A Prospective Randomized Study of Surgical Site Infection After Linear Repair With or Without Cyanoacrylate Skin Adhesive Following Mohs Micrographic Surgery and Wide Local Excision

Surgical site infection is an uncommon but clinically important complication after dermatologic surgery. Linear repairs are frequently performed after Mohs micrographic surgery and wide local excision, and closure technique may affect infection risk, wound healing, scar quality, and patient experience.

This is a prospective, randomized, stratified parallel group clinical study evaluating postoperative outcomes after standardized running epidermal suture closure with or without cyanoacrylate skin adhesive. Adult patients undergoing Mohs micrographic surgery or wide local excision for skin cancer will be screened on the day of surgery. Participants will be eligible if the surgical defect is suitable for linear repair using standardized running epidermal sutures.

Participants will be stratified by suture type. In the absorbable suture stratum, participants will be randomized using a 2×2 factorial design to fast gut or Vicryl Rapide suture material and to adhesive use or no adhesive. In the non-absorbable suture stratum, participants will receive Prolene and will be randomized to closure with or without cyanoacrylate skin adhesive.

All participants will undergo Mohs micrographic surgery or wide local excision as part of standard clinical care. Research procedures include randomization of closure approach, standardized wound photography, follow-up assessments at approximately 2 weeks and 3 months, documentation of infection or suspected infection, wound healing assessment, adverse event assessment, and patient-reported outcome measures.

The primary outcome is surgical site infection within 30 days following linear repair. Secondary outcomes include antibiotic use, wound healing metrics, patient-reported treatment satisfaction and wound care burden, scar quality using the Patient and Observer Scar Assessment Scale 3.0 Linear Scar Version, culture results and treatment descriptions when infection is suspected, health care utilization related to wound concerns, and adverse events.