A prospective comparative evaluation of wound healing and scar formation using surgical sutures, surgical staplers, and tissue glue

Objectives: Techniques for closing wounds have progressed from early developments in suturing material to advanced resources, including skin staplers, adhesive tapes, and, most recently, cyanoacrylate tissue adhesives. Yet, no gold standard technique promises an absolute skin flap approximation with obliteration of underlying space to promote quick recovery and optimal esthetic results with minimized complications. Materials and Methods: Our study compared the effectiveness of tissue glue, surgical staplers, and sutures. This careful design included 225 patients randomly allocated into three groups of 75 patients each: Group(A) – tissue glue, Group(B) – skin staplers, and Group(C) – sutures. We evaluated wound infection using the Additional treatment, Serous discharge, Erythema, Purulent exudate, Separation of deep tissues, Isolation of bacteria, and duration of inpatient stay (ASEPSIS) score, pain levels using the visual analog scale, and scar formation using the Vancouver scale. The final analysis used patient satisfaction (PS) scores and the surgeon’s satisfaction scores. Results: The mean asepsis score was found to be lowest for Group A, with values of 12.28 (7 th day), 9.88 (14 th day), 6.48 (30 th day), and 3.92 (60 th day). However, no significant difference was found between groups in wound infection rates. The pain was higher on the 14 th day of the procedure in Group B and Group C patients. There was a significant difference between the groups, comparing the Vancouver Scale, with glue showing a better cosmetic outcome. Conclusion: Our study established that tissue glue, with its faster wound closure, lower pain levels, and patient and doctor convenience, emerged as a promising option. These findings have significant practical implications, as they can potentially improve patient outcomes, reduce healthcare costs, and instill a sense of optimism about their application in wound closure techniques.