Kanegaye J T, Vance C W, Chan L, Schonfeld N
Division of Emergency Medicine, Childrens Hospital of Los Angeles, California, USA.
J Pediatr. 1997 May;130(5):808-13. doi: 10.1016/s0022-3476(97)80025-x.
To compare the total costs and the physician time requirements for suture and staple repair of pediatric scalp lacerations.
Eighty-eight children, 13 months to 16 years of age, coming to a children's hospital emergency department with simple scalp lacerations were prospectively randomly selected to receive staple or suture repair. Wound lengths, times required for initial wound care and closure, and equipment use were recorded. Patients returned in 1 week for suture or staple removal and wound reevaluation. The two methods were compared in terms of both time expended and costs of equipment and physician compensation.
Forty-five children underwent staple repair and 43 underwent suture repair. There were no differences in age, sex, wound length, number of sutures or staples per centimeter, or physician experience. Stapling resulted in shorter wound closure times (65 vs 397 seconds; p < 0.0001) and shorter overall times for wound care and closure (395 vs 752 seconds; p < 0.0001). Staple repair was less expensive in terms of equipment ($12.55 vs $17.59; p < 0.0001) and total cost based on equipment and physician time ($23.55 vs $38.51; p < 0.0001). The follow-up rate was 91%, with no cosmetic or infectious complications in either group.
Stapling is faster and less expensive than suturing in the repair of uncomplicated pediatric scalp lacerations, with no additional complications. Physicians who treat children with scalp lacerations should consider the use of stapling devices.
比较小儿头皮裂伤缝合与吻合器修复的总成本及医生所需时间。
前瞻性随机选取88名年龄在13个月至16岁、因单纯头皮裂伤前往儿童医院急诊科的儿童，接受吻合器或缝合修复。记录伤口长度、初始伤口处理及缝合所需时间以及设备使用情况。患者在1周后返回进行缝线或吻合器拆除及伤口重新评估。从时间消耗、设备成本及医生报酬方面对两种方法进行比较。
45名儿童接受吻合器修复，43名接受缝合修复。在年龄、性别、伤口长度、每厘米缝线或吻合器数量或医生经验方面无差异。吻合器修复导致伤口缝合时间更短（65秒对397秒；p<0.0001），伤口处理及缝合的总时间更短（395秒对752秒；p<0.0001）。吻合器修复在设备方面成本更低（12.55美元对17.59美元；p<0.0001），基于设备和医生时间的总成本也更低（23.55美元对38.51美元；p<0.0001）。随访率为91%，两组均无美容或感染并发症。
在修复小儿单纯头皮裂伤时，吻合器修复比缝合更快且成本更低，无额外并发症。治疗小儿头皮裂伤的医生应考虑使用吻合器。
