Comparison of Tissue Adhesive Glue with Subcuticular Absorbable Suture for Skin Closure Following Thyroid Surgery: A single blinded randomized controlled trial

Objectives: The objective of this study was to compare the skin closure time, postoperative pain and the scar outcome between tissue adhesive and sub-cuticular sutures in thyroid surgery. Methods: This was a prospective, single-blinded, randomized controlled trial. A sample size of 64 in each group was calculated. Adult patients undergoing thyroid surgery were included while those with previous neck surgery, history of keloids/hypertrophic scars and those undergoing concomitant neck dissections were excluded. Following platysma closure, they were randomised into two groups - tissue adhesive or subcuticular sutures, using Serially Numbered Opaque Sealed Envelopes technique. The primary outcome was the skin closure time. The secondary outcomes were postoperative pain at 24 hours and scar scoring at 1st and 3rd post-operative month. Statistical analysis was done using SPSS software version 19.0 for Windows. Results: The median skin closure time and postoperative pain was significantly lower in the tissue adhesive group as compared to the suture group (p<0.01). However, there was no statistically significant difference in scar outcome at 1st month (p=0.088) and in 3rd month (p=0.137) between the two groups. There were no wound-related complications in either group. It was seen on a subgroup analysis that there was no difference in the scar outcome or wound-related complications in patients with comorbidities. There were no instances of allergic contact dermatitis to the tissue adhesive. Conclusion: The use of tissue adhesive leads to lower operative time and less post-operative pain in thyroid surgeries. The scar outcome is comparable between tissue adhesives and subcuticular sutures. Keywords: Thyroidectomy; scar; tissue glue; subcuticular suture