A Randomized Controlled Trial of High-Viscosity 2-Octyl Cyanoacrylate Tissue Adhesive versus Sutures in Repairing Facial Wounds Following Mohs Micrographic Surgery


Address correspondence and reprint requests to: Hobart W. Walling, MD, PhD, 6000 University, Suite 450, West Des Moines, IA 50266, or e-mail: hobartwalling@yahoo.com


BACKGROUND High-viscosity 2-octyl cyanoacrylate (HVOCA) is a rapidly polymerizing liquid topical adhesive indicated for epidermal approximation of superficial lacerations and surgical wounds. Use of HVOCA in repair of facial wounds after Mohs micrographic surgery (MMS) has not been reported.

OBJECTIVE To compare aesthetic outcome of HVOCA versus sutured epidermal closure of linearly repaired facial wounds following MMS.

METHODS Patients undergoing MMS for facial tumors with postoperative wounds >3 cm appropriate for linear closure were recruited. After placement of dermal sutures, half the wound was randomly selected for closure with HVOCA and the other half was closed with 5-0 polypropylene suture.

RESULTS Fourteen patients (13 men and 1 woman; mean age, 72±8.8 years; range, 52–81 years) with basal cell or squamous cell carcinoma of the face (n=12) or neck (n=2) were enrolled. The mean wound length was 4.9±1.9 cm (range, 3.1–10 cm). No postoperative complications, including bleeding, infection, or dehiscence, occurred. Using photographs obtained 3 months postoperatively, five dermatologists (including two Mohs surgeons) blinded to the intervention rated cosmesis using a visual analog scale from 1 (worst) to 10 (best). The mean ratings for HVOCA half (6.64±1.55) versus sutured half (6.77±1.88) were not significantly different (p=.35). Paired comparisons of rater preferences similarly showed no cosmetic differences. All 14 patients preferred OCA for ease of postoperative care.

CONCLUSION HVOCA tissue adhesive is cosmetically equivalent to epidermal sutures in the linear repair of facial wounds following MMS. This technique represents an additional option for Mohs surgeons.