Simon H K, McLario D J, Bruns T B, Zempsky W T, Wood R J, Sullivan K M
Department of Pediatrics, Egleston Children's Hospital, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Pediatrics. 1997 Feb;99(2):193-5. doi: 10.1542/peds.99.2.193.
Histoacryl Blue (HAB), a tissue adhesive, has been shown to decrease laceration repair time, cause less pain to the child, eliminate the need for suture removal, and result in a similar short-term cosmetic outcome compared with conventional suturing. Reports suggest that poor correlation can exist between the short-term and long-term cosmetic outcomes for lacerations repaired by conventional suturing. Therefore, this study compares the long-term cosmetic outcome of HAB to conventional suturing for laceration repair in children.
Prospective, randomized clinical trial.
Children presenting an urban pediatric emergency department for laceration repair between October 1994 and February 1995 were eligible. Patients less than 1 or more than 18 years old, those with lacerations more than 5 cm in length, or in areas of high tension or mobility were excluded.
After routine wound management, including subcutaneous closure when deemed necessary, patients were randomized to receive skin sutures or HAB for cutaneous closure. Photographs taken at the 2-month and 1-year follow-up visits were evaluated for cosmetic appearance by two plastic surgeons blinded to the method of repair.
Sixty-one children were enrolled: HAB (N = 30), suture (N = 31). Thirty HAB and 25 sutured patients were assessed at 2 months, while 17 HAB and 15 sutured patients were reevaluated at 1 year. Patients that followed-up at 2 months and 1 year were comparable to those with no follow-up in: treatment group (HAB vs suture), demographics, wound characteristics, and initial parental satisfaction. The two plastic surgeons graded the cosmetic appearance of the wounds repaired by HAB to be comparable to those repaired by conventional suturing at both the 2-month and 1-year follow-up.
The use of HAB is an ideal alternative to conventional suturing for the cutaneous closure of low tension lacerations in children with a long-term cosmetic outcome comparable to conventional suturing.
组织黏合剂Histoacryl Blue（HAB）已被证明可缩短裂伤修复时间，减少儿童疼痛，无需拆线，且与传统缝合相比，短期美容效果相似。报告表明，传统缝合修复裂伤的短期和长期美容效果之间可能存在较差的相关性。因此，本研究比较了HAB与传统缝合在儿童裂伤修复中的长期美容效果。
前瞻性随机临床试验。
1994年10月至1995年2月在城市儿科急诊科就诊进行裂伤修复的儿童符合条件。排除年龄小于1岁或大于18岁、裂伤长度超过5 cm或位于高张力或高活动区域的患者。
在进行常规伤口处理（必要时包括皮下缝合）后，患者被随机分配接受皮肤缝合或HAB进行皮肤闭合。由两位对修复方法不知情的整形外科医生对2个月和1年随访时拍摄的照片进行美容外观评估。
共纳入61名儿童：HAB组（N = 30），缝合组（N = 31）。2个月时评估了30名HAB组和25名缝合组患者，1年时对17名HAB组和15名缝合组患者进行了重新评估。在2个月和1年进行随访的患者在以下方面与未随访的患者相当：治疗组（HAB组与缝合组）、人口统计学、伤口特征和初始家长满意度。两位整形外科医生将HAB修复伤口的美容外观在2个月和1年随访时评定为与传统缝合修复的伤口相当。
对于儿童低张力裂伤的皮肤闭合，使用HAB是传统缝合的理想替代方法，长期美容效果与传统缝合相当。
