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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.