Use of Cyanoacrylate N-Butyl Versus Subcuticular Suture in the Dermal Closure Following Cesarean Delivery: A Randomized Controlled Trial

Background: Currently the use of tissue adhesives for surgical wound closure has multiplied; however, its use in cesarean sections is still not well determined. The objective of this study was to compare the surgical wound healing following cesarean sections between N-butyl cyanoacrylate (Tisuacryl) and suture (Monocryl 2-0). Methods: A randomized, non-blinded controlled clinical trial was conducted from October 2017 to March 2018 at the Instituto Nacional de Perinatologia. Forty women undergoing cesarean delivery were randomly assigned to skin closure group using a random number table: 20 with N-butyl cyanoacrylate (Tisuacryl) (cases group) and 20 with Monocryl (control group). Scars were evaluated at 24 h, 1 week, 1 month and 3 months. Primary objective was to evaluate the esthetics of the scar with the scar cosmesis assessment and rating (SCAR) scale. Secondary objectives were skin closing time, the satisfaction of the patient and the satisfaction of the surgeon. Results: Demographic characteristics, including average age, body mass index and number of pregnancies, were similar in both groups. The skin closing time showed a significant decrease with a P value of 0.000 between Tisuacryl and Monocryl (54.95 ± 10.353 s in the first group vs. 407.5 ± 72.61 s). The esthetic evolution of surgery using the SCAR scale showed a better evolution in the first visits (weekly and monthly) in the Monocryl group (2.05 ± 0.60 and 1.68 ± 0.477) vs. Tisuacryl (2.77 ± 0.685 and 2.55 ± 0.74) with a P value of 0.001 in SCAR 1 (first visit) and 0.000 in SCAR 2 (second visit). However, no significant differences were observed in the last result at 3 months (SCAR 3). Similarly, no significant differences were observed regarding the satisfaction of the surgeon or the patient. Conclusions: The results of skin healing with Tisuacryl vs. Monocryl were similar in terms of the esthetics and satisfaction of the patient or the surgeon. Therefore, the use of each one depends on surgeon/patient preferences and the availability of materials. J Clin Gynecol Obstet. 2019;8(3):85-90 doi: https://doi.org/10.14740/jcgo560