Tissue Adhesive‐Assisted Closure After Venous Port Implantation

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Abstract
Background: Evidence on tissue adhesive for skin closure after totally implantable venous access port (TIVAP) implantation is limited. We evaluated whether alpha‐n‐butyl cyanoacrylate applied after subcutaneous tension‐reducing sutures was associated with fewer clinically relevant early wound complications and lower postoperative care burden. Methods: This retrospective propensity score‐matched cohort study included 2118 analysis‐eligible TIVAP implantations performed from July 2024 to March 2026 after exclusion of four records with implausible anthropometric values. The adhesive group underwent tension‐reducing subcutaneous closure followed by cyanoacrylate sealing; the control group underwent conventional intradermal continuous suturing. The primary outcome was clinically relevant wound complication within 21 ± 3 days, excluding mild erythema without antibiotics and dressing frequency. One‐to‐one nearest‐neighbour propensity score matching without replacement was performed using age, sex, body mass index, comorbidities, laboratory indices, tumour type, port indication and puncture side. Results: After matching, 972 pairs were retained with good covariate balance (maximum absolute standardised mean difference, 0.046). The primary outcome occurred in 101/972 patients (10.4%) in the adhesive group and 173/972 (17.8%) in the suture group (absolute risk reduction, 7.4 percentage points; number needed to treat, 14; odds ratio, 0.54; 95% confidence interval, 0.41–0.70; p < 0.001). Adhesive‐assisted closure was associated with fewer wound dehiscence events, secondary closure or incision reopening, antibiotic‐requiring wound infections, port‐use delay and unplanned wound visits. Mild erythema without antibiotics was more frequent with adhesive‐assisted closure (12.8% vs. 4.8%). Closure time was shorter in the adhesive group (3.7 ± 0.7 vs. 8.0 ± 1.2 min; p < 0.001). Conclusion: Adhesive‐assisted closure after TIVAP implantation was associated with fewer objective early wound complications and reduced postoperative care burden. Mild erythema should be reported separately from infection or wound failure.

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