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Use of cyanoacrylate tissue adhesive under a diaper
V J Ferlise1, M K Ankem, J G Barone
1Division of Urology, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Insights
Cyanoacrylate tissue adhesive is safe and effective for closing skin incisions in children under diapers after inguinal surgery. This method showed no increased risk of infection or wound separation compared to traditional sutures.
Area of Science:
- Pediatric Surgery
- Wound Closure Techniques
- Dermatology
Background:
- Traditional wound closure methods for pediatric inguinal surgery can be challenging in non-toilet-trained children.
- Exposure to bodily fluids under diapers may affect wound healing and increase infection risk.
Purpose of the Study:
- To evaluate the efficacy and safety of cyanoacrylate tissue adhesive for epithelial skin closure in infants undergoing inguinal surgery.
- To compare outcomes of cyanoacrylate adhesive versus traditional closure methods in a diapered population.
Main Methods:
- Retrospective chart review of 45 non-toilet-trained boys undergoing inguinal surgery (orchidopexy, hernia, hydrocele repair) between July 1998 and July 2000.
- Subcutaneous tissues were closed with polyglactin suture; skin closure involved either poliglecaprone suture with adjuncts or cyanoacrylate adhesive.
- Follow-up at 2 weeks and 3 months assessed for infection, wound dehiscence, and cosmetic outcome.
Main Results:
- A total of 52 incisions were reviewed; 27 closed with sutures and 25 with cyanoacrylate adhesive.
- No instances of infection or wound dehiscence were observed in either closure group at 2-week follow-up.
- Cosmetic outcomes were identical between the two groups at 3-month follow-up.
Conclusions:
- Cyanoacrylate tissue adhesive is a safe and effective option for epithelial skin closure in pediatric inguinal surgery, even when constantly exposed to bodily fluids under a diaper.
- This method offers comparable cosmetic results and safety profile to traditional closure techniques in this patient population.
Objective:
To examine the utility of cyanoacrylate tissue adhesive (Dermabond, Ethicon, Somerville, NJ, USA; an effective means of epithelial skin closure) under a diaper (i.e. constantly exposed to bodily fluids) in 25 children (not toilet-trained) undergoing inguinal surgery.
Patients And Methods:
A retrospective review of charts between July 1998 and July 2000 was used to identify children who were not toilet-trained and who had undergone inguinal surgery (e.g. orchidopexy, hernia and hydrocele repair). In addition to the type of surgery, the method of closure was also assessed; in all cases reported the subcutaneous tissues were approximated with 4/0 polyglactin suture. From July 1998 to October 1999 all epithelial skin was closed with 5/0 poliglecaprone, benzoin, sterile strips and collodion; from October 1999 to July 2000 all skin was closed with cyanoacrylate tissue adhesive.
Results:
The chart review identified 45 boys (mean age 15.3 months, range 1-26) of whom 26 (57%) had undergone either inguinal hernia or hydrocele repair, and 19 (42%) who had undergone orchidopexy. These procedures resulted in a total of 52 incisions in the 45 children. Of the 52 incisions, 27 were closed with suture and 25 with cyanoacrylate adhesive. All patients were followed up at 2 weeks; there were no instances of infection or wound dehiscence in either group. The incisions were cosmetically identical at 3 months of follow-up.
Conclusion:
Cyanoacrylate adhesive is a safe and effective method of skin closure that can be used under a diaper.
