In accordance with the study objective, each parameter was inspected carefully, and statistical assessment was performed for descriptive and inferential observations. The specific objective of these observations was to understand the possible relationships between the important parameters, such as sex difference, age, wound length, and drying time. However, every variable was keenly inspected for any plausible impacts they may have had on patient outcomes.
All resections involved linear vertical incisions. Some patients developed hematoma after almost 2 weeks of surgery, and examples are presented in Figure 1 and Figure 2 as observed post-operatively.
Observations and outcomes
Most of the subjects who participated in this study were aged between 40 and 70 years (Fig. 3A). The mean patients’ age was 50.41 (±16.83) years (Fig. 3B). The mean age of the female patients was 50.46 (±16.36) years, and the mean age of the male patients was 50.32 (±17.80) years. The total number of female participants in this study was 62 (62.62%), and the number of male participants was 37 (37.37%) of the 99 subjects selected for the study (Fig. 3C).
All selected participants underwent proper diagnosis and were categorized on the basis of the diagnostic (Dx) categories (Table 1) and the type of cancer (Fig. 3D). The Dx categories constituted 26 cases of lipoma (26.26%) and 14 cases of liposarcoma (14.14%), followed by ganglion cyst (n = 8, 8.08%) (Table 1). Metastasis was observed in 13/99 cases (13.13%).
Patients’ diagnoses were categorized on the basis of the type of the tumor, benign, malignant, or metastatic. Additionally, in the benign group, benign bone tumors (n = 10, 10%) and benign soft tissue tumor (n = 47, 47.47%) were diagnosed and recorded. Similarly, in the case of malignancy, malignant bone tumor (n = 3, 3.03%) and malignant soft tissue tumors (n = 26, 26.26%) were identified. Bone metastasis was observed in 13 cases (Fig. 3D).
Inspection and demographics of the tumor or diagnosed cancer were also performed on the basis of the body part of origin (Fig. 3E) to understand the most predominant body part affected by musculoskeletal cancer; 59 cases (59.59%) had musculoskeletal cancer in the upper extremities and back, and, in contrast, 40 (40.40%) cases had cancer in the lower extremities. Most cancers in the upper extremities were observed in the shoulder, forearm, and hand (Fig. 3E); several cases were recorded in the back region as well. The thigh and hip were the most affected areas in the lower body (Fig. 3E).
Analysis of the pain intensity due to the surgical wounds and the scars was performed using a VAS (Fig. 3F), with a scale range of 1–4, and with most patients reporting scores of 2 or 3 (Fig. 3F). Hematoma was observed in 10 patients during the post-operative follow-up (Fig. 3G). Table 1 presents the distribution of the diagnosed cases on the basis of the Dx category and shows a predominance of lipoma (n = 26, 26%), liposarcoma (n = 14, 14%), and metastasis (n = 13, 13%) (Table 1).
We further analyzed the surgical operations that were performed, which constituted the following: curettage and cementation and intramedullary nailing (IMN); marginal resection; curettage, cementation and cephalomedullary nailing (CMN); curettage, cementation and IMN; curettage, cementation, and plating; endoprosthesis; hemiarthroplasty; marginal resection; open biopsy; and wide resection. The majority of the surgeries were performed either with marginal resection (n = 44, 44%) or by wide resection (n = 40, 40%) (Table 2).
The distribution of the wound length, drying time, and patients’ responses are shown in Figure 4. Most surgical wounds were within 15 cm (Fig. 4A), and the mean incision length was 10.24 (±5.7) cm (Fig. 4B).
The mean drying time was 1.81 (±0.59) minutes. In most cases, the adhesive dried within 2 minutes after application (Fig. 4C). All patients were requested to provide feedback on the treatment outcomes (Fig. 4D). Of the 99 patients, 91 (91%) patients reported excellent satisfaction with the treatment approach (Fig. 4D). The remainder of the patients reported scores of “good” (6%) and “fair” (2%). No negative feedback was received from any of the patients regarding the use of the adhesive as a method of surgical wound treatment and closure.
Adverse event assessment
Careful monitoring was performed for possible adverse events intra- and post-operatively. Two patients developed minor infections, keloid formation was observed in five patients, and poor wound healing as dehiscence was observed in 7% of patients. Post-operative incisional bleeding was recorded in 3% of the patients, and hematoma was observed in 10 patients (Fig. 3G).
Statistical evaluation of wound length and drying time
We performed a correlation analysis for the wound length and drying time (Fig. 5), with separate analyses for the male (Fig. 5A) and female (Fig. 5B) patients. Although the correlation values were similar between the sexes (Fig. 5C–E), the relationship between the wound length and drying time was significant for both male patients (P = 0.019) and female patients (P = 0.010).
These findings motivated us to conduct Pearson’s Chi-square test to detect statistically significant observations that differed between the male and female patients. However, for the considered parameters, no statistically significant difference was observed for the observed outcomes between the sexes (Table 3).