Comparative trial of octyl‐cyanoacrylate and silver sulfadiazine for the treatment of full‐thickness skin wounds

A prospective, randomized, blinded, controlled experimental trial was performed in pigs to compare the rates of reepithelialization of 126 full-thickness cutaneous 4-mm punches treated with an octyl-cyanoacrylate spray, silver sulfadiazine, or a dry gauze (controls). Full thickness biopsies were taken 7, 14, or 30 days later for histopathological evaluation of hematoxylin and eosin stained tissue sections by a dermatopathologist. The primary outcome measure was the proportion of wounds completely re-epithelialized at days 7 and 14. Secondary outcomes were the rates of infection, foreign body reactions, and the depth of any resulting cutaneous dells measured with a micrometer. Between-group comparisons were performed with ANOVA or Chi-square tests. Octyl-cyanoacrylate treated wounds re-epithelialized more slowly, as fewer wounds treated with octyl-cyanoacrylate were re-epithelialized at day 7 in comparison with silver sulfadiazine or control wounds (50% vs. 90% vs. 100%, p < 0.001). There were no infections or foreign body type reactions. Amounts of granulation tissue were similar among groups. Octyl-cyanoacrylate wounds were more depressed than silver sulfadiazine wounds at days 7 and 14 yet had similar histopathological characteristics at day 30. We conclude that treatment of small, full thickness cutaneous wounds with octyl-cyanoacrylate results in delayed re-epithelialization and dermal repair in comparison with silver sulfadiazine, yet it does not result in any foreign body-type reaction. However, by 30 days, histopathological wound characteristics were similar in all groups.