***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND While a variety of epidermal wound closure techniques are utilized , there are few evidence based studies comparing techniques in head-to-head studies . OBJECTIVE To compare the aesthetic outcomes and wound healing properties of 2 epidermal closure mechanisms : 2-octylethylcyanoacrylate adhesive and rapid absorbing gut suture in skin closures . METHODS A total of 8 patients were enrolled in this r and omized right-left comparative trial . Patients were r and omized for epidermal closure with one half of their wounds ( chest [ n=6 ] and upper extremities [ n=2 ] ) with tissue adhesive and the contralateral with rapid absorbing gut suture . RESULTS Three months following wound closure , overall cosmetic outcome was slightly greater on the half closed with rapid absorbing gut suture ( mean=3.56 ) relative to the tissue adhesive ( mean=3.19 , P=.05 ) . For dyspigmentation , the half of the scar treated with the suture had a better outcome ( mean=3.50 ) relative to tissue adhesive ( mean=2.75 ) ( P<.05 ) . All other variables ( i.e. , scar thickness , wound approximation , patient outcome , and preference ) were highly equivalent . CONCLUSION Both rapid absorbing gut suture and tissue adhesive appear to be highly efficacious techniques for epidermal closure . It appears that tissue adhesive may not be as effective in achieving optimal cosmesis for defects after Mohs micrographic surgery on the trunk and extremities in follow-up at 3 months Traditional skin sutures ( TSS ) and metal skin clips ( SC ) are the most common devices utilized for closure of surgical incisions . They are safe and effective , although they require instruments to apply them , are time consuming and , above all , create an extra staff and cost burden for removal of sutures/staples . The ideal incision closure should be simple , effective , safe , rapid , inexpensive , painless , cosmetic and bactericidal . The present study was design ed to determine the safety and efficacy of N-butyl octyl cyanoacrylate ( NCA ) tissue adhesive , a liquid b and age surgical product , for wound closure in brain surgery . Our prospect i ve r and omized controlled study compared NCA with traditional methods for wound closure in brain surgery . Over a 6-month period , 40 patients who underwent a supratentorial elective craniotomy were enrolled and r and omly allocated into two groups . The 20 participants in group A were treated using a new NCA tissue adhesive while the 20 participants in group B were treated using either nylon monofilament , TSS or SC . In the post-operative period and during follow-up , two different nurses ( the second nurse was blinded to the closure method used ) recorded details regarding wound aspects , complications and patient satisfaction using a modified version of the Holl and er Wound Score Scale . We found no difference in the cosmetic outcome of the two groups , or in wound complications rate , but the patient satisfaction score was higher in group A ( 9.4 vs. 7.1 ; p<0.005 ) . The mean application time of the tissue adhesive was significantly faster than that of the st and ard suture ( 115s vs. 300s ; p<0.001 ) ; in the skin clips subgroup it was 105s . Our study suggests that the new NCA tissue adhesive is a safe , effective and reliable skin closure for neurosurgical procedures in the supratentorial region ; it also achieves optimal cosmetic results , is less time consuming to use and has greater patient satisfaction . However , further studies with a larger number of patients are necessary to corroborate these results OBJECTIVE To compare the surgical efficacy and wound-healing characteristics of the tissue adhesive octyl-2-cyanoacrylate ( approved by the Food and Drug Administration ) with traditional suture closure in upper blepharoplasty . METHODS Prospect i ve , r and omized , blinded study comparing cosmetic and functional outcome and time efficiency .  Twenty subjects underwent upper eyelid blepharoplasty .  Each patient had a control side and an experimental side determined r and omly . One eyelid incision was closed with octyl-2-cyanoacrylate ( Dermabond ; Ethicon Inc , Somerville , NJ ) tissue glue , and the other with 6.0 suture ( polypropylene or fast-absorbing gut ) . Comparisons were performed for the time for closure by each method , wound healing , and patient satisfaction . Macrophotographs of the wounds at 1 , 2 , and 4 weeks after surgery were grade d by 5 observers blinded to the closure method , using a 10-point scale and a modified Holl and er wound evaluation scale . RESULTS No statistically significant difference was found between the quality of octyl-2-cyanoacrylate closure and suture closure  at 1 month . There were no differences in wound complications , duration of healing , inflammation , or final incision appearance . By 2 weeks , the sides were indistinguishable in 15 ( 75 % ) of the patients . Time for closure averaged 7 minutes with suture and 8 minutes with glue . CONCLUSIONS Octyl-2-cyanoacrylate glue is an excellent alternative to suture closure , producing equivalent quality of closure at all time points and no difference in appearance . This adhesive was sufficient to withst and the forces of closure in upper eyelid blepharoplasty without dehiscence in the absence of sutures BACKGROUND Topical 2-octylcyanoacrylate tissue adhesive is an alternative to traditional devices for closing short surgical incisions . METHODS An open-label , r and omized study compared a new high-viscosity formulation of 2-octylcyanoacrylate with commercially available devices , including low-viscosity 2-octylcyanoacrylate , for epidermal closure of incisions > or = 4 cm requiring subcutaneous and /or deep-dermal suturing . RESULTS Of patients with 1 to 3 wounds , 106 were treated with high-viscosity 2-octylcyanoacrylate and 103 with commercially available devices . The day-10 rates of healing by wound were 96 % and 97 % for study versus control treatment and 97 % and 95 % for new and old 2-octylcyanoacrylate formulations versus other controls , respectively . Day-10 infection rates by wound were 4 of 145 versus 7 of 131 for study versus control treatment and 6 of 207 and 5 of 69 for new and old 2-octylcyanoacrylate versus other controls , respectively . CONCLUSIONS The new tissue adhesive formulation provides epidermal wound closure equivalent to commercially available devices with a trend to decreased incidence of wound infection STUDY OBJECTIVE To compare the 1-year cosmetic outcome of wounds treated with octylcyanoacrylate tissue adhesive and monofilament sutures  and to correlate the early , 3-month , and 1-year cosmetic outcomes . METHODS We prospect ively r and omized 136 cases of traumatic laceration to repair with octylcyanoacrylate tissue adhesive or 5 - 0 or smaller monofilament suture .  A wound score was assigned by a research nurse , and vali date d by a second nurse blinded to the treatment , at 5 to 10 days after injury ( early ) , 3 months , and 1 year . St and ardized photographs were taken at 3 months and 1 year and shown to a cosmetic surgeon blinded to the method of closure , who rated the wounds on a vali date d cosmesis scale . RESULTS We were able to examine 77 lacerations at 1 year for follow-up . No differences were found in the demographic or clinical characteristics between groups . Likewise , at 1 year no difference was found in the optimal wound scores ( 73 % versus 68 % , P = .60 ) or in visual analog scale cosmesis scores ( 69 versus 69 mm , P = .95 ) for octylcyanoacrylate and sutures , respectively . Agreement was poor between early and 3-month wound scores ( kappa=.34 ; 95 % confidence interval [CI],.10 to.58 ) but a strong association existed between 3-month and 1-year wound scores ( kappa=.71 ; 95 % CI,.52 to.90 ) . We noted a moderate correlation between 3-month and 1-year results on the visual analog cosmesis scale ( intraclass correlation,.48 ; 95 % CI , .30 to.63 ) . CONCLUSION One year after wound repair , no difference is noted in the cosmetic outcomes of traumatic lacerations treated with octylcyanoacrylate tissue adhesive and sutures . The assessment of wounds 3 months after injury and wound repair provides a good measure of long-term cosmetic outcome BACKGROUND Wound closure devices include sutures , tissue adhesives , adhesive strips , and staples . Recent studies suggest no differences between various tissue adhesives and sutures for dehiscence , infection , and satisfaction when assessed by patients or surgeons . To date , no studies have investigated ClozeX ( Clozex Medical LLC , Wellesley , MA , USA ) , a novel adhesive strip , for closure of surgical incisions . OBJECTIVE To compare surgical wounds repaired with ClozeX versus suture . METHODS A prospect i ve , r and omized study was conducted , in which 15 patients with surgical incisions were allocated to closure with ClozeX on half of the wound and monofilament suture on the other half .  Physician satisfaction with blinded assessment , patient satisfaction , complication rates , and closure times were recorded . RESULTS Application with ClozeX was faster than with suture ( p=.007 ) . There were no complications in either group . Sixty-nine percent of the patients gave ClozeX a higher satisfaction score ( p=.02 ) . More physicians were satisfied with the ClozeX half than with the suture half ( p=.007 ) . CONCLUSIONS This pilot study demonstrates ClozeX to be a safe and effective closure device . The cosmetic outcome seems to be at least as good as simple running suture . Physicians and patients were generally more satisfied with ClozeX. No difference was found in the rate of dehiscence or infection between the groups A r and om study for management of wound by cyanoacrylate glue in 213 patients , irrespective of age and sex with different types of wounds was carried out over a period of 4 years ( 1996 - 2000 ) . In this series both dean surgical wounds and infected accidental wounds were included . Most of the patients recovered uneventfully , except 5 , who showed wound gap . Reapplication of glue was done on them and 3 had similar wound union but 2 patients ( 0.94 % ) required surgical suture Background Topical 2-octylcyanoacrylate tissue ( OCA ) adhesive has been used as an alternative to close wounds with a comparable cosmetic outcome . The use of 2-OCA in the closure of abdominal laparotomy wounds has not been thoroughly evaluated . Our aim was to compare 2-OCA with conventional skin stapling devices in colorectal surgery . Methods A prospect i ve r and omised study was conducted in which 74 consecutive patients above the age of 21 undergoing open elective colectomies for benign or malignant indications were allocated to skin closure with 2-OCA or skin staples .  Cosmetic outcome as assessed with the Holl and er Cosmesis Scale with a single assessor , complication rates , and patient satisfaction were recorded at discharge ( 4–10POD ) 2 weeks after discharge and then at 3 months . Results Of the 74 patients , 38 were r and omised to skin staples and 36 to 2-OCA . There was no significant difference in cosmetic outcomes between the two groups as assessed with a visual analogue scale or the Holl and er Cosmesis Scale but showed a trend to better cosmetic outcomes in the 2-OCA group . Patient satisfaction scores were higher but did not reach statistical significance . The time taken to close a wound with 2-OCA was significantly longer than with skin staples . There was no statistical difference in rates of wound infection . Conclusion 2-OCA is a safe and effective means of skin closure in patients undergoing elective colectomies with a good and at least equivalent outcome to traditional methods of closure PURPOSE In this study , we compared the skin adhesive 2-octylcyanoacrylate to subcuticular suture for closure of pediatric inguinal hernia incisions to determine if skin adhesive improves wound cosmesis , shortens skin closure time , and lowers operative costs . METHODS We prospect ively r and omized 134 children undergoing inguinal herniorrhaphy at our institution to have skin closure with either skin adhesive ( n = 64 ) or subcuticular closure ( n = 70 ) . Data collected included age , sex , weight , type of operation , total operative time , and skin closure time . Digital photographs of healing incisions were taken at the 6-week postoperative visit . The operating surgeon assessed cosmetic outcome of incisions using a previously vali date d visual analog scale , as well as an ordinate scale . A blinded assessment of cosmetic outcome was then performed by an independent surgeon comparing these photographs to the visual analog scale . Operating room time and re source use ( ie , costs ) relative to the skin closure were assessed . Comparisons between groups were done using Student 's t tests and chi(2 ) tests . RESULTS Children enrolled in the study had a mean + /- SE age of 3.7 + /- 0.3 years and weighed 16 + /- 0.8 kg . Patients were predominantly male ( 82 % ) . Patients underwent 1 of 3 types of 
    Output:
    
No evidence of differences was found between tissue adhesives and tapes for minimising dehiscence , infection , patients ' assessment of cosmetic appearance , patient satisfaction or surgeon satisfaction .
There appeared to be little difference in outcome for different types of tissue adhesives .
One study that compared high viscosity with low viscosity adhesives found that high viscosity adhesives were less time-consuming to use than low viscosity tissue adhesives , but the time difference was small .
Sutures are significantly better than tissue adhesives for minimising dehiscence .
In some cases tissue adhesives may be quicker to apply than sutures .