Rebello Gleeson, Parikh Ravi, Grottkau Brian
Department of Pediatric Orthopedics, Massachusetts General Hospital for Children, Boston, MA 02114, USA.
J Pediatr Orthop. 2009 Sep;29(6):626-8. doi: 10.1097/BPO.0b013e3181b2ba1b.
This study is a randomized controlled trial comparing skin closure time between coaptive film and subcuticular monocryl sutures in children undergoing identical single session, bilateral limb multiple soft tissue releases.
Eight children less than 18 years of age (mean 14.5) with cerebral palsy underwent identical, single session bilateral multiple soft tissue releases in the lower limb from August 2005 to March 2007. There were 50 incisions in all in which 25 incisions were closed with 4-0 intracuticular monocryl sutures and 25 were closed with coaptive film (Steri Strip S; 3M company). Time taken for closure using either technique was recorded. A blinded plastic surgeon used a visual analog scale to assess the cosmetic results at the end of a 3 month follow-up.
The average length of incisions closed with coaptive film was almost identical to the corresponding incision on the contralateral limb that was closed with subcuticular monocryl suture (4.45 and 4.81 cm, P=0.66). The average time for skin closure using monocryl sutures was 167.04 seconds compared with the average time of 79.36 seconds when using coaptive film (P <0.0001). There was no significant difference in the cosmetic results or the number of wound complications using either technique.
Coaptive film is an attractive and cost-effective option for skin closure after pediatric surgery.
The time saved, comparable cosmetic results and lack of complications makes coaptive film an attractive option for skin closure in the pediatric age group.
本研究是一项随机对照试验，比较在接受相同单次双侧肢体多处软组织松解术的儿童中，粘贴薄膜与皮下单丝缝线的皮肤闭合时间。
2005年8月至2007年3月，8名年龄小于18岁（平均14.5岁）的脑瘫患儿接受了相同的单次双侧下肢多处软组织松解术。共有50处切口，其中25处切口用4-0皮内单丝缝线缝合，25处用粘贴薄膜（3M公司的思乐扣S）闭合。记录使用每种技术的闭合时间。一名不知情的整形外科医生在3个月随访结束时使用视觉模拟量表评估美容效果。
用粘贴薄膜闭合的切口平均长度与对侧肢体用皮下单丝缝线闭合的相应切口几乎相同（4.45和4.81厘米，P=0.66）。使用单丝缝线闭合皮肤的平均时间为167.04秒，而使用粘贴薄膜时平均时间为79.36秒（P<0.0001）。两种技术在美容效果或伤口并发症数量方面没有显著差异。
粘贴薄膜是小儿外科手术后皮肤闭合的一种有吸引力且经济有效的选择。
节省的时间、相当的美容效果以及无并发症使得粘贴薄膜成为小儿年龄组皮肤闭合的一个有吸引力的选择。
