Service de Chirurgie Orthopédique Infantile, Hôpital Lapeyronie, CHU Montpellier, Université de Montpellier, 191, Avenue du Doyen Gaston Giraud, 34925 Montpellier Cedex 5, France.
Service des urgences pédiatriques, Hôpital Lapeyronie, CHU Montpellier, Université de Montpellier, 191, Avenue du Doyen Gaston Giraud, 34925 Montpellier cedex 5, France.
Hand Surg Rehabil. 2020 Dec;39(6):550-555. doi: 10.1016/j.hansur.2020.09.001. Epub 2020 Sep 9.
The main objective of this study was to compare the medium-term results of nail bed repair in children using glue (2-octylcyanoacrylate) versus absorbable sutures. The secondary objective was to compare the results of treatment in the emergency room versus the operating room. This retrospective review of 74 fingertip nail bed lacerations (68 children) evaluated the appearance and pain at the last follow-up visit (minimum of 1 year), and the operating time. Mean age was 3.3 years at time of injury (range 10 months-13 years), with a mean follow-up of 2.6 (1-7) years. Thirty-six nail beds were repaired with glue; 38 were sutured. The clinical outcomes in the two groups were similar. The rate of nail dystrophy was 14% (5% major) regardless of the technique. Nail bed repair time was significantly shorter in the glue group (10.2 vs. 20.3min, p<0.001). Forty-five repairs were performed in the operating room and 29 in the emergency room. The complication rate (early infections) was significantly higher in patients treated in the emergency room. Tissue adhesive (2-octylcyanoacrylate glue) is a reliable option for repairing nail bed lacerations, both in terms of outcomes and speed of repair. Treatment in the operating room is preferable.
本研究的主要目的是比较使用胶水（2-辛基氰基丙烯酸酯）和可吸收缝线修复儿童指甲床的中期结果。次要目的是比较急诊室和手术室治疗结果的差异。这项回顾性研究共纳入了 74 例指尖指甲床裂伤（68 例患儿），评估了末次随访（至少 1 年）时的外观和疼痛情况，以及手术时间。损伤时的平均年龄为 3.3 岁（10 个月至 13 岁），平均随访 2.6（1-7）年。36 个指甲床用胶水修复，38 个指甲床缝合。两组的临床结果相似。无论采用哪种技术，指甲营养不良的发生率均为 14%（5%为严重）。胶水组的指甲床修复时间明显短于缝线组（10.2 分钟比 20.3 分钟，p<0.001）。45 例在手术室修复，29 例在急诊室修复。急诊室治疗患者的并发症（早期感染）发生率明显更高。组织粘合剂（2-辛基氰基丙烯酸酯胶）是修复指甲床裂伤的可靠选择，无论是在疗效还是修复速度方面。在手术室治疗更为可取。
