tOPICAL sKIN aDHESIF

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Dermabond Advanced®

DERMABOND ADVANCED®
Topical Skin Adhesive
Evidence Brief
Overview
As the final layer of wound closure, topical skin adhesives (TSAs) are an integral part of a successful clinical
outcome. When deciding which TSA to use, clinical study information on closure strength, microbial
protection, patient comfort, and cosmesis allows healthcare practitioners to evaluate which product will
provide the greatest benefits for their patients.

DERMABOND ADVANCED® Topical Skin Adhesive is supported by an extensive body of published literature,
including 51 randomized controlled trials (RCTs). DERMABOND ADVANCED Adhesive has a patented,
proprietary chemical formulation1 that has been shown to provide superior strength versus other
commercially available TSAs,2 and also has benefits that enhance patient comfort and cosmetic outcomes.3-6

This Evidence Summary includes a sample of the available RCTs for DERMABOND® Topical Skin Adhesive.
A full list of published studies can be found in the bibliography section of this document.
• DERMABOND ADVANCED Adhesive is Supported by 51 Published RCTs*†‡
• Total of 5,718 Patients Evaluated

References
1. Data on File. Ethicon, Inc. LAB0012182DNX12.
2. Singer AJ, Perry LC, Allen RL. In vivo study of wound-bursting strength and compliance of topical skin adhesives. Acad Emerg Med. 2008;15(12):1290-1294.
3. Nipshagen MD, Hage JJ, Beekman W. Use of 2-octyl-cyanoacrylate skin adhesive (Dermabond) for wound closure following reduction mammaplasty: a
prospective, randomized intervention study. Plast Reconstr Surg. 2008;122:10-18.
4. Scott GR, Carson CL, Borah G. Dermabond skin closures for bilateral reduction mammaplasties:a review of 255 consecutive cases. Plast Reconstr Surg.
2007;120:1460-1465.
5. Toriumi DM, O’Grady K, Desai D, Bagal A. Use of octyl-2-cyanoacrylate for skin closure in facial plastic surgery. Plast Reconstr Surg. 1998;102:2209-2219.
6. Quinn J, Wells G, Sutcliffe T, et al. A randomized trial comparing octylcyanoacrylate tissue adhesive and sutures in the management of lacerations. JAMA.
1997;277(19):1527-1530.

*DERMABOND ADVANCED Adhesive tests equivalent or superior to DERMABOND Adhesive in head-to-head testing for microbial barrier, wound-bursting
strength, tensile strength, flexibility, durability, viscosity, drying time, water vapor transmission rate, water resistance, and physician satisfaction.

†Based on published literature in PubMed and SCOPUS, using only RCTs that evaluated the use of the product in a manner consistent with intended indication.
‡Based on search results in Pubmed and SciFinder databases in October 2016.
Summary of Key Studies
The publications that support the claims for DERMABOND ADVANCED® Topical Skin
Adhesive are listed in the table below. A summary of each of these studies can be found
on the subsequent pages.

Publication Lead Source Outcome


Title Author Studied

In vitro Bhende Surgical Microbial


Assessment of Infections. Barrier
Microbial Barrier 2002;3(3):251-257.
Properties of
DERMABOND®
Topical Skin
Adhesive

In vitro study Bhende Data on File. Inhibition of


to determine the Ethicon, Inc. Bacteria
ability of DERMABOND
ADVANCED® Topical
Skin Adhesive to
inhibit bacterial growth

In Vivo Study of Singer Academic Strength


Wound Bursting Emergency and
Strength and Medicine. Flexibility
Compliance of 2008;15(12):1290–1294.
Topical Skin Adhesives

Postoperative Outcomes Murrmann Surgical Hospitalization


Associated with Topical Infections. Costs
Skin Adhesives among 2010;11(5):441-447.
Women Having
Hysterectomies

A Randomized Quinn JAMA. Cosmesis,


Trial Comparing 1997;277(19):1527-1530. Time, Pain
Octylcyanoacrylate
Tissue Adhesive
and Sutures in the
Management of
Lacerations

2
Clinical Reference Article Summary

In Vitro Assessment of Microbial Barrier Properties of


DERMABOND® Topical Skin Adhesive
Bhende S, Rothenburger S, Spangler D, Dito M

Source:
Surgical Infections. 2002;3(3):251-257

Study Objective
The purpose of this study was to evaluate the ability of DERMABOND Adhesive to provide an effective
microbial barrier against the penetration of microorganisms in vitro.
Bacteria used in this study included:
Staphylococcus aureus
Staphylococcus epidermidis
Escherichia coli
Pseudomonas aeruginosa
Enterococcus faecium

Method
Plates containing an agar media were created in a sterile environment. The agar media contained
a pH-sensitive dye designed to color when exposed to the acidic metabolic products of bacteria.
DERMABOND Adhesive was applied to the agar surface. In total, 300 single-layer films and 300 triple-layer
films were examined. The surface of each film was inoculated with a 10 μL aliquot of bacteria containing
at least 1x103 cfu.
All test and control plates were incubated at 37°C for 72 hours. A change in color indicated a breach
in the adhesive’s microbial barrier.

Results
Single-layer films: 299 of the 300 samples retained their integrity as microbial barriers for 72 hours.
All 300 samples maintained their microbial barrier for 48 hours.
For the triple-layer films, 299 of the 300 samples retained their integrity as microbial barriers for 72 hours.

Conclusion
The results of this study demonstrate that DERMABOND Adhesive provides a microbial barrier with
99% protection in vitro for at least 72 hours against organisms commonly responsible for SSIs, including:
Staphylococcus epidermidis, Staphylococcus aureus , Escherichia coli, Pseudomonas aeruginosa, and
Enterococcus faecium.

3
Clinical Reference Article Summary

In vitro study to determine the ability of


DERMABOND ADVANCED® Topical Skin Adhesive
to inhibit bacterial growth
Bhende S

Source:
Data on File. Ethicon, Inc.

Study Objective
The purpose of this study was to demonstrate that DERMABOND ADVANCED Adhesive inhibits
gram-positive bacteria and gram-negative bacteria in vitro.
Bacteria evaluated in this study:
Methicillin-resistant Staphylococcus aureus (MRSA)
Methicillin-resistant Staphylococcus epidermidis (MRSE)
Escherichia coli

Method
Cultures of each organism were grown under sterile conditions for 18-24 hours at 35-37°C. Before being used
in the experiment, each culture was diluted to achieve an approximate bacteria count of 105 cfu/0.04 ml.
A 2cm diameter circle was drawn on the bottom of a sterile agar plate. In the center of this circle, 0.04 ml of
the diluted inoculum was placed on the surface of the agar.
After allowing the inoculum to dry, the adhesive material was applied to the inoculated surface area, making
sure to cover the area beyond the marked circle.
After 10 minutes of contact time between the adhesive and the inoculated area, the adhesive’s polymerized
film was removed from the surface of the agar, and the plates were incubated at 37°C for up to 48 hours.
In total, 210 samples (70 samples per organism) were evaluated. The samples were examined for bacterial
growth at 24 and 48 hours. Any growth originating beneath the area of adhesive application was recorded as
a positive test.

Results
After 48 hours, the test plates exhibited colony counts ranging from 0 – 59 cfu, indicating significant
inhibition of the bacteria.
Each inoculated plate was declared a success if a minimum of 99.9% inhibition of the initial inoculum load
was observed. For all bacteria evaluated (MRSA, MRSE, E. coli), contact with the adhesive led to a 99.9%
inhibition in bacteria load from the initial inoculum.

Conclusion
In this in vitro study, DERMABOND ADVANCED Adhesive was shown to demonstrate inhibition of
gram-positive bacteria (MRSA, MRSE) and gram-negative bacteria (E. coli).*

*Clinical significance is unknown. 4


Clinical Reference Article Summary

In Vivo Study of Wound Bursting Strength and Compliance


of Topical Skin Adhesives
Singer AJ, Perry LC, Allen Jr. RL

Source:
Academic Emergency Medicine. 2008;15(12):1290–1294

Study Objective
The purpose of this study was to evaluate the wound-bursting strength and flexibility of five topical skin
adhesives during the two day period after wound closure.
The following adhesives were evaluated in the study:
DERMABOND® Topical Skin Adhesive
INDERMIL® Tissue Adhesive
Histoacryl® Topical Skin Adhesive
LiquiBand® Topical Skin Adhesive
GluStitch®

Method
Using a template for incision length and location, two symmetric incisions (2cm long each) were created
over the dorsolateral flank area of 210 anesthetized, male Sprague-Dawley rats.
After achieving hemostasis and manually approximating the skin edges, a randomized computer algorithm was
used to select an adhesive to close the incision. All adhesives were applied according to manufacturer’s instructions.
The adhesives were evaluated three times during the study – immediately after closure, 1 day after closure,
and 2 days after closure.
For each evaluation, 14 samples from each adhesive group were tested for wound-bursting strength, and
another 14 samples were tested for flexibility.
To test for wound-bursting strength, a vacuum chamber was placed over each sample and negative
pressure was applied, stressing the wound in 3 dimensions. The pressure (mmHg) needed to cause wound
failure was recorded.
To test for flexibility, a vacuum chamber was placed over the sample and negative pressure was applied
to the wound while a laser measured the vertical deformation of the skin (μm). Energy absorption
(mmHg x mm) was calculated to quantify the adhesives’ flexibility.

The third-party trademarks used herein are trademarks of their respective owners. 5
Results
Figure 1 Figure 2 Figure 3
Wound-bursting Strength Percent of Samples with Visible Fractures Flexibility of Five Topical Skin Adhesives

Percentage of compliance samples not tested


100

Tissue adhesive flexibility (mm Hg/mm)


450 90
400 80 40
350 70 35
WBS (mm Hg)

300 60 30
250 50 25
200 40 20
150 30 15
100 20 10
50 10 5
0 0 0
Immediate Day 1 Day 2 Day 1 Day 2 Immediate Day 1 Day 2

DERMABOND® Histoacryl® With the exception of the samples As seen in Figure 3, for the samples
Adhesive LiquiBand™ in the DERMABOND® Topical Skin that maintained their integrity
Indermil® GluStitch® Adhesive group, measurements through the testing, the samples in
could not be taken on all samples in the DERMABOND Adhesive group
In total, 210 measurements were an adhesive group because, in some consistently had the greatest
taken on 210 incisions (5 adhesives, samples, the adhesive’s inflexibility flexibility. Additionally, across all
3 time points, 14 samples per time had caused the adhesive to fracture adhesive groups, the adhesive’s
point). Results are shown in Figure 1. during testing. flexibility decreased over time.
As shown in Figure 2, the percent
of samples in an adhesive group
experiencing fractures ranged from
36% to 86%.

Conclusion
The results of this study demonstrate that DERMABOND Adhesive was significantly stronger and more
flexible than the other adhesives evaluated in the study.*

*This study was funded in full or in part by an educational grant from Ethicon, Inc.

The third-party trademarks used herein are trademarks of their respective owners. 6
Clinical Reference Article Summary

Postoperative Outcomes Associated with Topical Skin


Adhesives among Women Having Hysterectomies
Murrmann SG, Markowitz JS, Gutterman EM, Magee G

Source:
Surgical Infections. 2010;11(5):441-447

Study Objective
The purpose of this study was to evaluate the clinical and economic outcomes associated with use of a topical
skin adhesive (TSA) versus traditional methods for skin closure following total abdominal hysterectomy.

Method
The study utilized Premier, Inc.’s Perspective™ Comparative Database, which is a large, administrative
database containing clinical and economic data from all patient discharge records at more than 400 US
hospitals.
Any patient in the database who was discharged from a hospital in 2005 following a total abdominal
hysterectomy was included in the study.
The subjects were classified into one of four treatment groups based on the clinical method used to close
the surgical incision:
• Sutures • Staples • TSA • Staples and TSA
While the study was open to all commercially available TSAs, at the time of the study the only TSA used on
patients in the database was DERMABOND® Topical Skin Adhesive. Thus, the TSA group only had patients
treated with DERMABOND Adhesive.
All treatment groups were assessed on three continuous outcomes: length of inpatient stay, total inpatient
cost, and days of antibiotic treatment. Length of stay and inpatient cost was available directly from the
database; antibiotic treatment days were estimated using the last date when at dose of antibiotic was
administered.

Results Figure 1
Distribution of Skin Closure Method
In total, 46,011 patients were included in the study.
The method of wound closure for these patients Skin Closure Method # of Patients (n)
is summarized in Figure 1: Evaluated in Study
Due to the large sample size, there were no Sutures 21,201
statistically significant differences in the clinical, Staples 23,441
demographic, or hospital characteristics of the
TSA 880
four treatment groups.
Staples
489
and TSA

All Methods 46,011

7
Length of Stay (LOS) and Total Costs Figure 2
LOS and Total Costs by Closure Method
A summary of mean LOS and total
hospitalization costs is shown in Figure 2. Skin Closure Mean LOS Mean Total
Method Evaluated (days) Hospitalization
While the difference in total costs in Study Costs
between suture and TSA groups did
Sutures 3.9 $5,862
not meet the significance requirement
for this study (p≤0.01), the difference Staples 4.5 $6,965
suggests lower total costs for the TSA 3.7 $5,816
TSA group (p=0.039).
Staples 5.2 $9,434
and TSA

Conclusions
The results of this study demonstrate that the clinical and economic outcomes were consistently worse
when staples were used to close an incision compared with use of suture or TSA alone.

The clinical outcomes resulting from the use of DERMABOND Adhesive to close wounds were at least as
good as the outcomes resulting from the use of suture to close wounds.

Additionally, there is evidence that the total costs of hospitalization for total hysterectomy patients may
be less when the incision is closed with DERMABOND Adhesive versus sutures or staples.*

*This study was funded in full or in part by an educational grant from Ethicon, Inc. 8
Clinical Reference Article Summary

A Randomized Trial Comparing Octylcyanoacrylate Tissue


Adhesive and Sutures In the Management of Lacerations
Quinn J, Wells G, Sutcliffe T, Jarmuske M, Maw J, Stiell I, Johns P

Source:
JAMA. 1997;277(19):1527-1530

Study Objective
The purpose of this study was to assess whether using DERMABOND® Topical Skin Adhesive for laceration
repair is an effective alternative to suturing.

Method
Patients with non-mucosal facial lacerations as well as certain extremity and torso lacerations, but not on
hands, feet or joints, were eligible for this study.
Using a computer algorithm, patients were prospectively segregated into facial and non-facial groups and
randomized into two groups – DERMABOND Adhesive and sutures.
In the suture group, lacerations were anesthetized and cleaned, as needed, before repair with a 5-0 or 6-0
monofilament suture. A dressing was applied for at least 48 hours.
In the DERMABOND Adhesive group, lacerations were cleaned with chlorhexidene, and hemostasis was
achieved using pressure or topical 1:1000 epinephrine. The wound edges were manually approximated and
the adhesive was applied to the surface of the skin, covering the wound edges. The wound was held in place
for 30 seconds. No dressing was applied.
The primary outcome was the cosmetic appearance of the scar, evaluated by a blinded plastic surgeon using
a photograph of the wound taken three months after closure.
On two occasions, the surgeon examined the photograph and provided a cosmesis score based on a
validated 100-mm visual analog scale, ranging from “best scar” to “worst scar.”
Additionally, time of procedure, patient pain, and wound complications (i.e., dehiscence, infection) were
recorded. Time of procedure was evaluated from start of wound care to complete closure; patient pain
and wound complications were recorded on a previously validated scale.
Wound complication was initially evaluated at 3-5 days for facial and at 10-14 days for torso and extremity
lacerations. A second assessment occurred 3 months after closure.

Results Figure 1
Patient Retention During Study
In total, 130 patients with 136
lacerations were included in the DERMABOND Adhesive Suture
study. As summarized in Figure 1,
an equal number of lacerations Randomized 68 68
(68 per group) were randomized Initial follow-up 53 53
to the suture and DERMABOND
3 month follow-up 55 50
Adhesive groups.
Withdrawn 1 1
Lost to follow-up 12 17
No Photographs 5 2

Completed Study 50 48

9
As shown in Figure 2, there was no Figure 2
significant difference in the blinded, Summary of Observed Clinical Outcomes
3-month cosmetic score of the
DERMABOND® Topical Skin DERMABOND Suture (p) Value
Adhesive
Adhesive group compared with
the suture group. Similarly, there Mean Cosmetic
67 68 0.65
Score (mm)
was no significant difference in
wound complications between the % Optimal Wound
80% 82% 0.80
Scores (initial eval)
suture group and the DERMABOND
Adhesive group. Statistically % Optimal Wound
72% 75% 0.74
Scores (3 month eval)
significant differences were seen for
patient pain and procedure time. Mean Pain
7.2 18.0 <0.001
Scores (mm)
Mean Time of
3.6 12.4 <0.001
Procedure (min)

Conclusions
The results of this study demonstrate that DERMABOND Adhesive produces cosmetic results similar to
suturing on certain types of lacerations.

Additionally, lacerations closed with DERMABOND Adhesive were associated with shorter procedure time
and less patient pain than lacerations closed with sutures.*

*This study was funded in full or in part by an educational grant from Ethicon, Inc. 10
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Bibliography
Listed below are all of the currently published RCTs that have evaluated the use of DERMABOND® Topical
Skin Adhesive in an application consistent with the indication in the product’s label (e.g. skin closure). Studies
that evaluated the use of DERMABOND Adhesive for purposes inconsistent with the intended indication
were excluded from the bibliography.

Amin M, Glynn F, Timon C. Randomized trial of tissue adhesive vs staples in thyroidectomy integrating patient satisfaction and Manchester score.
Otolaryngol Head Neck Surg. 2009;140(5):703-8.

Blondeel, PNV, Murphy JW, Debrosse D, Nix III JC, Puls LE, Theodore N, Coulthard P. Closure of long surgical incisions with a new formulation of
2-octylcyanoacrylate tissue adhesive versus commercially available methods. Am J Surg. 2004;188(3):307-313.

Brown JK, Campbell BT, Drongowski RA, Alderman AK, Geiger JD, Teitelbaum DH, Quinn J, Coran AG, Hirschl RB. A prospective, randomized comparison
of skin adhesive and subcuticular suture for closure of pediatric hernia incisions: cost and cosmetic considerations. J Pediatr Surg. 2009;44(7):1418-1422.

Bruns TB, Robinson BS, Smith RJ, Kile DL, Davis TP, Sullivan KM, Quinn JV. A new tissue adhesive for laceration repair in children. J Pediatr.
1998;132(6):1067-1070.

Carleo C, Singer AJ, Thode HC Jr. Effect of frequent water immersion on the rate of tissue adhesive sloughing: a randomized study. CJEM. 2005;7(6):391-395.

Chen K, Klapper AS, Voige H, Del Priore G. A randomized, controlled study comparing two standardized closure methods of laparoscopic port sites. JSLS.
2010;14(3):391-394.

El-Gazzar Y., Smith D.C., Kim S.J., Hirsh D.M., Blum Y., Cobelli M., Cohen H.W. The Use of Dermabond® as an Adjunct to Wound Closure After Total Knee
Arthroplasty: Examining Immediate Post-Operative Wound Drainage. J Arthroplasty. 2013;28:553-556.

Eymann R, Kiefer M. Glue instead of stitches: a minor change of the operative technique with a serious impact on the shunt infection rate. Acta Neurochir
Suppl. 2010;106:87-89.

Gennari R, Rotmensz N, Ballardini B, Scevola S, Perego E, Zanini V, Costa A. A prospective, randomized, controlled clinical trial of tissue adhesive
(2-octylcyanoacrylate) versus standard wound closure in breast surgery. Surgery. 2004;136(3):593-599.

Greene D, Koch RJ, Goode RL. Efficacy of octyl-2-cyanoacrylate tissue glue in blepharoplasty. A prospective controlled study of wound-healing
characteristics. Arch Facial Plast Surg. 1999;1(4):292-296.

Handschel JG, Depprich RA, Dirksen D, Runte C, Zimmermann A, Kübler NR. A prospective comparison of octyl-2- cyanoacrylate and suture in standardized
facial wounds. Int J Oral Maxillofac Surg. 2006;35(4):318-323.

Holger JS, Wandersee SC, Hale DB. Cosmetic outcomes of facial lacerations repaired with tissue-adhesive, absorbable, and nonabsorbable sutures.
Am J Emerg Med. 2004;22(4):254-257.

Hollander JE, Singer AJ. Application of tissue adhesives: rapid attainment of proficiency. Acad Emerg Med. 1998;5(10):1012-1017

Jallali N, Haji A, Watson CJ. A prospective randomized trial comparing 2-octyl cyanoacrylate to conventional suturing in closure of laparoscopic
cholecystectomy incisions. J Laparoendosc Adv Surg Tech A. 2004;14(4):209-211.

Kent A., Liversedge N., Dobbins B., McWhinnie D., Jan H. A prospective, randomized, controlled, double-masked, multi-center clinical trial of medical adhesives
for the closure of laparoscopic incisions. J Minim Invasive Gynecol. 2014;21:252-258.

Khan RJ, Fick D, Yao F, Tang K, Hurworth M, Nivbrant B, Wood D. A comparison of three methods of wound closure following arthroplasty: a prospective,
randomised, controlled trial. J Bone Joint Surg Br. 2006;88(2):238-242.

Koonce SL, Eck DL, Shaddix KK, Perdikis G. A prospective randomized controlled trial comparing N-butyl-2 cyanoacrylate (Histoacryl), octyl cyanoacrylate
(Dermabond), and subcuticular suture for closure of surgical incisions. Ann Plast Surg. 2015;74:107-110.

Krishnamoorthy B, Najam O, Khan UA, Waterworth P, Fildes JE, Yonan N. Randomized prospective study comparing conventional subcuticular skin closure
with Dermabond skin glue after saphenous vein harvesting. Ann Thorac Surg. 2009;88(5):1445-1449.

Maartense S, Bemelman WA, Dunker MS, de Lint C, Pierik EG, Busch OR, Gouma DJ. Randomized study of the effectiveness of closing laparoscopic trocar
wounds with octylcyanoacrylate, adhesive papertape or poliglecaprone. Br J Surg. 2002;89(11):1370-1375.

Maloney J, Rogers GS., Kapadia M. A prospective randomized evaluation of cyanoacrylate glue devices in the closure of surgical wounds. J Drugs Dermatol.
2013;12:810-814.

Man SY, Wong EM, Ng YC, Lau PF, Chan MS, Lopez V, Mak PS, Graham CA, Rainer TH. Cost-consequence analysis comparing 2-octyl cyanoacrylate tissue
adhesive and suture for closure of simple lacerations: A randomized controlled trial. Ann Emerg Med. 2009;53(2):189-197.

Martin JG, Hollenbeck ST, Janas G, Makar RA, Pabon-Ramos WM, Suhocki PV, Miller MJ, Sopko DR, Smith TP, Kim CY. Randomized controlled trial of octyl
cyanoacrylate skin adhesive versus subcuticular suture for skin closure after implantable venous port placement. J Vasc Interv Radiol. 2017;28:111-116.

Mota R, Costa F, Amaral A, Oliveira F, Santos CC, Ayres-De-Campos D. Skin adhesive versus subcuticular suture for perineal skin repair after episiotomy -
A randomized controlled trial. Acta Obstet Gynecol Scand. 2009;88(6):660-666.

Mudd CD, Boudreau JA, Moed BR. A prospective randomized comparison of two skin closure techniques in acetabular fracture surgery. J Orthop Traumatol.
2014;15:189-194.

12
Nipshagen MD, Hage JJ, Beekman WH. Use of 2-octyl-cyanoacrylate skin adhesive (Dermabond) for wound closure following reduction mammaplasty:
A prospective, randomized intervention study. Plast Reconstr Surg. 2008;122(1):10-18.

Ong CC, Jacobsen AS, Joseph VT. Comparing wound closure using tissue glue versus subcuticular suture for pediatric surgical incisions: A prospective,
randomised trial. Pediatr Surg Int. 2002;18(5-6):553-555.

Ong J, Ho KS, Chew MH, Eu KW. Prospective randomised study to evaluate the use of DERMABOND ProPen (2- octylcyanoacrylate) in the closure of
abdominal wounds versus closure with skin staples in patients undergoing elective colectomy. Int J Colorectal Dis. 2010;25(7):899-905.

Osmond MH, Quinn JV, Sutcliffe T, Jarmuske M, Klassen TP. A randomized, clinical trial comparing butylcyanoacrylate with octylcyanoacrylate in the
management of selected pediatric facial lacerations. Acad Emerg Med. 1999;6(3):171-177.

Patel HM, Shah MJ, Duttaroy DD, Kacheriwala SM, Patel SJ, Patel RM. Superiority of octyl-2 cyanoacrylate over polyamide black for surgical site incisions.
Prospective randomized trial. Surg Chron. 2013; 18(3):139-143.

Pronio A, Di Filippo A, Narilli P, Caporillli D, Vestri A, Ciamberlano B, Pelle F, Montesani C. Closure of cutaneous incision after thyroid surgery: A comparison
Quinn J, Wells G, Sutcliffe T, Jarmuske M, Maw J, Stiell I, Johns P. A randomized trial comparing octylcyanoacrylate tissue adhesive and sutures in the
management of lacerations. JAMA. 1997;277(19):1527-1530.

Ridgway DM, Mahmood F, Moore L, Bramley D, Moore PJ. A blinded, randomised, controlled trial of stapled versus tissue glue closure of neck surgery
incisions. Ann R Coll Surg Engl. 2007;89(3):242-246.

Romero P, Frongia G, Wingerter S, Holland-Cunz S. Prospective, randomized, controlled trial comparing a tissue adhesive (Dermabond) with adhesive strips
(Steri-Strips) for the closure of laparoscopic trocar wounds in children. Eur J Pediatr Surg. 2011;21(3):159-162.

Sebesta MJ, Bishoff JT. Octylcyanoacrylate skin closure in laparoscopy. JSLS. 2004;8(1):9-14.

Shamiyeh A, Schrenk P, Stelzer T, Wayand WU. Prospective randomized blind controlled trial comparing sutures, tape, and octylcyanoacrylate tissue
adhesive for skin closure after phlebectomy. Dermatol Surg. 2001;27(10):877-880.

Siddiqui M, Bidaye A, Baird E, Abu-Rajab R, Stark A, Jones B, Ingram R, Anthony I. Wound dressing following primary total hip arthroplasty: A prospective
randomised controlled trial. J Wound Care. 2016;25-40.

Singer AJ, Giordano P, Fitch JL, Gulla J, Ryker D, Chale S. Evaluation of a new high-viscosity octylcyanoacrylate tissue adhesive for laceration repair: a
randomized, clinical trial. Acad Emerg Med. 2003;10(10):1134-1137.

Singer AJ, Hollander JE, Valentine SM, Turque TW, McCuskey CF, Quinn JV. Prospective, randomized, controlled trial of tissue adhesive (2- octylcyanoacrylate)
vs standard wound closure techniques for laceration repair. Acad Emerg Med. 1998;5(2):94-99.

Sniezek PJ, Walling HW, DeBloom JR 3rd, Messingham MJ, VanBeek MJ, Kreiter CD, Whitaker DC, Arpey CJ. A randomized controlled trial of high-viscosity
2-octyl cyanoacrylate tissue adhesive versus sutures in repairing facial wounds following Mohs micrographic surgery. Dermatol Surg. 2007;33(8):966-971.

Soni A, Narula R, Kumar A, Parmar M, Sahore M, Chandel M. Comparing cyanoacrylate tissue adhesive and conventional subcuticular skin sutures for
maxillofacial incisions - A prospective randomized trial considering closure time, wound morbidity, and cosmetic outcome. J Oral Maxillofac Surg. 2013
Dec;71(12):2152.e1-8.

Spencker S, Coban N, Koch L, Schirdewan A, Mueller D. Comparison of skin adhesive and absorbable intracutaneous suture for the implantation of cardiac
rhythm devices. Europace. 2011;13:416-420.

Strauss EJ, Weil WM, Jordan C, Paksima N. A prospective, randomized, controlled trial of 2-octylcyanoacrylate versus suture repair for nail bed injuries. J Hand
Surg Am. 2008;33(2):250-253.

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