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A randomized, controlled study comparing two standardized closure methods of laparoscopic port sites
Kai Chen1, Allan S Klapper, Hayley Voige
1Department of Obstetric and Gynecology, New York Downtown Hospital, New York, New York, USA.
JSLS : Journal of the Society of Laparoendoscopic Surgeons
|February 22, 2011
Summary
Octyl-cyanoacrylate tissue adhesive (OCT) offers fewer early complications and better cosmetic outcomes for laparoscopic port site closure compared to traditional sutures. This surgical adhesive provides a superior alternative for wound healing and aesthetics.
Area of Science:
- Minimally Invasive Surgery
- Surgical Wound Management
- Dermatologic Surgery
Background:
- Laparoscopic surgery necessitates effective port site closure techniques.
- Traditional suture methods can lead to complications and suboptimal cosmetic results.
- Octyl-cyanoacrylate (OCT) tissue adhesive presents a potential alternative for wound closure.
Purpose of the Study:
- To compare the efficacy and cosmetic outcomes of octyl-cyanoacrylate (OCT) tissue adhesive versus standard suture techniques for laparoscopic port site closure.
- To evaluate complication rates and wound appearance between the two closure methods.
Main Methods:
- A randomized clinical trial involving 40 patients undergoing laparoscopic procedures.
- One lower abdominal port site per patient was closed with OCT, while the contralateral site used 4-0 monocryl suture.
- Wound evaluation using the Hollander Wound Evaluation Scale (HWES) and assessment for complications (erythema, tenderness, drainage, infection) at 2-4 weeks post-surgery.
Main Results:
- OCT closure resulted in significantly lower rates of erythema, tenderness, and drainage compared to sutures (P<0.001).
- OCT demonstrated superior cosmetic outcomes, indicated by higher overall HWES scores and reduced margin separation (P=0.05).
- While skin contour irregularity was higher with OCT initially, it was significantly improved when applied with fine tissue forceps (P=0.002).
Conclusions:
- Octyl-cyanoacrylate tissue adhesive is associated with fewer early surgical site complications, including erythema, tenderness, and drainage.
- Laparoscopic port sites closed with OCT exhibit improved cosmetic appearance compared to suture closure.
- OCT adhesive represents a viable and potentially advantageous option for laparoscopic port site management.