A Prospective Controlled Study on Long-Term Outcomes of Facial Lacerations in Children

Abstract

Background: Although skin adhesives have been used for decades to treat skin lacerations, uncertainty remains about long-term results, and complications.Methods: In this prospective, controlled, single-blinded, observational cohort study, outcomes were assessed by five plastic surgeons with standardized photographs at 6–12 months using a modified Patient and Observer Scar Assessment Scale (POSAS) and Vancouver Scar Scale (VSS); additionally, the POSAS was performed by the patients/caregivers and the physician; pain, requirement of anesthesia, treatment time, costs, complications, and quality of live (QoL) were assessed.Results: A total of 367 patients were enrolled; 230 were included in the main analysis; 96 wounds were closed using tissue adhesives (group 1); 134 were sutured (group 2). Assessment by the independent observers revealed an improved mean modified overall POSAS score in group 1 in comparison with group 2 [2.1, 95% CI [1.97–2.25] vs. 2.5, 95% CI [2.39–2.63]; p < 0.001, d = 0.58] and mean VSS score [1.2, 95% CI [0.981–1.34] vs. 1.6, 95% CI [1.49–1.79], p < 0.001, d = 0.53]. At the early follow-up, dehiscence rate was 12.5% in group 1 and 3.7% in group 2 (p < 0.001); later on, one dehiscence remained per group. Mild impairment of QoL was found at the early follow-up in both groups, with no impairment remaining later on. Duration of treatment and treatment costs were lower in group 1.Conclusion: Both modalities of wound closure yield favorable esthetic results, and complications are rare. Adhesives are more cost-effective, and its application is less time-consuming; therefore, tissue adhesives offer considerable advantages when used appropriately.Trial Registration: Public trial registration was performed at www.ClinicalTrials.gov (Identifier: NCT03080467).

A Comparison between 2-Octyl Cyanoacrylate and Conventional Suturing for the Closure of Epiblepharon Incision Wounds in Children: A Retrospective Case–Control Study

“…However, the higher cost may be justified by the ease of postoperative care and the elimination of the need for wound dressing as well as suture removal. The cost-effectiveness of cyanoacrylate in facial lacerations in children has also been reported in a previous study [ 44 , 45 , 46 ].…”

Factors Associated With Low Procedural Pain Scores Among 1- to 5-Year-Old Patients Undergoing Facial Laceration Repair

“…Although we could not find previous research aimed specifically at quantifying young children’s pain during facial laceration repair, studies of various interventions and wound closure methods offer perspective on our findings. A prospective study of the use of skin adhesives versus sutures for facial laceration repair in children aged 0 to 16 years found mean pain scores of 1.7 of 10 in both groups 69 . Notably, almost one-fourth of participants received either 50% nitrous oxide or midazolam, and mean participant age was significantly older compared with our study.…”

“…A prospective study of the use of skin adhesives versus sutures for facial laceration repair in children aged 0 16 years found mean pain scores of 1.7 of 10 in both groups. 69 Notably, almost one-fourth of participants received either 50% nitrous oxide or midazolam, and mean participant age was significantly older compared with our study. Mean pain scores were similar to our findings (2/10) in a study comparing the efficacy of 2 topical anesthetics for laceration repair among considerably older children (5-17 years of age).…”