6- Randomized trial of tissue adhesive vs staples

Objective: Closure of skin incision of minimally invasive thyroidectomy with tissue adhesive is compared with surgical staples for 1) cosmetic appearance, 2) patient pain score, and 3) patient satisfaction score.

Study design: Prospective single-blinded randomized study.

Subjects and methods: Seventy-two patients undergoing minimally invasive thyroid surgery using video-assisted thyroidectomy (VAT) and minimal incision thyroidectomy (MIT) techniques were randomized for skin closure into two groups, one using staples and the other using tissue adhesive. Patients evaluated their pain on the first and tenth postoperative days. Scars were assessed using the Manchester scar assessment tool, and patients completed a satisfaction assessment form.

Results: Sixty out of the 72 patients were followed up for three months postoperatively. Assessment of wound cosmesis revealed no statistical difference; however, there was a statistical difference in ability to shower and overall satisfaction in the tissue adhesive group (P = 0.017).

Conclusion: Tissue adhesive is an excellent alternative for skin incision closure, having the added advantage of ability to shower on the same day, avoidance of the anxiety associated with staple removal, and no General Practitioner (GP) visit required for wound care. The use of tissue adhesive achieves higher patient satisfaction levels and enhances the perception of minimally invasive thyroid surgery (MITS) techniques among patients and surgeons alike.