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

Background: 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.

Methods: 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.

Results: 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).

Conclusion: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.