Comparing tissue adhesive (2-octylcyanoacrylate) to subcuticular vicryl 3/0 skin closure following excision of benign breast masses
Keywords:
Benign breast lumps, octylcyanoacrylates, wound closure.Abstract
Background: Most breast lumps occur in females. They are a course of anxiety because of the fear of cancer and the distortion of the shape of the affected breast. Most women wish to remove such lumps but are also anxious about the resulting scar on their breast. The final arbiter for the optimal management of breast lumps is histology. This involves a biopsy which often requires an incision and consequently, a surgical scar. Several studies comparing various methods of skin closure after open biopsy, and illustrating varying cosmetic results have been reported. However, there is paucity of such studies on breast surgery in our environment.
Aim: This study compared 2-octylcyanoacrylate (OCA) and vicryl 3/0 subcuticular skin closure following excision of palpable benign breast lumps in terms of cosmetic outcomes, wound complication and patient satisfaction.
Methodology: This was a prospective randomised controlled study in which 70 patients were randomly allocated for skin closure of their wounds with either OCA or vicryl 3/0 subcuticular wound closure following breast lump excision biopsy. Cosmetic outcome was assessed using the Hollander wound evaluation scale (HWES) and the visual analogue scale (VAS). Wound management and complication rates, and patients’ satisfaction were also compared. Data was collated and analysed using the statistical package for the social sciences (SPSS) version 23.
Results: A total of 67 patients completed the study and the outcome of 71 wounds was analysed: n = 34 for the tissue adhesive group (OCA) and n = 37 for the vicryl group (SVC). There was no statistically significant difference in age distribution, or educational status between both groups. Both groups had similar cosmetic outcomes when assessed using the Hollander wound evaluation scale (P=0.535) and visual analogue scale (P=0.232) with no statistically significant difference found between both groups. Similarly, patients’ satisfaction and wound complication rates were the same, but OCA had a statistically significant faster skin closure time when compared to SVC (p=0.000).
CONCLUSION
The use of OCA did not give superior cosmetic results following excision of benign breast lumps when compared to SVC but was found to have a faster skin closure. OCA also had similar wound complication rates and thus can be incorporated into the practice of wound closure in our environment.
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