Background: Wound closure has evolved with advancements in sutures and materials, yet no single method is ideal for all situations. Surgeons seek the fastest, easiest, and most cosmetically pleasing techniques, with cyanoacrylate tissue adhesive offering benefits like improved cosmesis, versatility, moisture resistance, better patient compliance, and ease of application. Evaluating newer methods against traditional sutures remains crucial. Study objective: To compare and evaluate cyanoacrylate tissue adhesive and subcuticular suture techniques for maxillofacial incision closure in terms of speed, early wound complications, patient cosmetic satisfaction, and scar cosmesis.

Method: In a comparative prospective randomized clinical study at Al-Imamain Al-Kadhemain Medical City, patients undergoing maxillofacial surgery were divided into two groups for skin incision closure using tissue adhesive or subcuticular sutures. Postoperative wound healing was assessed at 5 to 10 days, and scar evaluation at 4 months by a blinded plastic surgeon using the Scar Cosmesis Assessment and Rating Scale. Patients' scar satisfaction was measured with a visual analog scale, and data analysis was performed using SPSS version 25.0.

Results: 32 patients, 40 incisions, 20 per group. The tissue adhesive group had a substantially faster mean closure time (106.25±25.43 seconds) compared to the subcuticular suture group (188.40±44.11 seconds) (p<0.05). Early wound problems, patient scar satisfaction, and scar cosmesis at 4 months were not significantly different between the two groups.

Conclusion: Our study reveals that tissue adhesive is a dependable, effective, and safe skin closure for maxillofacial surgeries in the face and neck. It also takes less time to apply and seal the skin and offers good aesthetic outcomes. These findings need to be confirmed by bigger patient investigations.