The utility of 2-octyl cyanoacrylate wound closure in 577 cases of colon cancer surgery: a retrospective cohort study

Abstract Background Surgical site infection (SSI) remains an important complication after colon cancer surgery. We evaluated the SSI incidence associated with a standardized wound closure protocol combining tension-reducing subcutaneous suturing and 2-octyl cyanoacrylate (2-OCA). Methods We retrospectively reviewed 577 eligible colon cancer surgical cases at our institution between January 2024 and December 2025 (open, n = 30; laparoscopic, n = 209; robot-assisted, n = 338). All cases underwent standardized fascial and subcutaneous closure followed by application of 2-OCA. SSI was assessed through institutional surveillance using CDC/NHSN criteria. Results SSI occurred in 4 of 577 surgical cases (0.69%). All four were superficial incisional infections (three Clavien–Dindo Grade I and one Grade II); no deep incisional or organ/space SSI was identified by institutional surveillance. SSI occurred in 3 of 30 open procedures (10.0%), 0 of 209 laparoscopic procedures (0%), and 1 of 338 robot-assisted procedures (0.30%). Given the small number of events, these subgroup rates were interpreted descriptively. Conclusions A standardized wound closure protocol combining subcutaneous tension reduction with 2-OCA was associated with a low observed SSI incidence. Without an internal comparison group and with only four SSI events, the independent effect of this protocol cannot be established. Further prospective validation is warranted.