Tissue Adhesive Versus Sutures for Skin Closure in Primary Cleft Lip Repair: A Systematic Review and Meta-Analysis

Area of Science:

• Plastic Surgery
• Pediatric Surgery
• Wound Healing and Closure

Background:

• Sutures are the traditional method for skin closure in primary cleft lip repair.
• Evaluating alternative closure methods like tissue adhesives is crucial for optimizing outcomes.

Purpose of the Study:

• To compare the effectiveness of cyanoacrylate tissue adhesives versus sutures for skin closure in primary cleft lip repair.
• To assess esthetic, clinical, and patient-centered outcomes, including scar quality, complications, and parental satisfaction.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials and comparative observational studies.
• Included 8 studies with 442 patients (402 with outcome data) undergoing primary cleft lip repair.
• Compared epidermal closure using tissue adhesives (e.g., octyl-2-cyanoacrylate) with conventional fine nonabsorbable sutures.

Main Results:

• No significant difference in esthetic outcomes between tissue adhesives and sutures (SMD -0.05).
• Comparable wound complication rates (RR 0.93).
• Tissue adhesives demonstrated significantly shorter operative times (5-7 minutes saved per case) and higher parental satisfaction.

Conclusions:

• Cyanoacrylate tissue adhesives provide equivalent esthetic and complication outcomes to sutures in cleft lip repair.
• Adhesives offer advantages of faster closure and improved parental satisfaction.
• Further high-quality trials with long-term follow-up are needed to confirm these findings.