A randomized controlled trial comparing the hair apposition technique with tissue glue to standard suturing in scalp lacerations (HAT study)

Hock, Marcus Ong Eng; Ooi, Shirley Beng Suat; Saw, Seang Mei; Lim, Swee Han

doi:10.1067/mem.2002.125928

Cited by 45 publications

(19 citation statements)

References 21 publications

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“…Tissue adhesives (Farion et al, 2003 Level I) and hair apposition for scalp lacerations (Hock et al, 2002 Level III-1) were as effective as suturing for simple lacerations but produced less pain and may be more acceptable to children.…”

Section: Laceration Repairmentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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Section: Laceration Repairmentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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“…A randomized controlled trial comparing the hair apposition technique and suturing was held in the EDs of 2 tertiary-level hospitals in Singapore from December 1999 to March 2001. 2 On the basis of the outcomes reported in this trial, differential costs caused by complications were also calculated.…”

Section: Methodsmentioning

confidence: 99%

“…The hair apposition technique is probably not suitable for severely contaminated wounds, actively bleeding (arterial) wounds with blood flow not stopping after pressure is applied for at least 5 minutes, and patients with scalp hair less than 3 cm long. 2 The use of tissue adhesives in wound care has been well documented. [6][7][8][9][10][11][12] Osmond et al 13 found tissue adhesives to result in significant cost savings compared with suturing in facial lacerations.…”

Section: Introduction Backgroundmentioning

confidence: 99%

“…Advantages included fewer complications, a shorter procedure time, less pain, no need for shaving or removal of stitches, satisfactory wound healing, and high patient acceptance. [2][3][4][5] For the hair apposition technique, a scalp laceration is closed by bringing together the hair on both sides of the wound with a single twist. No actual knot is made.…”

Section: Introduction Backgroundmentioning

confidence: 99%

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Cost-Effectiveness of Hair Apposition Technique Compared With Standard Suturing in Scalp Lacerations

Ong

Coyle

Lim

et al. 2005

Annals of Emergency Medicine

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“…For example, studies of laceration repair techniques often enroll both adult and pediatric subjects. 39,40 Adult subjects are protected by the Common Rule, while the pediatric subjects in the same study are protected by the DHHS pediatric regulations. Similarly, studies that enroll subjects using the Final Rule may also enroll incapable subjects with the consent of a substitute decision-maker, along with other subjects who are capable of providing consent.…”

Section: Inconsistency Of Multiple Federal Regulations For Emergency mentioning

confidence: 99%

U.S. Federal Regulations for Emergency Research: A Practical Guide and Commentary

McRae

Weijer²

2008

Academic Emergency Medicine

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Emergency medicine research requires the enrollment of subjects with varying decision-making capacities, including capable adults, adults incapacitated by illness or injury, and children. These different categories of subjects are protected by multiple federal regulations. These include the federal Common Rule, the Department of Health and Human Services (DHHS) regulations for pediatric research, and the Food and Drug Administration's (FDA) Final Rule for the Exception from the Requirements of Informed Consent in Emergency Situations. Investigators should be familiar with the relevant federal research regulations to optimally protect vulnerable research subjects, and to facilitate the institutional review board (IRB) review process. IRB members face particular challenges in reviewing emergency research. No regulations exist for research enrolling incapacitated subjects using proxy consent. The wording of the Final Rule may not optimally protect vulnerable subjects. It is also difficult to apply conflicting regulations to a single study that enrolls subjects with differing decision-making capacities. This article is intended as a guide for emergency researchers and IRB members who review emergency research. It reviews the elements of Federal Regulations that apply to consent, subject selection, privacy protection, and the analysis of risks and benefits in all emergency research. It explores the challenges for IRB review listed above, and offers potential solutions to these problems. ACADEMIC EMERGENCY MEDICINE 2008; 15:88-97 ª 2008 by the Society for Academic Emergency MedicineKeywords: emergency research, research ethics, federal regulations, bioethics, community consultation E mergency medicine has a broad scope of practice. The spectrum of clinical research that is required to advance emergency care is correspondingly broad. To examine clinical problems ranging from minor to life-threatening conditions, emergency research enrolls subject populations with differing decision-making capacities, including capable adults, adults incapacitated by acute illness or injury, and children. These different categories of subjects are protected by several overlapping U.S. federal regulations. Investigators should be familiar with the federal regulations that govern emergency research. Knowledge of the regulations will facilitate the IRB review process by enabling researchers to design studies that comply with the rules and preserve the rights of vulnerable research subjects.This article is intended as a guide for emergency researchers and for IRB members who oversee emergency research. It reviews the federal regulations that govern emergency research, examines necessary protections for subjects in research for which few regulations exist, and explores potential solutions to regulatory problems that present barriers to the conduct of emergency research.

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A randomized controlled trial comparing the hair apposition technique with tissue glue to standard suturing in scalp lacerations (HAT study)

Cited by 45 publications

References 21 publications

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cost-Effectiveness of Hair Apposition Technique Compared With Standard Suturing in Scalp Lacerations

U.S. Federal Regulations for Emergency Research: A Practical Guide and Commentary

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