Efficacy of Octyl-Cyanoacrylate Dermabond Adhesive Glue versus Polyglactin 3/0 Suture for Closure of Caesarean Section Skin Incision - A Prospective Randomised Controlled Trial

Abstract

This was a prospective randomised controlled trial conducted at a tertiary hospital on 82 women who underwent caesarean section aiming to assess the efficacy of octyl-cyanoacrylate tissue adhesive glue versus polyglactin 3/0 suture for the closure of caesarean sections skin incision. The study group consisted of 41 women who underwent skin closure using octyl-cyanoacrylate tissue adhesive glue, whereas 41 women in the control group had subcuticular skin closure using polyglactin 3/0 sutures. The choice of anaesthesia, prophylactic antibiotic, operative technique, and immediate post-operative oral analgesia was standardised between the two groups. Time taken for skin closure, pain score at day 2 and 14, the total analgesia dose needed and duration (day two onwards), and any adverse events were recorded. The time required for skin closure was significantly less in the study group, with a mean difference of 97.7 seconds (170.8 seconds vs 268.5 seconds, p<0.001). Pain scores on day 2 were similar between the two groups (4.0 vs 5.0, p=0.09), whereas pain score on day 14 was significantly lower in the study group (2.0 vs 4.0, p<0.001). The median duration (day two onward) of oral analgesia use was four days in the study group and six days in the control group. The difference was statistically significant (p=<0.001). The median amount of additional analgesia required was a third less in the tissue adhesive group than in the control group. On day 14, surgical site infection was similar in both groups. In conclusion, octyl-cyanoacrylate tissue adhesive glue may safely close a caesarean section skin incision. It was associated with faster application, lesser pain score, and lesser need for analgesia without additional adverse events compared to the conventional suturing method.