Coaptive film versus subcuticular suture: comparing skin closure time following identical, single-session, bilateral
Gleeson Rebello1, Ravi Parikh, Brian Grottkau
1Department of Pediatric Orthopedics, Massachusetts General Hospital for Children, Boston, MA 02114, USA. grebello@partners.org
Insights
Coaptive film significantly reduces skin closure time in pediatric surgery compared to monocryl sutures. This method offers comparable cosmetic results and a similar complication rate, making it a cost-effective choice.
Area of Science:
- Pediatric Surgery
- Wound Closure Techniques
- Biomaterials
Background:
- Randomized controlled trial comparing two skin closure methods.
- Focus on pediatric patients undergoing lower limb soft tissue release.
Purpose of the Study:
- To compare skin closure time between coaptive film and subcuticular monocryl sutures.
- To evaluate cosmetic outcomes and wound complications.
Main Methods:
- Eight pediatric patients (<18 years) with cerebral palsy included.
- 50 incisions: 25 closed with monocryl sutures, 25 with coaptive film.
- Time for closure and cosmetic results (3-month follow-up) were assessed.
Main Results:
- Coaptive film closure time averaged 79.36 seconds vs. 167.04 seconds for monocryl sutures (P <0.0001).
- No significant difference in cosmetic results or wound complications between the two methods.
- Incisions closed with coaptive film were slightly shorter on average.
Conclusions:
- Coaptive film is a faster and cost-effective skin closure option for pediatric surgery.
- Offers comparable cosmetic outcomes and safety to traditional sutures.
- Recommended for pediatric wound management.
Background:
This study is a randomized controlled trial comparing skin closure time between coaptive film and subcuticular monocryl sutures in children undergoing identical single session, bilateral limb multiple soft tissue releases.
Methods:
Eight children less than 18 years of age (mean 14.5) with cerebral palsy underwent identical, single session bilateral multiple soft tissue releases in the lower limb from August 2005 to March 2007. There were 50 incisions in all in which 25 incisions were closed with 4-0 intracuticular monocryl sutures and 25 were closed with coaptive film (Steri Strip S; 3M company). Time taken for closure using either technique was recorded. A blinded plastic surgeon used a visual analog scale to assess the cosmetic results at the end of a 3 month follow-up.
Results:
The average length of incisions closed with coaptive film was almost identical to the corresponding incision on the contralateral limb that was closed with subcuticular monocryl suture (4.45 and 4.81 cm, P=0.66). The average time for skin closure using monocryl sutures was 167.04 seconds compared with the average time of 79.36 seconds when using coaptive film (P <0.0001). There was no significant difference in the cosmetic results or the number of wound complications using either technique.
Conclusion:
Coaptive film is an attractive and cost-effective option for skin closure after pediatric surgery.
Clinical Relevance:
The time saved, comparable cosmetic results and lack of complications makes coaptive film an attractive option for skin closure in the pediatric age group.
