two University of Ottawa teaching hospitals.MethodsTwenty-six patients underwent skin closure with monofilament suture and 24 were closed with tissue adhesive. At 4 to 6 weeks the incisions were evaluated with a validated wound scale. Photographs of the incisions were rated using a visual analogue scale by two facial-plastic otolaryngologists who were blinded to the method of skin closure.ResultsThe adhesive provided faster skin closure (29.7 seconds vs 289.0 seconds, p < .0001), and there were no differences in complications between the two groups. The primary outcome measure was the cosmetic appearance of the incision at 4 to 6 weeks. Although the adhesive group scored higher on both cosmesis scales, the visual analogue scale (octylcyanoacrylate 58.7 mm vs suture 53.2 mm) and the wound evaluation scale (57% vs 50% optimal wound scores), there were no statistical or clinically significant differences on either scale. The two facial-plastic otolaryngologists had good intraobserver and interobserver agreement when rating the cosmetic outcomes (0.87 and 0.71 respectively).ConclusionsOctylcyanoacrylate was found to be an effective method of skin closure in clean head and neck incisions. The practical advantages of tissue adhesives are reviewed.

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