The outcome of sutured wounds compared with tissue adhesive for paediatric wound closure: A meta-analysis
Xiaomei Cui1, Yuanbo Zhang2, Na Wang3
1School of Pediatrics, Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, China.
Insights
Sutured wounds (SWs) offer better cosmetic outcomes and lower costs for pediatric wound closure (PWC) than tissue adhesive (TA). SWs also reduce wound dehiscence, with no significant difference in wound infection rates between the two methods.
Area of Science:
- Pediatric Surgery
- Wound Healing Research
- Medical Device Comparison
Background:
- Evaluating the efficacy of different wound closure methods in pediatric patients is crucial for optimizing outcomes.
- Sutured wounds (SWs) and tissue adhesives (TA) are common techniques, but direct comparative data for pediatric wound closure (PWC) requires synthesis.
Approach:
- A meta-analysis was conducted, reviewing 2018 investigations up to February 2023.
- Eighteen studies involving 1697 children (977 SWs, 906 TA) were analyzed using odds ratios and confidence intervals.
- Statistical models were employed to assess outcomes such as wound cosmetic scores, wound dehiscence, wound infection, and cost.
Key Points:
- Sutured wounds demonstrated significantly higher wound cosmetic scores (MD, 1.70; P=.003) compared to tissue adhesive.
- Wound dehiscence was significantly lower with SWs (OR 0.60; P<.001), alongside reduced costs (MD, -10.22; P<.001).
- No significant difference in wound infection rates was observed between SWs and TA (OR, 0.45; P=.14), with no heterogeneity (I²=0%).
Conclusions:
- Sutured wounds are associated with superior cosmetic results, reduced wound dehiscence, and lower costs in pediatric wound closure.
- Tissue adhesive did not show a significant difference in preventing wound infections compared to sutured wounds.
- Findings should be interpreted cautiously due to the low sample size in some studies and the limited number of investigations included in the meta-analysis.
Abstract:
A meta-analysis investigation was executed to measure the outcome of sutured wounds (SWs) compared with tissue adhesive (TA) for paediatric wound closure (PWC). A comprehensive literature inspection till February 2023 was applied and 2018 interrelated investigations were reviewed. The 18 chosen investigations enclosed 1697 children with PWC in the chosen investigations' starting point, 977 of them were utilising SWs, and 906 were utilising TA. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were used to compute the value of the effect of SWs compared with TA for PWC by the dichotomous approaches and a fixed or random model. SWs had significantly higher wound cosmetic (WC) scores (mean deviation [MD], 1.70; 95% CI, 0.57-2.84, P = .003), lower wound dehiscence (WD) (OR 0.60; 95% CI, 0.06-0.43, P < .001), and lower cost (MD, -10.22; 95% CI, -10.94 to -9.50, P < .001) compared with those with TA in PWC. No significant difference was found between children utilising SWs and TA in wound infection (WI) (OR, 0.45; 95% CI, 0.15-1.30, P = .14) with no heterogeneity (I2 = 0%) in PWC. SWs had significantly higher WC scores, lower WD, and lower cost, yet, no significant difference was found in WI compared with those with TA in PWC. However, care must be exercised when dealing with its values because of the low sample size of some of the nominated investigations and the low number of selected investigations for the meta-analysis.
