Orthopedics. 2022 Jan-Feb;45(1):e42-e46. doi: 10.3928/01477447-20211101-08. Epub 2021 Nov 8.
Adhesive taping is commonly used to reinforce wound closure and approximate minor lacerations. Recently, tissue adhesives such as 2-octylcyanoacrylate have gained popularity because of their high tensile strength, bacteriostatic properties, and spontaneous peeling. We sought to evaluate the cosmetic result of upper extremity incisions closed primarily by subcuticular suture, randomizing the application of tissue adhesive vs adhesive taping to different halves of the same surgical incision. Subjects were recruited from patients undergoing common procedures at the senior surgeon's hand surgery clinic. After primary closure, we applied either quarter-inch adhesive tape or tissue adhesive to the proximal and distal aspects of the wounds, based on a preoperative randomization protocol. We assessed the scars at approximately 3 months (range, 2-5 months). Subjects completed a validated scar assessment questionnaire, and a blinded photograph was obtained to allow 2 independent surgeons to assess the scar. Mean age was 63 years (SD, 11.8 years; range, 21-88 years); 56% of patients were women, and 44% were men. Most of the incisions were open carpal tunnel release and thumb carpometacarpal arthroplasty (14 each). Adhesive taping showed a better overall mean score based on evaluation by the hand surgeons, a finding that was statistically significant. The greatest differences were observed between color and size, but no subcategories were significantly different. Patients reported nonstatistical, but slightly better overall cosmetic outcomes with adhesive taping rather than tissue adhesive. Adhesive strips provide a modest but significant improvement in cosmetic outcomes vs more expensive tissue adhesive. Future evaluation of closure methods that evaluate cost, speed of application, suture technique, and dressing will optimize scar appearance. [. 2022;45(1):e42-e46.].
粘胶带通常用于加强伤口闭合和接近小的裂伤。最近，由于其高拉伸强度、抑菌特性和自发剥离，2-辛基氰基丙烯酸酯等组织粘合剂越来越受欢迎。我们试图通过将组织粘合剂与粘胶带随机应用于同一手术切口的不同半部分，来评估上肢切口的美容效果，这些切口主要通过皮下缝合闭合。研究对象从高级外科医生手外科诊所接受常规手术的患者中招募。在初次闭合后，我们根据术前随机分组方案，将四分之一英寸的粘胶带或组织粘合剂应用于伤口的近端和远端。我们在大约 3 个月（范围，2-5 个月）时评估疤痕。患者完成了一份经过验证的疤痕评估问卷，并获得了一张盲法照片，以便 2 名独立的外科医生评估疤痕。平均年龄为 63 岁（标准差，11.8 岁；范围，21-88 岁）；56%的患者为女性，44%为男性。大多数切口为开放性腕管松解和拇指腕掌关节成形术（各 14 例）。手部外科医生的评估显示，粘胶带的整体平均评分更好，这一发现具有统计学意义。颜色和大小的差异最大，但没有任何亚类有显著差异。患者报告说，与组织粘合剂相比，粘胶带的整体美容效果略好，但无统计学意义。粘带条与更昂贵的组织粘合剂相比，在美容效果上有适度但显著的改善。未来对闭合方法的评估，包括成本、应用速度、缝合技术和敷料，将优化疤痕外观。[。2022；45（1）：e42-e46。]。
