Ann Surg Treat Res.  2020 Sep;99(3):146-152. 10.4174/astr.2020.99.3.146.

Surgical skin adhesive bond is safe and feasible wound closure method to reduce surgical site infection following minimally invasive colorectal cancer surgery

• Lee CS
• Han SR
• Kye BH
• Bae JH
• Koh W
• Lee IK
• Lee DS
• Lee YS

• KMID: 2505486
• DOI: http://doi.org/10.4174/astr.2020.99.3.146

Abstract

Purpose
Minimally invasive colorectal surgery had reduced the rate of surgical site infection. The use of surgical skin adhesive bond (2-octyl cyanoacrylate) for wound closure reduces postoperative pain and provides better cosmetic effect compared to conventional sutures or staples. But role of surgical skin adhesive bond for reducing surgical site infection is unclear. Our objective in this study was to evaluate the role of surgical skin adhesive bond in reducing surgical site infection following minimally invasive colorectal surgery.
Methods
We performed a retrospective analysis of 492 patients treated using minimally invasive surgery for colorectal cancer at Seoul St. Mary’s Hospital, the Catholic University of Korea. Of these, surgical skin adhesive bond was used for wound closure in 284 cases and skin stapling in 208. The rate of surgical site infection including deep or organ/space level infections was compared between the 2 groups.
Results
The rate of superficial surgical site infection was significantly lower in the group using skin adhesive (p = 0.024), and total costs for wound care were significantly lower in the skin adhesive group (p < 0.001).
Conclusion
This study showed that surgical skin adhesive bond reduced surgical site infection and total cost for wound care following minimally invasive colorectal cancer surgery compared to conventional skin stapler technique. Surgical skin adhesive bond is a safe and feasible alternative surgical wound closure technique following minimally invasive colorectal cancer surgery.

Keyword

Cyanoacrylates; Octyl 2-cyanoacrylate; Surgical stapling; Surgical wound infection; Tissue adhesives

Reference

1. Anderson DJ, Podgorny K, Berrios-Torres SI, Bratzler DW, Dellinger EP, Greene L, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014; 35 Suppl 2:S66–S88. PMID: 25376070.

2. Merkow RP, Ju MH, Chung JW, Hall BL, Cohen ME, Williams MV, et al. Underlying reasons associated with hospital readmission following surgery in the United States. JAMA. 2015; 313:483–495. PMID: 25647204.

3. Hedrick TL, Sawyer RG, Friel CM, Stukenborg GJ. A method for estimating the risk of surgical site infection in patients with abdominal colorectal procedures. Dis Colon Rectum. 2013; 56:627–637. PMID: 23575403.

4. Young H, Bliss R, Carey JC, Price CS. Beyond core measures: identifying modifiable risk factors for prevention of surgical site infection after elective total abdominal hysterectomy. Surg Infect (Larchmt). 2011; 12:491–496. PMID: 22142313.

5. Bekelis K, Coy S, Simmons N. Operative duration and risk of surgical site infection in neurosurgery. World Neurosurg. 2016; 94:551–555. PMID: 27485528.

6. Pommerening MJ, Kao LS, Sowards KJ, Wade CE, Holcomb JB, Cotton BA. Primary skin closure after damage control laparotomy. Br J Surg. 2015; 102:67–75. PMID: 25393208.

7. Tong AY, Gupta PK, Kim T. Wound closure and tissue adhesives in clear corneal incision cataract surgery. Curr Opin Ophthalmol. 2018; 29:14–18. PMID: 28902719.

8. 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; 25:899–905. PMID: 20352261.

9. Ando M, Tamaki T, Yoshida M, Sasaki S, Toge Y, Matsumoto T, et al. Surgical site infection in spinal surgery: a comparative study between 2-octyl-cyanoacrylate and staples for wound closure. Eur Spine J. 2014; 23:854–862. PMID: 24487558.

10. Keenan JE, Speicher PJ, Thacker JK, Walter M, Kuchibhatla M, Mantyh CR. The preventive surgical site infection bundle in colorectal surgery: an effective approach to surgical site infection reduction and health care cost savings. JAMA Surg. 2014; 149:1045–1052. PMID: 25163027.

11. Darouiche RO, Wall MJ Jr, Itani KM, Otterson MF, Webb AL, Carrick MM, et al. Chlorhexidine-alcohol versus povidoneiodine for surgical-site antisepsis. N Engl J Med. 2010; 362:18–26. PMID: 20054046.

12. Kim MK, Kim JG, Lee G, Won DD, Lee YS, Kye BH, et al. Comparison of the effects of an ERAS program and a single-port laparoscopic surgery on postoperative outcomes of colon cancer patients. Sci Rep. 2019; 9:11998. PMID: 31427651.

13. Allegranzi B, Bischoff P, de Jonge S, Kubilay NZ, Zayed B, Gomes SM, et al. New WHO recommendations on preoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infect Dis. 2016; 16:e276–e287. PMID: 27816413.

14. Kim ES, Kim HB, Song KH, Kim YK, Kim HH, Jin HY, et al. Prospective nationwide surveillance of surgical site infections after gastric surgery and risk factor analysis in the Korean Nosocomial Infections Surveillance System (KONIS). Infect Control Hosp Epidemiol. 2012; 33:572–580. PMID: 22561712.

15. Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ, et al. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Surg Infect (Larchmt). 2010; 11:79–109. PMID: 20163262.

16. Campbell DA Jr, Henderson WG, Englesbe MJ, Hall BL, O'Reilly M, Bratzler D, et al. Surgical site infection prevention: the importance of operative duration and blood transfusion: results of the first American College of Surgeons-National Surgical Quality Improvement Program Best Practices Initiative. J Am Coll Surg. 2008; 207:810–820. PMID: 19183526.

17. Kwon JY, Yun HG, Park IY. n-Butyl-2-cyanoacrylate tissue adhesive (Histoacryl) vs. subcuticular sutures for skin closure of Pfannenstiel incisions following cesarean delivery. PLoS One. 2018; 13:e0202074. PMID: 30216337.

18. Tacconi L, Spinelli R, Signorelli F. Skin glue for wounds closure in brain surgery: our updated experience. World Neurosurg. 2019; 121:e940–e946. PMID: 30336296.

19. Sahu S, Mishra S, Lenka S, Banerjee R, Pachisia S, Ghosh S. Comparison between N-butyl cyanoacrylate tissue adhesive and Ethilon nylon sutures in extraoral maxillofacial incisions: a randomized prospective study. J Oral Biol Craniofac Res. 2019; 9:173–178. PMID: 31049280.

20. Kim MJ, Park SC, Park JW, Chang HJ, Kim DY, Nam BH, et al. Robot-assisted versus laparoscopic surgery for rectal cancer: a phase II open label prospective randomized controlled trial. Ann Surg. 2018; 267:243–251. PMID: 28549014.

21. Trastulli S, Cirocchi R, Desiderio J, Coratti A, Guarino S, Renzi C, et al. Robotic versus laparoscopic approach in colonic resections for cancer and benign diseases: systematic review and meta-analysis. PLoS One. 2015; 10:e0134062. PMID: 26214845.

22. Singer AJ, Hollander JE, Quinn JV. Evaluation and management of traumatic lacerations. N Engl J Med. 1997; 337:1142–1148. PMID: 9329936.