PEDIATRICS Vol. 99 No. 2 February 1997, pp. 193-195 (doi:10.1542/peds.99.2.193)
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PEDIATRICS Vol. 99 No. 2 February 1997, pp. 193-195

Long-term Appearance of Lacerations Repaired Using a Tissue Adhesive

Received Jan 19, 1996; accepted Mar 18, 1996.

Harold K. Simon*, David J. McLario*, Thomas B. Bruns*, Dagger , William T. Zempsky*, Robert J. Wood§, and Kevin M. Sullivan*

From the * Department of Pediatrics, Division of Critical Care and Emergency Medicine, Egleston Children's Hospital, Emory University School of Medicine, Atlanta, Georgia; the Dagger  Department of Pediatrics, Department of Ambulatory/Emergency Services, T.C. Thompson Children's Hospital, University of Tennessee School of Medicine, Chattanooga, Tennessee; and the § Center for Cleft and Craniofacial Anomalies, Plastic, Reconstructive and Maxillo-Facial Surgery, Emory Clinic, Emory University School of Medicine, Atlanta, Georgia.

Background.  Histoacryl Blue (HAB), a tissue adhesive, has been shown to decrease laceration repair time, cause less pain to the child, eliminate the need for suture removal, and result in a similar short-term cosmetic outcome compared with conventional suturing. Reports suggest that poor correlation can exist between the short-term and long-term cosmetic outcomes for lacerations repaired by conventional suturing. Therefore, this study compares the long-term cosmetic outcome of HAB to conventional suturing for laceration repair in children.

Design.  Prospective, randomized clinical trial.

Participants.  Children presenting an urban pediatric emergency department for laceration repair between October 1994 and February 1995 were eligible. Patients less than 1 or more than 18 years old, those with lacerations more than 5 cm in length, or in areas of high tension or mobility were excluded.

Interventions.  After routine wound management, including subcutaneous closure when deemed necessary, patients were randomized to receive skin sutures or HAB for cutaneous closure. Photographs taken at the 2-month and 1-year follow-up visits were evaluated for cosmetic appearance by two plastic surgeons blinded to the method of repair.

Results.  Sixty-one children were enrolled: HAB (N = 30), suture (N = 31). Thirty HAB and 25 sutured patients were assessed at 2 months, while 17 HAB and 15 sutured patients were reevaluated at 1 year. Patients that followed-up at 2 months and 1 year were comparable to those with no follow-up in: treatment group (HAB vs suture), demographics, wound characteristics, and initial parental satisfaction. The two plastic surgeons graded the cosmetic appearance of the wounds repaired by HAB to be comparable to those repaired by conventional suturing at both the 2-month and 1-year follow-up.

Conclusions.  The use of HAB is an ideal alternative to conventional suturing for the cutaneous closure of low tension lacerations in children with a long-term cosmetic outcome comparable to conventional suturing.

Key words: Histoacryl Blue, tissue adhesive, long-term, cosmetics, lacerations, cyanoacrylates.




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