Eur J Pediatr Surg 2011; 21(3): 159-162
DOI: 10.1055/s-0030-1270458
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Prospective, Randomized, Controlled Trial Comparing a Tissue Adhesive (Dermabond™) with Adhesive Strips (Steri-Strips™) for the Closure of Laparoscopic Trocar Wounds in Children

P. Romero1 , G. Frongia1 , S. Wingerter1 , S. Holland-Cunz1
  • 1University of Heidelberg, Department of Surgery, Section Pediatric Surgery, Heidelberg, Germany
Further Information

Publication History

received November 18, 2010

accepted after revision November 20, 2010

Publication Date:
31 January 2011 (online)


Background: 4 methods are used in pediatric laparoscopic surgery to close trocar wounds. While tissue adhesives or adhesive strips have been shown to produce fewer wound complications and a better cosmetic result compared to trans- or only subcutaneous sutures, the choice of technique is still often based on the surgeon's personal experience. Thus, the objective of this trial was to assess the impact of tissue adhesives (Dermabond™) compared to adhesive strips (Steri-Strip™) on potential complications of wound healing, wound pain, cosmetic outcome, and patient satisfaction after laparoscopic appendectomy in children.

Methods: 49 patients undergoing laparoscopic appendectomy were enrolled in this prospective randomized trial. In every patient, two 5-mm and one 10-mm port-site incision was closed either with Dermabond™ or Steri-Strip™ after placing subcuticular absorbable sutures (4–0 Vicryl™). Postoperative complications, pain, and patient satisfaction with scars were evaluated at follow-up on day 10 and day 90 after the operation using a questionnaire and a visual analogue scale (VAS). Photographs of scars taken on day 90 were evaluated on a VAS by 2 pediatric surgeons blinded to the closure method used.

Results: According to the surgeons’ evaluation of the cosmetic outcome, a significant difference between the 2 groups with regard to the cosmetic score was found on day 90 of follow-up, favoring Steri-Strip™ wound closure (p<0.05). On day 10 and 90 there were no statistical differences between the 2 methods as regards the result of patient evaluations (p>0.05). Only one wound infection (4%) was observed in the Steri-Strip™ group (n=25) on day 10. At follow-up on day 90 two patients (9.1%) in the Dermabond™ group and one (4.8%) in the Steri-strip™ group complained of wound pain (p=0.52).

Conclusions: Both tissue adhesives and adhesive strips are excellent “no needle” alternatives for the closure of laparoscopic port-site incisions in children. As regards cosmetic outcome, Steri-Strip™ wound closure seems to be the most suitable and is also the less expensive technique.


  • 1 Quinn JV, Drzewiecki A, Li MM. et al . A randomized controlled trial comparing a tissue adhesive with suturing in the repair of pediatric facial lacerations.  Ann Emerg Med. 1993;  22 1130-1135
  • 2 Bruns TB, Simon HK, Mclario DJ. et al . Laceration repair using a tissue adhesive in a children's emergency department.  Pediatrics. 1996;  99 673-675
  • 3 Jallali N, Haji A, Watson CJ. A prospective randomized trial comparing 2-octyl cyanoacrylate to conventional suturing in closure of laparoscopic cholecystectomy incisions.  J Laparoendosc Adv Surg Tech A. 2004;  14 (4) 209-211
  • 4 Matin SF. Prospective randomized trial of skin adhesive versus sutures for closure of 217 laparoscopic port-site incisions.  J Am Coll Surg. 2003;  196 (6) 845-853
  • 5 Sajid MS, Siddiqui MR, Khan MA. et al . Meta-analysis of skin adhesives versus sutures in closure of laparoscopic port-site wounds.  Surg Endosc. 2009;  23 1191-1197
  • 6 Guyuron B, Vaughan C. A comparison of absorbable and nonabsorbable suture materials for skin repair.  Plastic Reconstr Surg. 1992;  89 234-236
  • 7 Rosen DM, Carlton MA. Skin closure at laparoscopy.  J Am Assoc Gynecol Laparosc. 1997;  4 347-351
  • 8 Irvin TT. Simple skin closure.  Br J Hosp Med. 1985;  33 325-330
  • 9 Mattick A, Clegg G, Beattie T. et al . A randomised, controlled trial comparing a tissue adhesive (2-octlycyanoacrylate) with adhesive strips (Steristrips) for pediatric laceration repair.  Emerg Med J. 2002;  19 405-407
  • 10 Zempsky W, Parrotti D, Grem C. et al . Randomized controlled comparison of cosmetic outcomes of simple facial lacerations closed with Steri Strip™ skin Closures or Dermabond™ tissue adhesive.  Pediatric Emergency Care. 2004;  20 (8) 519-524
  • 11 Buchweitz O, Wülfing P, Kiesel L. A prospective randomized trial of closing laparoscopic trocar wounds by transcutaneous versus subcuticular suture or adhesive papertape.  Surgical Endoscopy. 2004;  10.1007/s00464-004-9043-2


Dr. Philipp Romero

University of Heidelberg

Department of Surgery

Section Pediatric Surgery

Im Neuenheimer Feld 110

69120 Heidelberg


Phone: +49 6221 566 283

Fax: +49 6221 565 105