# Comparison of N-butylcyanoacrylate glue and sutures for closure of inguinal skin incision after hernioplasty

## TL;DR

This study compares N-butylcyanoacrylate glue and sutures for closing skin after hernia surgery, finding that the glue reduces pain, healing time, and hospital stay while improving patient satisfaction.

## Contribution

The study provides new evidence that tissue adhesive is a viable alternative to sutures for skin closure in inguinal hernia surgery.

## Key findings

- N-butyl-2-cyanoacrylate tissue adhesive reduced postoperative pain and healing time compared to sutures.
- Patients reported higher satisfaction with tissue adhesive, while surgeons preferred sutures.
- Tissue adhesive showed better wound healing and scar outcomes at 7 and 30 days.

## Abstract

Skin closure techniques in inguinal hernia surgery significantly influence postoperative outcomes, including pain, healing, scar formation, and patient satisfaction. The aim of this study is to evaluate the efficacy of N-butyl-2-cyanoacrylate tissue adhesive as an alternative to conventional sutures for skin closure in inguinal hernia surgeries.

A prospective cross-sectional study was conducted at a tertiary care center from November 2023 to October 2025. Seventy patients aged 18–60 years undergoing inguinal hernia repair were randomly assigned to two groups: Group 1 (sutures) and Group 2 (tissue adhesive). Exclusion criteria included recurrent or strangulated hernia, allergies to cyanoacrylate/formaldehyde, and immunocompromised states. Outcomes assessed included pain (VAS), wound healing (Hollander score), scar quality (Vancouver Scar Scale and Visual Analogue Scar Scale), complications, and satisfaction scores.

Group 2 showed significantly lower pain scores at early postoperative intervals (p < 0.05), shorter wound closure time (8.8 ± 1.4 min vs. 11.7 ± 2.6 min; p = 0.000), and reduced hospital stay (1.9 ± 0.8 days vs. 3.5 ± 1.6 days; p = 0.000). No infections were reported in either group. Chronic pain at 30 days was less frequent in Group 2 (p = 0.046). Wound healing and scar scores favored Group 2 on days 7 and 30 (p < 0.05). Patient satisfaction was higher in Group 2 across all follow-up visits, while surgeons preferred sutures (p < 0.05).

N-Butyl-2-cyanoacrylate tissue adhesive offers superior early postoperative outcomes and higher patient satisfaction compared to sutures, although surgeons reported greater satisfaction with traditional methods. Tissue adhesive is a viable alternative for skin closure in inguinal hernia surgeries.