Hock Marcus Ong Eng, Ooi S B S, Saw S M, Lim S H
Department of Emergency Medicine, Singapore General Hospital, Singapore.
Ann Emerg Med. 2002 Jul;40(1):19-26. doi: 10.1067/mem.2002.125928.
We evaluate a new technique of treating scalp lacerations, the hair apposition technique (HAT). After standard cleaning procedures, hair on both sides of a laceration is apposed with a single twist. This is then held with tissue adhesives. HAT was compared with standard suturing in a multicenter, randomized, prospective trial.
All linear lacerations of the scalp less than 10 cm long were included. Severely contaminated wounds, actively bleeding wounds, patients with hair strand length less than 3 cm, and hemodynamically unstable patients were excluded. Patients were randomized to receive either HAT or standard suturing, and the time to complete the wound repair was measured. All wounds were evaluated 7 days later in a nonblinded manner for satisfactory wound healing, scarring, and complications.
There were 96 and 93 patients in the study and control groups, respectively. Wound healing trended toward being judged more satisfactory in the HAT group than standard suturing (100% versus 95.7%; P =.057; effect size 4.3%; 95% confidence interval 0.1% to 8.5%). Patients who underwent HAT had less scarring (6.3% versus 20.4%; P =.005), fewer overall complications (7.3% versus 21.5%; P =.005), significantly lower pain scores (median 2 versus 4; P <.001), and shorter procedure times (median 5 versus 15 minutes; P <.001). There was a trend toward less wound breakdown in the HAT group (0% versus 4.3%; P =.057). When patients were asked whether they were willing to have HAT performed in the future, 84% responded yes, 1% responded no, and 15% were unsure.
HAT is equally acceptable and perhaps superior to standard suturing for closing suitable scalp lacerations. Advantages include fewer complications, a shorter procedure time, less pain, no need for shaving or removal of stitches, similar or superior wound healing, and high patient acceptance. HAT has become our technique of choice for suitable scalp lacerations.[Ong Eng Hock M, Ooi SBS, Saw SM, Lim SH. A randomized controlled trial comparing the hair apposition technique with tissue glue to standard suturing in scalp lacerations (HAT study).
我们评估一种治疗头皮裂伤的新技术——毛发对合技术（HAT）。在进行标准清洁程序后，将裂伤两侧的毛发进行单次扭转对合，然后用组织粘合剂固定。在一项多中心、随机、前瞻性试验中，将HAT与标准缝合进行比较。
纳入所有长度小于10 cm的头皮线性裂伤。排除严重污染伤口、活动性出血伤口、发束长度小于3 cm的患者以及血流动力学不稳定的患者。患者被随机分配接受HAT或标准缝合，并测量完成伤口修复的时间。7天后以非盲法对所有伤口进行评估，观察伤口愈合情况、瘢痕形成及并发症。
研究组和对照组分别有96例和93例患者。与标准缝合相比，HAT组伤口愈合情况在满意度方面呈更好趋势（100%对95.7%；P = 0.057；效应量4.3%；95%置信区间0.1%至8.5%）。接受HAT治疗的患者瘢痕形成较少（6.3%对20.4%；P = 0.005），总体并发症较少（7.3%对21.5%；P = 0.005），疼痛评分显著更低（中位数2对4；P < 0.001），手术时间更短（中位数5对15分钟；P < 0.001）。HAT组伤口裂开有减少趋势（0%对4.3%；P = 0.057）。当询问患者未来是否愿意接受HAT治疗时，84%回答愿意，1%回答不愿意，15%不确定。
对于合适的头皮裂伤，HAT同样可接受，且可能优于标准缝合。其优点包括并发症更少、手术时间更短、疼痛减轻、无需剃发或拆线、伤口愈合相似或更好以及患者接受度高。HAT已成为我们处理合适头皮裂伤的首选技术。[翁恩霍克M，黄淑贤SBS，苏秀梅，林世和。一项比较毛发对合技术加组织胶水与标准缝合治疗头皮裂伤的随机对照试验（HAT研究）。
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