Department of Surgery and Perioperative Care, The University of Texas at Austin Dell Medical School.
Research and Support Services, Dell Children's Medical Center, Austin, TX.
Pediatr Emerg Care. 2022 Oct 1;38(10):477-480. doi: 10.1097/PEC.0000000000002837. Epub 2022 Aug 26.
A randomized controlled trial was designed to compare 2 methods of repairing simple pediatric facial lacerations. We hypothesized that wounds repaired with skin adhesive and underlying adhesive strips compared with skin adhesive alone would be superior in regard to cosmetic outcome.
Patients aged younger than 18 years presenting to the emergency department with simple facial lacerations requiring repair were eligible for enrollment. Patients were randomly assigned to repair with either skin adhesive alone or skin adhesive with underlying adhesive strips. Families were contacted by phone 1 week after enrollment to discuss short-term complications. The cosmetic appearance of photographs of the scars at 2 months was analyzed using a visual analog scale by a blinded pediatric emergency physician and pediatric plastic surgeon.
One hundred twenty patients were enrolled, with 92 returning for the 2-month follow-up. The visual analog scale scores for the skin adhesive with adhesive strips group were similar to the skin adhesive alone group (60 mm vs 58 mm, P = 0.540). Spearman ρ correlation coefficient between the raters was 0.669, indicating strong agreement. There was no significant difference in rates of return visits, wound dehiscence, or infection. The skin adhesive with adhesive strips group had a longer time to perform the repair (195 seconds vs 107 seconds, P < 0.001).
Using adhesive strips to first approximate a wound before applying skin adhesive leads to a similar cosmetic outcome compared with simple facial lacerations repaired with skin adhesive alone. Although the study showed longer time to complete the repair, this approach may still be useful in settings where approximation is difficult to obtain manually.
设计了一项随机对照试验，比较修复单纯小儿面部裂伤的两种方法。我们假设，与单独使用皮肤粘合剂相比，使用皮肤粘合剂和底层胶带修复的伤口在美容效果方面会更好。
年龄在 18 岁以下的患者，因需修复的单纯面部裂伤而到急诊科就诊，符合入组条件。患者被随机分配接受单独使用皮肤粘合剂或皮肤粘合剂加底层胶带修复。在入组后 1 周，通过电话联系患者家属，讨论短期并发症。由一名盲法的儿科急诊医生和小儿整形外科医生使用视觉模拟量表对 2 个月后疤痕的照片进行美容外观分析。
共入组 120 例患者，其中 92 例患者在 2 个月时进行了随访。使用皮肤粘合剂加胶带组的视觉模拟量表评分与单独使用皮肤粘合剂组相似（60 毫米比 58 毫米，P = 0.540）。两位评分者之间的斯皮尔曼 ρ相关系数为 0.669，表明存在强相关性。两组患者的复诊率、伤口裂开或感染率无显著差异。使用皮肤粘合剂加胶带组修复的时间更长（195 秒比 107 秒，P < 0.001）。
与单独使用皮肤粘合剂修复单纯面部裂伤相比，使用胶带先将伤口初步贴合，然后再使用皮肤粘合剂，可达到相似的美容效果。尽管该研究显示修复完成时间更长，但在手动难以实现贴合的情况下，这种方法可能仍然有用。
