Pediatric circumcision using n-butyl-cyanoacrylate plus MS monomer: Bacteriostatic and cosmetic advantages over suture

Purpose: The aim of this study is to compare the use of n-butyl-cyanoacrylate plus MS monomer (NBCA-MS) glue with suture in pediatric circumcision. Materials and Methods: Between January 2013 and January 2017, 160 consecutive pediatric patients (range 18 months-14 years, mean 7.5 years) underwent circumcision. Eighty patients were randomly allocated to the glue group and 80 to the suture group. In the glue group wound margins were approximated by n-butyl-cyanoacrylate plus MS monomer (NBCA-MS) glue while in the suture group interrupted 5-0 polyglycolic acid stitches were used. Each group was randomized into two subgroups: forty patients (subgroup A) received antibiotics (6 days of amoxicillin/clavulanic acid) and 40 (subgroup B) patients did not receive any postoperative drug. Operative time, pain score, postoperative complications and cosmesis were statistically evaluated. Results: The operation time was significantly higher in the suture group; pain severity and duration were not significantly lower in the glue group. In the 80 patients of the glue group no complications occurred; in the suture group 20 (25%) cases of wound edema and 6 (7.5%) infections occurred. Cosmesis evaluation 1 and 6 months postoperatively showed significantly better results in the glue group. Conclusion: Our study demonstrates that NBCA-MS glue wound closure in pediatric circumcision is a safe and effective technique.