Division

North Florida

Hospital

Orange Park Medical Center

Document Type

Presentation

Publication Date

10-11-2020

Keywords

tissue adhesives, surgical fixation devices

Disciplines

Dermatology | Equipment and Supplies | Neoplasms | Skin and Connective Tissue Diseases

Abstract

Background: The utilization of tissue adhesives for wound closure has historically been well established in the emergency department setting. More recently, it has been adopted by dermatologists and other surgical specialties as an alternative or adjunct to more traditional bilayered wound closures.

Purpose: This serves as a comprehensive review of the available scientific literature on the utilization of tissue adhesives compared to traditional bilayered closures. We discuss benefits, drawbacks, as well as novel surgical techniques, as applicable to dermatologic surgery.

Methods: A literature review was performed using Pubmed and MEDLINE for relevant articles related to the use of adhesives and adhesive strips in the surgical setting for skin closure. References of incorporated articles were also reviewed for possible inclusion in our review.

Results: We discuss the various options of tissue adhesives, indications, uses, and optimal anatomic locations. Several studies demonstrate equivalent cosmesis of adhesives compared to standard bilayered closure for linear facial wounds, however adhesives may yield poorer cosmesis on the trunk and extremities.1-7 Application is faster than epidermal suturing and it requires less wound care, however drawbacks include possible increased scar pigmentation, lack of eversion, risk of allergic contact dermatitis, and increased risk of wound dehiscence.1-7 The incorporation of several new surgical techniques utilizing adhesives or adhesive strips as an adjunct to more traditional methods may allow for primary closure in thin, atrophied skin that otherwise would not have enough integrity to support sutures.7-8 Tissue adhesives have been utilized as a method for securing both split-thickness and full-thickness skin grafting,9-11 as well as a for achieving and maintaining hemostasis.12 Furthermore, adhesives can be applied to excised tissue specimens to improve ease of handling during histologic processing of Mohs micrographic surgery tissue specimens.13

Conclusion: In the appropriate dermatologic setting, adhesives can serve as a safe and effective suture alternative. It is important to consider surgical site location, defect size, wound tension, patient compliance, and risk of dehiscence when considering closure method. Novel techniques utilizing adhesives or adhesive strips are continuously emerging in the literature as a means to assist in multiple aspects of dermatologic surgery.

Comments

Please contact the authors with any questions.

Publisher or Conference

American Society for Dermatologic Surgery

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