Comparison of Cyanoacrylate Tissue Adhesives to Polytetrafluoroethylene Sutures in the Donor Site of Connective Tissue Grafts – A Randomized Clinical Trial

Abstract

Purpose: The aim of this study was to compare patient-centered outcomes, wound healing and post-operative complications at palatal donor area of SECT grafts between cyanoacrylates tissue adhesives and Polytetrafluoroethylene (PTFE) sutures. Methods: 36 patients who required harvesting of SECT graft were enrolled in this prospective 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 post-operative week; this was self-reported on a visual analogue scale (VAS) questionnaire. Secondary outcomes were the time required for suture placement or cyanoacrylate application, the 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 cm in the “suture” group and 1.86 cm 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 level of pain, in analgesic intake and in MEHI. Conclusion: Cyanoacrylate can safely be used for wound closure of donor palatal site of SCTG. The application was about 5 minutes faster than conventional suture placement, reducing the total time of the surgical procedure.