Childhood Kidney Diseases

  • 제16권2호
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  • Pages.115-120
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  • 2012
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  • 2384-0242(pISSN)
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  • 2384-0250(eISSN)
대한소아신장학회 (Korean Society of Pediatric Nephrology)
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소아비뇨기과 관혈적 수술 시 피부봉합제로 사용된 Octyl-2-Cyanoacrylate (Dermabond$^{TM}$)의 효용성

Analysis of Octyl-2-Cyanoacrylate as a Dressing Material after Pediatric Urological Procedures

  • 이한이 (서울대학교 의과대학 비뇨기과학교실) ;
  • 민선호 (서울대학교 의과대학 비뇨기과학교실) ;
  • 김광명 (서울대학교 의과대학 비뇨기과학교실)
  • Lee, Hahn-Ey (Division of Pediatric Urology, Seoul National University College of Medicine) ;
  • Min, Sun Ho (Division of Pediatric Urology, Seoul National University College of Medicine) ;
  • Kim, Kwang Myung (Division of Pediatric Urology, Seoul National University College of Medicine)
  • 투고 : 2012.09.22
  • 심사 : 2012.10.17
  • 발행 : 2012.10.31
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초록

목적: 소아비뇨기과 관혈적 수술 시 피부봉합제로 사용된 Octyl-2-Cyanoacrylate (Dermabond$^{TM}$)의 효용성에 대해 알아보고자 하였다. 방법: 2010년 8월부터 2011년 8월까지 1년 동안 서울대학교 어린이병원 소아비뇨기과에서 단일 술자에 의해 음낭수종절제술, 고환고정술, 음경성형술을 시행받은 환자들을 대상으로 상처 합병증 발생율을 후향적으로 비교분석하였다. 총 128명을 대상으로 210개의 절개 창에서 시행되었으며, 피부 봉합에 Dermabond$^{TM}$을 사용하였다. 모든 절 개창은 Dermabond$^{TM}$을 사용하기 전 흡수사를 이용하여 표피 밑 봉합 혹은 몇 개의 단순 봉합을 시행하였다. Dermabond$^{TM}$는 4 mm 너비로 얇게 두 번 사용되었으며, 건조시키는 과정이 포함되었다. 추가적인 붕대나 드레싱은 적용되지 않았다. 결과: 128명의 환자들을 수술 종류에 따라 세 그룹으로 나누었다(Group 1: 음낭수종 절제술, 55례, 41.3%; Group 2: 고환고정술, 43례, 32.3%; Group 3: 음경성형술, 35례, 26.4%). 수술 후 외래에서 추적 관찰한 210개의 절개창 중에서 총 5개(2.3%)에서 상처 합병증이 발생하였고, 이를 그룹별로 다시 분석해 보면 Group 1에서 0개(0/55, 0%), Group 2에서 1개(1/43, 2.3%), Group 3에서 4개(4/35, 11.4%)가 각각 발생하였다. 상처 부위별로 다시 분석해 보면 서혜부 상처 1개(1/120, 0.83%), 고환 상처 0개(0/55, 0%), 음경 상처 4개(4/35, 11.4%)가 각각 발생하였다. Group 3의 음경 상처에서 다른 군에 비해 통계적으로 의미 있게 증가되었다(P=0.008). Group 2와 3에서 상처 합병증이 발생한 환자들의 평균 나이는 각각 1세, 9.50세 이었고 상처 합병증이 없는 환자들의 평균 나이는 2.34세, 5.61세 였지만 통계적으로 의미는 없었다(P=0.639, 0.122). 5개의 상처 합병증은 모두 가벼운 염증반응이었으며, 항생제 연고만을 적용 후 술 후 평균 13.8일(13-15일) 후 모두 치료되었다. 결론: Dermabond$^{TM}$는 소아비뇨기과에서 음낭수종절제술과 고환고정술 시 피부봉합제로서 기존의 피부 봉합에 대한 대안으로 안전한 방법으로 사료된다. 하지만 음경성형술에서는 향후 더 많은 연구가 필요하다.

Purpose: We aimed to evaluate the efficacy of Octyl-2-cyanoacrylate (Dermabond$^{TM}$) as a topical skin adhesive for pediatric urologic open surgery. Methods: From August 2010 to August 2011, we retrospectively evaluated pediatric patients who underwent urologic open surgery at our institution. A total of 128 pediatric patients with 210 incisions used Dermabond$^{TM}$ for skin closure. Results: We divided the 128 patients into 3 groups according to type of surgery. Group 1 underwent hydrocelectomy (55 cases, 41.3%), Group 2 underwent orchiopexy (43 cases, 32.3%), Group 3 underwent penoplasty (35 cases, 26.4%). One hundred and twenty eight patients who underwent 133 surgeries in total, with a total of 210 incisions visited our outpatient department postoperatively, and a total of 5 wound complications (2.3%) occurred, but were simple inflammations and no dehiscence was observed. When analyzed according to groups, no wound problems occurred in Group 1 (0/55, 0%), one occurred in Group 2 (1/43, 2.3%) and four cases occurred in Group 3 (4/35, 11.4%) respectively. When re-analyzed according to wound locations, one occurred in an inguinal wound (1/120, 0.83%), none occurred in scrotal wounds (0/55, 0%), and four occurred in penile wounds (4/35, 11.4%). In Group 3, the incidence of penile wounds was significantly increased compared to other groups (P=0.008). All 5 wound problems were inflammatory and healed at an average of 13.8 days (13-15 days) with antibiotic ointment application only. Conclusion: Dermabond$^{TM}$ is feasible and safe topical skin adhesive alternative to standard skin suture in pediatric urologic surgery. However, further research about its efficacy and safety could be valuable in the future.

키워드

참고문헌

  1. Rajimwale A, Golden BK, Oottomasathien S, Krishnamurthy M, Ullrich NO, Koyle MA. Octyl-2-Cyanoacrylate as a Routine Dressing after Open Pediatric Urological Procedures. The Journal of Urology 2004;171:2407-8. https://doi.org/10.1097/01.ju.0000125221.50141.33
  2. Singer AJ, Quinn JV, Hollander JE. The cyanoacrylate topical skin adhesives. The American journal of emergency medicine. 2008;26:490-6. https://doi.org/10.1016/j.ajem.2007.05.015
  3. Bruns TB, Worthington JM. Using tissue adhesive for wound repair: a practical guide to dermabond. American Family Physician 2000;61:1383-8.
  4. Bernard L, Doyle J, Friedlander SF, Eichenfield LF, Gibbs NF, Cunningham BB. A prospective comparison of octyl cyanoacrylate tissue adhesive (dermabond) and suture for the closure of excisional wounds in children and adolescents. Archives of Dermatology 2001;137:1177-80. https://doi.org/10.1001/archderm.137.9.1177
  5. Nahas FX, Solia D, Ferreira LM, Novo NF. The use of tissue adhesive for skin closure in body contouring surgery. Aesthetic Plastic Surgery 2004;28:165-9.
  6. Kaye JD, Kalisvaart JF, Cuda SP, Elmore JM, Cerwinka WH, Kirsch AJ. Sutureless and scalpel-free circumcision--more rapid, less expensive and better?. J Urol 2010;184(4 Suppl): 1758-62. https://doi.org/10.1016/j.juro.2010.03.081
  7. Dragu A, Unglaub F, Schwarz S, Beier JP, Kneser U, Bach AD, et al. Foreign body reaction after usage of tissue adhesives for skin closure: a case report and review of the literature. Archives of Orthopaedic and Trauma Surgery 2009;129:167- 9. https://doi.org/10.1007/s00402-008-0643-5
  8. Rogerson L, Mason GC, Roberts AC. Preliminary experience with twenty perineal repairs using Indermil tissue adhesive. European journal of obstetrics, gynecology, and reproductive biology 2000;88:139-42. https://doi.org/10.1016/S0301-2115(99)00148-7
  9. Nitsch A, Pabyk A, Honig JF, Verheggen R, Merten HA. Cellular, histomorphologic, and clinical characteristics of a new octyl- 2-cyanoacrylate skin adhesive. Aesthetic plastic surgery 2005;29:53-8. https://doi.org/10.1007/s00266-004-0096-3
  10. Shapiro AJ, Dinsmore RC, North JH, Jr. Tensile strength of wound closure with cyanoacrylate glue. The American surgeon 2001;67:1113-5.
  11. Ferlise VJ, Ankem MK, Barone JG. Use of cyanoacrylate tissue adhesive under a diaper. BJU international 2001;87:672-3.
  12. van den Ende ED, Vriens PWHE, Allema JH, Breslau PJ. Adhesive bonds or percutaneous absorbable suture for closure of surgical wounds in children. Results of a prospective randomized trial. Journal of pediatric surgery 2004;39:1249- 51. https://doi.org/10.1016/j.jpedsurg.2004.04.013
  13. Singer AJ, Hollander JE, Quinn JV. Evaluation and management of traumatic lacerations. The New England journal of medicine 1997;337:1142-8. https://doi.org/10.1056/NEJM199710163371607
  14. Osmond MH, Klassen TP, Quinn JV. Economic comparison of a tissue adhesive and suturing in the repair of pediatric facial lacerations. The Journal of pediatrics 1995;126:892-5. https://doi.org/10.1016/S0022-3476(95)70203-2
  15. Osmond MH, Quinn JV, Sutcliffe T, Jarmuske M, Klassen TP. A randomized, clinical trial comparing butylcyanoacrylate with octylcyanoacrylate in the management of selected pediatric facial lacerations. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 1999;6:171-7.
  16. Lee JY, Kang DH, Chung JH, Jo JK, Lee SW. Laparoendoscopic single-site surgery for benign urologic disease with a homemade single port device: design and tips for beginners. Korean journal of urology 2012;53:165-70. https://doi.org/10.4111/kju.2012.53.3.165

피인용 문헌

  1. The aplication of cyanoacrilate surgical glue on skin suture in rats vol.32, pp.1, 2012, https://doi.org/10.1590/s0102-865020170107
  2. Use of cyanoacrylate-based surgical adhesives associated to the macroporous tape in skin synthesis in rats vol.34, pp.7, 2019, https://doi.org/10.1590/s0102-865020190070000001