Tissue Adhjesive Versus Simple Suture for Wound Management in Children under 5 Years of Age in the Emergency Department

Kim, Ho Jung; Ha, Young Rock; Kim, Young Sik; Kim, Joo Hyun; Kim, Sang Chul; Kim, Jae Chul; Do, Han Ho

Abstract

PURPOSE
This research compared a new tissue adhesive, 2-octylcyanoacrylate, with standard wound closure techniques for the repair of traumatic lacerations.
METHODS
A prospective, randomized, controlled clinical trial enrolled consecutive patients under 5 yearsof age with non-bite, non-crush-induced lacerations who presented less than 6 hours after injury. Data sheets were completed at the time of laceration repair and suture removal. Patients were randomly assigned to treatment with either 2-octhlcyanoacrylate or standard wound closure. Infection was determined at the time of suture removal. Cosmetic appearance for 4 weeks was assessed by physicians using a previously validated categorical cosmetic scale and by patients and parentsusing a 100-mm visual analog scale.
RESULTS
There were 14 patients randomized to the octylcyanoacrylate group (group I) and 16 patients, with parental consent, were treated with the standard wound closure technique after being injected with the HCL ketamine (ketalar(R), 5mg/kg) (group II). The two treatment groups were similar with respect toage, gender, medical history, and wound characteristics. Immediately after treatment, tissue adhesive was judged to be more satisfactory than the standard wound closure (tissue adhesive 81 mm vs standard wound closure 76 mm; p=0.003) and the procedure was faster. (tissue adhesive 4.4min vs standard wound closure 6.8min; p=0.001). On the modified Hollander scale, the two groups were similar (tissue adhesive 78% vs standard wound closure 82%; p= 0.662 ).
CONCLUSION
Tissur adhesive is a more effective, faster procedure than the standard wound closure, but its use produced no significant difference in the cosmetic appearance.