Ong C C P, Jacobsen A S, Joseph V T
Department of Pediatric Surgery, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899.
Pediatr Surg Int. 2002 Sep;18(5-6):553-5. doi: 10.1007/s00383-002-0728-0. Epub 2002 Jun 14.
Tissue adhesives have gained favour for quicker and painless closure of lacerations. To compare the tissue adhesive 2-octylcyanoacrylate with our current standard subcuticular suture for closure of surgical incisions in children, looking at outcome measures of time efficiency, cosmesis, and wound complications, a prospective, randomised, controlled trial was conducted at our institution's ambulatory surgery centre. All healthy patients undergoing unilateral or bilateral herniotomies were recruited prospectively with informed consent and randomly allocated to suture or glue. The exclusion criteria were neonates or children with allergy to tissue glue. Time of wound closure was measured from the subcutaneous layer to application of the dressing. An independent, blinded observer assessed cosmesis at 2 to 3 weeks using a validated wound scale ranging from worst (0) to best (6). Parent satisfaction with wound appearance was recorded on a 100-mm visual analogue scale (VAS). A total of 59 patients were recruited into the study with 26 in the glue group and 33 in the suture group. There was no difference in mean time of closure (glue 181 +/- 62 s vs suture 161 +/- 45 s, P = 0.18). Two patients in each group had a suboptimal Hollander wound score of 5 (7.7% glue, 6.1% suture). There was also no difference in parent satisfaction (VAS: glue 78 +/- 19 mm vs suture 81 +/- 15 mm, P = 0.68). No patient reported any rash, wound infection, or dehiscence. Tissue glue is easy to use with no complications and has equivalent cosmetic results, but is not faster than a subcuticular suture.
组织粘合剂因能更快速且无痛地闭合伤口而受到青睐。为了比较组织粘合剂2-辛基氰基丙烯酸酯与我们目前用于儿童手术切口闭合的标准皮下缝合线，观察时间效率、美容效果和伤口并发症等结果指标，我们在机构的门诊手术中心进行了一项前瞻性、随机、对照试验。所有接受单侧或双侧疝气修补术的健康患者均在获得知情同意后被前瞻性招募，并随机分配至缝合组或粘合剂组。排除标准为新生儿或对组织粘合剂过敏的儿童。伤口闭合时间从皮下层测量至敷料应用。一名独立的、不知情的观察者在2至3周时使用经过验证的伤口量表评估美容效果，量表范围从最差（0）到最佳（6）。家长对伤口外观的满意度通过100毫米视觉模拟量表（VAS）记录。共有59名患者纳入研究，粘合剂组26名，缝合组33名。闭合平均时间无差异（粘合剂组181±62秒，缝合组161±45秒，P = 0.18）。每组各有两名患者的霍兰德伤口评分不理想，为5分（粘合剂组7.7%，缝合组6.1%）。家长满意度也无差异（VAS：粘合剂组78±19毫米，缝合组81±15毫米，P = 0.68）。没有患者报告任何皮疹、伤口感染或裂开情况。组织粘合剂使用简便，无并发症，美容效果相当，但不比皮下缝合线更快。
