Gonsalves Clarelle L, Zhu Jie Wei, Kim Grace Y, Leveille Cameron F, Kam April J
Michael G. DeGroote School of Medicine, Master University, Hamilton, Ontario, Canada.
Division of Plastic, Reconstructive, and Aesthetic Surgery, University of Toronto, Toronto, Ontario, Canada.
Paediatr Child Health. 2021 Aug 3;27(1):32-42. doi: 10.1093/pch/pxab044. eCollection 2022 Mar.
The objective of this study was to determine whether suturing or conservative management of tongue lacerations results in differences in wound healing and functional outcome. The secondary aim was to identify whether antibiotics are required in the treatment of tongue lacerations.
Studies published between December 1954 and August 2020 were extracted from MEDLINE via PubMed, Embase via OVID, CINAHL via EBSCO, Web of Science, and the Cochrane Library and evaluated for inclusion based on predetermined inclusion and exclusion criteria by two independent reviewers in accordance with PRISMA guidelines.
The search yielded a total of 16,111 articles, 124 of which were evaluated by full-text review, resulting in 11 articles included in this systematic review representing 142 unique cases of tongue lacerations. At least 26 lacerations (18.3%) included penetration of the muscle layer of the tongue, and 24 (16.9%) were classified as full-thickness lacerations. Thirty-five of the 142 tongue lacerations (24.6%) were sutured. The remaining lacerations underwent some form of conservative management. The majority of studies reported excellent healing of tongue lacerations regardless of the management method, with minimal scarring and excellent return to normal functional status. No cases of infection were reported.
Current literature is inconsistent with regards to indications and guidelines for primary repair of tongue lacerations. The majority of tongue lacerations reported in the literature heal with excellent outcomes regardless of management method. Physician judgement along with patient and parental preference based on potential risks of the procedure should be used when deciding whether a tongue laceration requires primary repair. Tongue lacerations in otherwise healthy individuals are at very low risk of infection.
本研究的目的是确定舌部裂伤的缝合治疗或保守治疗在伤口愈合和功能结局方面是否存在差异。次要目的是确定舌部裂伤治疗中是否需要使用抗生素。
通过PubMed从MEDLINE、通过OVID从Embase、通过EBSCO从CINAHL、Web of Science以及Cochrane图书馆中检索1954年12月至2020年8月发表的研究，并由两名独立评审员根据预先确定的纳入和排除标准按照PRISMA指南进行评估以确定是否纳入。
检索共获得16111篇文章，其中124篇进行了全文评审，最终11篇文章纳入本系统评价，代表142例独特的舌部裂伤病例。至少26例裂伤（18.3%）累及舌肌层，24例（16.9%）为全层裂伤。142例舌部裂伤中有35例（24.6%）进行了缝合。其余裂伤采用了某种形式的保守治疗。大多数研究报告称，无论采用何种治疗方法，舌部裂伤愈合良好，瘢痕极小，功能恢复正常。未报告感染病例。
目前关于舌部裂伤一期修复的适应证和指南的文献并不一致。文献报道的大多数舌部裂伤无论采用何种治疗方法，愈合效果都很好。在决定舌部裂伤是否需要一期修复时，应结合医生的判断以及患者和家长基于手术潜在风险的偏好。健康个体的舌部裂伤感染风险极低。
