Advantages

Advantages of Adhesive vs Sutures

- Maximum bonding strength at two and one-half minutes
- Equivalent in strength to healed tissue at seven days post repair
- Can be applied using only a topical anesthetic, no needles
- Faster repair time
- Better acceptance by patients
- Water-resistant covering
- Does not require removal of sutures

*Reduce wound infection

Wound infection has been shown to be more in suture technique. Sutures provide an extra source of contamination via suture canal, perisutural cuff of dead epidermis, dermis and subcutaneous fat. It provides all the factors necessary to initiate infection in following ways by:

(1) providing route of entry from skin to subcutaneous tissue,

(2) providing route of entry from intradermal structures, hair follicles, sebaceous glands etc,

(3) maintaining patency of tract for 5-10 days,

(4) causing foreign body reaction with associated local tissue autolysis, so that sutures can break down the tissue barrier into more infected intradermal structures (e.g. sebaceous gland) which were not open at the time of initial passage of suture and

(5) due to foreign body reaction and local tissue autolysis, likelihood of suture to be bathed in liquified protein which will both proliferate and increase the activity of bacteria.

Tissue adhesive like cyanoacrylate leaves no such tract for infection to traverse in the subcutaneous tissues. There is no intradermal invasion or significant foreign body reaction produced.

*Cosmetic result

Several clinical studies have shown that 2-octyl cyanoacrylate provides cosmetic results equal to those of sutures. Therefore, given the speed and efficacy of this tissue adhesive, it should firmly establish itself in the treatment repertoire for closure of the skin. Future investigations with this product no doubt will expand its use.