Quinn J, Wells G, Sutcliffe T, Jarmuske M, Maw J, Stiell I, Johns P
Section of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA.
Ann Emerg Med. 1998 Dec;32(6):645-9. doi: 10.1016/s0196-0644(98)70061-7.
To compare the 1-year cosmetic outcome of wounds treated with octylcyanoacrylate tissue adhesive and monofilament sutures and to correlate the early, 3-month, and 1-year cosmetic outcomes.
We prospectively randomized 136 cases of traumatic laceration to repair with octylcyanoacrylate tissue adhesive or 5-0 or smaller monofilament suture. A wound score was assigned by a research nurse, and validated by a second nurse blinded to the treatment, at 5 to 10 days after injury (early), 3 months, and 1 year. Standardized photographs were taken at 3 months and 1 year and shown to a cosmetic surgeon blinded to the method of closure, who rated the wounds on a validated cosmesis scale.
We were able to examine 77 lacerations at 1 year for follow-up. No differences were found in the demographic or clinical characteristics between groups. Likewise, at 1 year no difference was found in the optimal wound scores (73% versus 68%, P =.60) or in visual analog scale cosmesis scores (69 versus 69 mm, P =.95) for octylcyanoacrylate and sutures, respectively. Agreement was poor between early and 3-month wound scores (kappa=.34; 95% confidence interval [CI],.10 to.58) but a strong association existed between 3-month and 1-year wound scores (kappa=.71; 95% CI,.52 to.90). We noted a moderate correlation between 3-month and 1-year results on the visual analog cosmesis scale (intraclass correlation,.48; 95% CI, .30 to.63).
One year after wound repair, no difference is noted in the cosmetic outcomes of traumatic lacerations treated with octylcyanoacrylate tissue adhesive and sutures. The assessment of wounds 3 months after injury and wound repair provides a good measure of long-term cosmetic outcome.
比较用氰基丙烯酸辛酯组织粘合剂和单丝缝线治疗伤口的1年美容效果，并关联早期、3个月和1年的美容效果。
我们前瞻性地将136例外伤性撕裂伤随机分为用氰基丙烯酸辛酯组织粘合剂或5-0或更细的单丝缝线进行修复。在受伤后5至10天（早期）、3个月和1年时，由一名研究护士分配伤口评分，并由另一名对治疗不知情的护士进行验证。在3个月和1年时拍摄标准化照片，并展示给对闭合方法不知情的整形外科医生，其根据经过验证的美容量表对伤口进行评分。
我们能够对77例撕裂伤进行1年的随访检查。两组之间在人口统计学或临床特征方面未发现差异。同样，在1年时，氰基丙烯酸辛酯和缝线的最佳伤口评分（分别为73%对68%，P = 0.60）或视觉模拟量表美容评分（分别为69对69mm，P = 0.95）也未发现差异。早期和3个月时的伤口评分之间一致性较差（kappa = 0.34；95%置信区间[CI]，0.10至0.58），但3个月和1年时的伤口评分之间存在强关联（kappa = 0.71；95%CI，0.52至0.90）。我们注意到视觉模拟美容量表上3个月和1年结果之间存在中度相关性（组内相关性，0.48；95%CI，0.30至0.63）。
伤口修复1年后，用氰基丙烯酸辛酯组织粘合剂和缝线治疗的外伤性撕裂伤的美容效果未发现差异。受伤和伤口修复3个月后对伤口的评估可很好地衡量长期美容效果。
