Evaluation of N-Butyl Cyanoacrylate Tissue Adhesive for Second Intention Healing Following Dermatologic Surgery: A Randomized Controlled Trial

BACKGROUND: Second intention healing is a frequent choice after dermatologic surgery, but prolonged wound care and daily dressings can pose practical challenges for patients. Tissue adhesives offer a low-maintenance alternative; however, their role in second intention healing remains underexplored. OBJECTIVE: To evaluate the efficacy of n-butyl cyanoacrylate tissue adhesive on second intention healing compared with the standard of care using petroleum-based dressings. METHODS: In this randomized controlled trial, 47 patients with postoperative wounds of the hands, feet, or genital region after Mohs micrographic surgery or excision received standard of care (n = 22) or tissue adhesive (n = 25). At 2 weeks postoperation, the tissue adhesive group was rerandomized to receive standard of care (n = 13) or tissue adhesive (n = 12). All patients received standard of care for the remainder of the study. Re-epithelialization, postoperative complications, and patient satisfaction were recorded at the 2-, 4-, and 12-week postoperative follow-up visits. RESULTS: Re-epithelialization, postoperative complication rates, and patient satisfaction scores were comparable among groups (p > .05). CONCLUSION: Tissue adhesive is a viable alternative to the standard of care for second intention healing, simplifying postoperative management without compromising healing outcomes or patient satisfaction.