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A randomized clinical trial of cyanoacrylate tissue adhesives in donor site of connective tissue grafts

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Background: The purpose was to compare patient-centered outcomes, early wound healing, and postoperative complications at the palatal donor area of subepithelial connective tissue grafts (CTG) between cyanoacrylates tissue adhesives and polytetrafluoroethylene (PTFE) sutures.

Methods: Thirty-six patients who required harvesting of CTG were enrolled in this randomized clinical trial and assigned to one of two groups. In the “suture” group, wound closure was achieved with standardized continuous interlocking 6-0 PTFE sutures, while in the “cyanoacrylate” group, a high viscosity blend of n-butyl and 2- octyl cyanoacrylate was applied until hemostasis was achieved. The primary outcome was the discomfort (eating, speaking, etc.) from the donor site during the first postoperative week; this was self-reported on a visual analog scale questionnaire. Secondary outcomes were the time required for suture placement or cyanoacrylate application, patient self-reported pain on the first day and the first week after surgery, the analgesic intake and the modified early-wound healing index (MEHI). Results: The median value of discomfort was 1.49 in the “suture” group and 1.86 in the “cyanoacrylate” (P = 0.56). The mean time required for suture placement was 7.31 minutes and for cyanoacrylate application 2.16 minutes (P < 0.0001). No statistically significant differences were found between the two methods in reported pain level, analgesic intake, and MEHI.

Conclusions: Cyanoacrylate performs similarly to sutures and can be used for wound closure of the donor site of CTG. The application was about 5 minutes faster than conventional suture placement, reducing the total time of the surgical procedure.