Abstract
Objective
To evaluate the effectiveness of cyanoacrylate tissue adhesives versus conventional sutures for skin closure in primary cleft lip repair, focusing on esthetic, clinical, and patient-centered outcomes.
Design
Systematic review and meta-analysis of randomized controlled trials and comparative observational studies.
Setting
Multicenter data synthesis including studies from the United States, the United Kingdom, India, Nigeria, and the Netherlands.
Patients, Participants
A total of 442 patients undergoing primary cleft lip repair, with 402 contributing extractable outcome data.
Interventions
Epidermal closure using tissue adhesives (octyl-2-cyanoacrylate, iso-amyl cyanoacrylate, or octyl-2-cyanoacrylate with polyester mesh tape) compared with fine nonabsorbable sutures (nylon, Prolene, or Monocryl).
Main Outcome Measure(s)
Esthetic scar quality, wound complications, parental satisfaction, operative time, and scar-related secondary parameters (eg, white roll alignment, hypertrophic scarring).
Results
Eight studies met inclusion criteria, of which 2 were randomized controlled trials. Meta-analysis showed no significant difference in esthetic outcomes between adhesives and sutures (SMD −0.05, 95 % confidence interval [95% CI] [−0.28 to 0.18]; I2 = 12%). Complication rates were comparable (RR 0.93, 95% CI [0.41-2.11]). Operative time was consistently shorter with adhesives, reducing closure by 5 to 7 min per case. Parental satisfaction was uniformly higher in adhesive groups. Evidence certainty was graded moderate for esthetic outcomes and wound complications, and low for operative time and satisfaction.
Conclusions
Tissue adhesives provide equivalent esthetic and complication outcomes to sutures in cleft lip repair, with added advantages of faster closure and improved parental satisfaction. Incorporating adhesives into cleft protocols may enhance efficiency and patient-centered care, though further high-quality trials with long-term follow-up are warranted.
Keywords
Get full access to this article
View all access options for this article.
References
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
