Tissue glue as an alternative method of skin approximation in patients undergoing circumcision – a one year randomized controlled trial at KLES Dr. Prabhakar Kore Hospital and MRC

Abstract

Background and objectives Traditionally, the circumcision wound was closed by absorbable sutures. Recently the use of tissue adhesive had evoked immense interest in the field of wound healing. This study was planned to compare tissue glue approximation with conventional suture method in terms of time consumed and incidence of infection in patients undergoing circumcision. Methodology This one year randomized controlled trial was performed on a total of 70 patients undergoing circumcision at Department of General Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum from January 2013 to December 2013. Patients were randomized by assigning even numbers to patients in group B (skin approximation by cyanoacrylate tissue glue) and odd number to those in group A (skin approximation by suture method). Operative time was noted and patients were examined for infection and other complication on the post operative day three and seven and. Results Majority of the patients were in the age group of three to six years (82.86% in group A and 80% in group B; p=1.000). The mean age was comparable in group A and B (5.51 ± 2.65 vs 5.32 ± 2.75 years; p=0.771). Further the clinical presentation, indications for circumcision, clinical examination findings and surgical characteristics were comparable in group A and B (p>0.050). Surgical time in group B was significantly less compared to group A with a difference of nearly more than five minutes (19.14 ± 5.54 vs 24.97 ± 3.93 minutes; p<0.001). On day three wound assessment, significantly lower rate of complications was noted among the patients with group B regard to tenderness and oedema (p<0.050). During day seven assessment also significantly lower number of patients had oedema and discharge in group B compared to group A (p<0.050). Conclusion and interpretation Skin approximation by cyanoacrylate tissue glue results in significant reduction of surgical time with lower rates of complications compared to skin approximation by suture method.