A COMPARATIVE STUDY BETWEEN SKIN STAPLER AND CYANOACRYLATE GLUE IN CLEAN ELECTIVE SURGICAL SKIN CLOSURE
Authors: R Dharshini. , Arava Srinivas , T Shivakumar. , Kalita Kakul 
Published: December 2024

Background: Wound closure is done to close dead space, to approximate the wound edges, to support and strengthen the wound until healing, to
reduce infection and bleeding. The choice of wound closure is concerned with easy closure, fast and comfortable recovery of patient, and the better
cosmetic outcome of the scar. Historically, sutures have been the mainstay method for wound closure , in recent years, alternative techniques such
as skin staples and cyanoacrylate adhesives have gained popularity. Surgical stapler and cyanoacrylate glue provide a needle-free method of wound
closure that is easy to use and offers a flexible skin closure. Objectives: The objective of the study is to do a comparative analysis of the ease of
usage and time taken for incision closure, overall postoperative pain and cosmetic outcome of using skin staplers to cyanoacrylate glue in clean
elective surgical skin closures. The study was conducted on 80 patients who underwent clean elective Methods: surgery in Sri Siddhartha Medical
College. The patients were divided into two groups of 40. One of the groups received closures using skin staplers whereas the other group received
closures of skin with cyanoacrylate glue. The study was conducted to compare the ease and duration of closure, postoperative pain overall cosmetic
outcome between the two groups for a period of 18 months between August 2022 to February 2024. The duration of wound closure assessed by
stopwatch. Post operative, pain is assessed using visual analogue scale on POD 0,1, 2, 3, 7, 14 and 28. The wound cosmetic outcome assessed using
modified Hollander Cosmesis scale assessed on POD 2, 4, 7, 14 and 28. Participants were equally distr Results: ibuted (n=80) between the
cyanoacrylate glue and stapler groups. The majority of participants (77.5%) were men. Hernioplasty (78.8%) was the most prevalent surgery,
followed by Excision biopsy (11.3%),. Compared to glue (mean 1.44), stapler showed considerably quicker wound closure times (mean 1:14).
Post-operative pain was assessed on POD 0,1,2,3 and on follow-up based on Visual Analogue Score. The participants in the cyanoacrylate glue
group reported significantly less pain on initial post-operative days as compared with the stapler group. (p = 0.041). After POD 5, the postoperative
pain ratings for the glue and stapler groups were comparable. Post-operative follow-up was done till POD 28, and cosmesis assessment using the
Modified Hollander Scale revealed a highly statistically significant difference between the skin stapler and glue groups (p < 0.05), suggesting that
the glue group has a superior cosmetic outcome compared to the stapler group. This study evaluated t Conclusion: he effectiveness of staplers and
cyanoacrylate glue in closing surgical wounds . Results showed that staplers were faster and is time efficient thereby reducing operative time.
However, cyanoacrylate glue excelled in pain management and cosmetic outcomes, eliminating the need for dressing and allowing patients to
shower after surgery. Both methods have advantages, Staplers are time-saving, while cyanoacrylate glue provides better pain management and
superior cosmetic outcomes. Individual patient factors and surgeon preferences will continue to play a critical role in the choice of closure method.