A Pilot Study of 2-Octyl Cyanoacrylate (Dermabond™) versus Conventional Suture Skin Closures for Caesarean Sections

Introduction: 2-octyl cyanoacrylate (Dermabond™, Ethicon, USA) has been available as an alternative skin closure since 1997. There are no reports on keloid formation with 2-octyl cyanoacrylate (2OC) closure for Caesarean section. Our study aims to assess keloid formation after Caesarean sections, as well as the safety and efficacy of 2OC for skin closure in Caesarean sections. Methods: A pilot study of 97 cases of Caesarean section performed by a single surgeon was done — 50 2OC closure versus 47 suture closure. Keloid formation, average operating time, wound infection, wound dehiscence and adverse peri-wound conditions were compared. Proportions across the two series were compared using chi-square/fisher exact test. Average operating time was compared using unpaired t-test. Results: Keloid formation was not statistically significant (2OC 24.0% versus S 14.9%, p=0.382). Mean operating time was similar (2OC 34.1±7.2 minutes versus S 32.7±7.2 minutes, p=0.33). Wound infection rate was similar (2OC 2.0% versus S 2.1%, p=0.939). More women experienced adverse peri-wound conditions with suture closure (2OC 2.0% versus S 6.4%, p=0.303). No woman experienced wound dehiscence. Conclusion: 2-octyl cyanoacrylate has similar efficacy to suture skin closure in terms of keloid formation, operating time, wound infection and adverse peri-wound conditions. It can be a safe alternative for Caesarean section skin closure

The Health and Well-Being of Caregivers of Technologically Dependent Children

Caregivers of technology-dependent children face considerable responsibilities. This study examined the association of 2 child-related stressors—functional status and use of mechanical ventilator—with 2 domains of family caregiver well-being—depressive symptoms (Center for Epidemiologic Studies Depression Scale [CES-D]) and health-related quality of life (HRQOL) and family function (PedsQL Family Impact Module). The secondary objective was to determine whether these associations were moderated by caregiver-perceived social support. Structured interviews were conducted with 88 primary family caregivers of technology-dependent children in Singapore. Hierarchical multiple regression was used to assess the primary and secondary objectives. A total of 44.3% of caregivers were at high risk of clinical depression. Moderately poor child functional status was associated with more caregiver depressive symptoms. Perceived social support moderated this association. Family caregivers of technology-dependent children have high levels of depressive symptoms and relatively poor HRQOL and family functioning. Enhancing caregivers’ social support is important for their well-being

Book 1.indb

Abstract Introduction: The 12-item Expectations Regarding Aging (ERA-12) instrument measures expectations that individuals have about how their health and cognitive function will be when they age. To date, primarily assessed among older adults in Western settings, expectations regarding ageing have been associated with physical activity and healthcare seeking behaviour. It has been suggested that it may be possible to develop interventions that promote positive expectations about ageing. Assessment of expectations regarding ageing among today's middleaged population would allow for earlier interventions to help give them positive (but realistic) ageing expectations, and age successfully. We assess the reliability and validity of ERA-12 for middle-aged Singaporeans. Materials and Methods: A questionnaire that included ERA-12 was administered to 1020 patients aged 41 to 62 years attending 2 SingHealth polyclinics in Singapore. Data from 981 respondents who completed the ERA-12 instrument were analysed. ERA-12's construct validity was determined using Exploratory Factor Analysis (EFA), and through its correlation with depressive symptoms, and self-rated health and education. Internal consistency reliability was assessed using Cronbach's alpha. Results: EFA confi rmed that the ERA-12 consisted of 3 factors (each with 4 items) -expectations regarding physical health, mental health and cognitive function, together explaining 64% of the variance in ERA-12 total score with high factor loadings (range, 0.6 to 0.8). The ERA-12 total score was positively correlated with self-rated health (r = 0.13) and education (r = 0.19), and negatively correlated with depressive symptoms (r = -0.25). Cronbach's alpha exceeded 0.7 for ERA-12 overall, and for each subscale. Conclusion: ERA-12 can be used to evaluate expectations regarding ageing not only among elderly populations in the West, but also among middle-aged Singaporeans. Ann Acad Med Singapore 2010;39:394-