Objectives: To compare the histopathological and cosmetic outcomes of ethyl-cyanoacrylate to n-butyl-2-cyanoacrylate in rats using an incision
wound model.
Methods: Two longitudinal incisions were made on the dorsal region of the back of 18 Wistar rats after ketamine anesthesia. Rats were divided
into three groups of six: the incisions were closed either using medical tissue adhesive or superglue or were left for secondary wound healing. In
each group, three rats were randomly euthanized on the 7th day. The rest were euthanized on the 21st day of the procedure. Tissue samples taken
on days 7 and 21 were Histopathologically evaluated blindly by a histologist. The cosmetic appearance was evaluated by a plastic surgeon blinded
to the method of closure using a visual analog scale.
Results: Histopathological evaluation revealed impaired epithelialization, inflammation, fibrosis, and dehiscence on connective tissue, and
foreign substance reactions were worse in the ethyl-2-cyanoacrylate group when compared with the other groups. A statistically significant difference
was not found among groups regarding the cosmetic outcome.
Conclusions: Cyanoacrylate glues produced for commercial purposes should not be used for the repair of skin lacerations due to their worse
histopathological results of epithelialization, inflammation, fibrosis, dehiscence on connective tissue, and foreign substance reaction.
Keywords: Lacerations, Wound closure techniques, Tissue adhesives, Cyanoacrylates, Wound healing.
Key Messages
Introduction
Traumatic injuries including lacerations are one of the most encountered problems in the Emergency Department (ED) and account for about 7% to 8% of all ED visits [1, 2]. Lacerations may be closed by one of four commonly available methods or devices: sutures, staples, adhesive tapes, or tissue adhesives. Each technique has some advantages and disadvantages over others [3, 4]. Cyanoacrylate-based tissue adhesives are approved to be used for laceration management. However, there are quite different forms of cyanoacrylate-based adhesives that are marketed as superglues for household and industrial use and as much more expensive forms for medical use. Cyanoacrylate adhesives were invented by Drs. Coover and Joyner in 1942 and globally known as superglues [5]. Methyl-2-cyanoacrylate was used to bond skin and control bleeding in open wounds in the 1950s and 1960s. Disposable sprays were extensively used over wounds to stop bleeding in the Vietnam War. Meanwhile, the Food and Drug Administration (FDA) changed standards and kept requesting additional data since methyl-2-cyanoacrylate provoked acute and chronic tissue reactions [6].
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