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A prospective randomised controlled trial comparing tissue adhesive and sutures for laparoscopic port-site skin
M Praveen Kumar1, P Niranjan, H R Ravishankar
1Department of General Surgery, Sagar Hospital, Bengaluru, Karnataka, India.
Introduction:
The cosmetic outcome of surgical scars plays an important role in overall patient satisfaction, particularly in minimally invasive procedures. Various skin closure techniques, including sutures and cyanoacrylate-based tissue adhesives, are used to optimise efficiency, patient comfort and aesthetic outcomes. This study compares sutures and adhesive skin glue for laparoscopic port-site skin closure.
Patients And Methods:
A prospective randomised controlled trial was conducted on 100 patients undergoing laparoscopic surgeries at Sagar Hospitals, Bangalore. Patients were randomised into suture and adhesive glue groups. Outcomes assessed included wound closure time (primary outcome), post-operative pain, cosmetic outcome and complications. Patients were followed up for a period of 1 month.
Results:
The mean wound closure time was significantly lower in the glue group (20.3 s) compared to the suture group (165.1 s) ( P < 0.0001). Post-operative pain scores were significantly lower in the glue group in the immediate post-operative period (3 and 12 h), but were comparable between groups at later time points. The Modified Hollander Score, assessing objective cosmesis at 1 month, showed no significant difference between the suture (5.52) and glue groups (5.67) ( P = 0.4256). However, patient-reported cosmetic outcomes were higher in the glue group, with excellent ratings in 80% versus 48% of patients ( P = 0.0009). Descriptive cosmetic scores also favoured the glue group ( P = 0.0051). No significant difference in wound complications was observed between the two groups.
Conclusion:
Tissue adhesive significantly reduces wound closure time and is associated with lower immediate post-operative pain, although this benefit is short lived. Objective cosmetic outcomes are comparable between techniques, whereas improved patient-reported cosmesis may be influenced by lack of blinding. Both methods are safe and effective, and the choice of closure technique should be guided by clinical context and resource considerations.