Adhesive strip wound closure after thyroidectomy/parathyroidectomy: A prospective, randomized controlled trial

Background. Conventional collar incision closure in thyroid and parathyroid surgery involves the insertion of an epidermal layer of subcutaneous absorbable sutures that are reinforced by a deep layer of sutures. Adhesive strips offer an alternative method to close the epidermal layer The, aim of this study was to compare adhesive strip closure with absorbable sutures for collar incisions in a prospective, single-blinded, randomized controlled trial. Methods. Eighty-two patients were randomized to wound closure using either adhesive strips or absorbable subcutaneous sutures (control). Operative time, complication rate, and postoperative pain at day I and 6 weeks postoperatively were recorded. Wound appearance was assessed using the Hollander Cosmesis and Likert scales at 6 weeks postoperatively by a single assessor and a plastic surgeon who was blinded to the study group. Results. Forty-three patients were randomized to the control group and 39 patients to the adhesive strip group. No difference was seen in operation time (93 vs 111 minutes; P=.341) and complication rate (2.5% vs 6.9%; P=.323). There was a decrease in the postoperative pain score on day 1 in the adhesive strip group (2.0 vs 2.6; P=.015) and improvement in the wound appearance at 6 weeks in the adhesive strip group using the Hollander Cosmesis (4.6 vs 3.7; P=.012) and Likert scales (3.3 vs 3.0; P=.046), as confirmed by independent assessment. Conclusion. Adhesive strips offer a safe and effective alternative approach to epidermal closure of surgical wounds in the neck. In addition, adhesive strips provide an equivalent if not better cosmetic benefit compared to traditional methods of epidermal closure. (Surgery 2013;153:408-12.)