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Tissue adhesive and adhesive tape for pediatric wound closure: A systematic review and meta-analysis
Sarthak Tandon1, Matthew Smale1, Maurizio Pacilli2
1Department of Paediatric Surgery, Monash Children's Hospital, 246 Clayton Road, Clayton, VIC 3168, Australia.
Insights
For children's wounds, adhesive tape (AdT) may offer slightly better cosmetic results than tissue adhesive (TiA), with no significant differences in infection or wound opening risks among AdT, TiA, and sutures.
Area of Science:
- Pediatric Surgery
- Wound Healing
- Dermatology
Background:
- Surgical wound and laceration closure in children commonly utilizes tissue adhesive (TiA), adhesive tape (AdT), or sutures.
- Optimal technique selection remains unclear regarding cosmetic outcomes and complication rates.
Purpose of the Study:
- To systematically review and compare the efficacy of TiA, AdT, and sutures for pediatric wound closure.
- To evaluate differences in wound cosmesis and complication incidence across these closure methods.
Main Methods:
- A systematic search of major scientific databases (PubMed, MEDLINE, Cochrane Library, etc.) was conducted for English-language studies.
- Included studies published between 1980 and 2017 focused on primary skin closure in patients 18 years or younger.
- Endpoints assessed were clinician-rated wound cosmesis and complication rates (infection, dehiscence).
Main Results:
- Thirty-one studies informed the systematic review, and 16 contributed to the meta-analysis.
- Adhesive tape (AdT) demonstrated marginally superior cosmetic outcomes compared to tissue adhesive (TiA) (p=0.04).
- No significant differences in cosmesis were found between sutures and TiA (p=0.2), nor in infection or dehiscence rates among TiA, AdT, and sutures.
Conclusions:
- Tissue adhesive (TiA), adhesive tape (AdT), and sutures are all viable options for pediatric wound closure, presenting similar risks for infection and dehiscence.
- Adhesive tape (AdT) may offer enhanced cosmetic results.
- Further high-powered studies directly comparing these techniques are warranted.
Background:
Tissue adhesive (TiA), adhesive tape (AdT), and sutures can be used to close surgical wounds and lacerations in children. However, it is unclear which technique produces the best results.
Methods:
In this prospectively registered study, the PubMed, Ovid MEDLINE, Cochrane Library, Centre for Reviews and Dissemination Database, and ScienceDirect databases were searched. English language studies published between January 1980 and August 2017 evaluating TiA and/or AdT for primary skin closure of surgical wounds or lacerations in patients aged ≤18 years were included. Study endpoints included clinician-rated wound cosmesis and incidence of wound complications.
Results:
Thirty-one studies were included in the systematic review and 16 studies in the meta-analysis. Amongst heterogeneous studies, AdT yielded marginally better cosmetic outcomes than TiA (p = 0.04). There was no difference in cosmesis between sutured wounds and those closed with TiA (p = 0.2). No difference in overall risk of wound infection or dehiscence was identified when comparing TiA with AdT (p = 0.3), and TiA with sutures (p = 0.9 and 0.3 respectively).
Conclusions:
TiA, AdT, and sutures can all be used for wound closure with equivalent risk of wound infection and dehiscence. AdT appears to convey better cosmesis. Further adequately powered studies directly comparing techniques are required.
Levels Of Evidence:
Level IV.
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