Cyanoacrylate Skin Adhesive After Mohs Surgery or Wide Local Excision

This study will compare surgical site infection after linear repair with or without cyanoacrylate skin adhesive following Mohs micrographic surgery or wide local excision. Adult participants undergoing Mohs micrographic surgery or wide local excision for skin cancer with a surgical defect suitable for linear repair will be stratified by suture type and randomized to standardized running epidermal suture closure with or without cyanoacrylate skin adhesive. The primary outcome is surgical site infection within 30 days after surgery. Secondary outcomes include scar quality, treatment satisfaction, wound care burden, wound healing characteristics, antibiotic use, culture results, health care utilization related to wound concerns, and adverse events.

Inclusion Criteria: * Age 18 years or older * Undergoing Mohs micrographic surgery or wide local excision for skin cancer * Surgical defect suitable for linear repair * Surgical defect suitable for linear repair using standardized running epidermal sutures * Ability to provide informed consent * Ability to read at a 5th grade level or above, needed for survey administration Exclusion Criteria: * Requirement for flap, graft, geometric repair, or healing by second intention * Active infection or severe contamination at the surgical site prior to closure * Known allergy or hypersensitivity to cyanoacrylate adhesive, fast gut, Vicryl Rapide, or Prolene * Recurrent tumor at the surgical site * Prior radiation therapy to the surgical site * Current use of systemic antibiotics for an unrelated medical condition at the time of surgery * Concurrent participation in another interventional research study that could confound wound healing or infection outcomes * Inability to comply with study procedures or follow-up visits * Any condition that, in the judgment of the investigator, would interfere with safe participation or interpretation of study outcomes * Children * Fetuses * Neonates * Prisoners * Adults lacking capacity to consent or adults with diminished or fluctuating capacity to consent * Non-English speakers * Individuals unable to read * Employees of the researcher