Skin Glue for Wounds Closure in Brain Surgery: Our Updated Experience

Background: Traditional wound closure techniques include skin sutures and metal clips. Cyanoacrylate has good neovascularization, epithelialization, and antimicrobial activity properties and a fast application procedure. This study presents our long-term experience. Methods: We retrospectively selected 362 patients who underwent brain surgery from January 2007 to March 2017. Exclusion criteria were applied for repeat surgeries, emergency/posttraumatic procedures, wound infections, wounds longer than 16 cm, skull base cases, and postoperative patients who stayed in the intensive care unit more than 1 day. We collected data from 250 cases of supratentorial procedures and 112 cases of infratentorial procedures. The median wound length was 11 cm (range, 4–15 cm); the median age was 51 years. We followed-up all patients for 1, 3, and 12 months focusing on wound complications, cosmetic results, based on the Hollander Wound Evaluation Scale (HWES), and patient satisfaction using a visual analog scale. Results: Cosmetic results were very good (HWES score of 5–6) in 99.5% of cases at 12 months. Patient satisfaction reached almost 100% at 12 months. We experienced 2 cases of wound dehiscence and 2 others with poor cosmetic results. The main complaint was a feeling of discomfort, during the first 2 weeks after surgery, because of the dried glue along the wound's edges. Conclusions: With additional research, we can confirm that cyanoacrylate glue may be a valid and useful alternative to traditional techniques for wound closure in brain surgery, carrying several advantages. However, a randomized controlled trial with a large number of patients is warranted to confirm our findings.