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Outcomes of Pediatric Facial Laceration Repair Using 5-0 Fast Absorbing Gut Sutures With and Without Overlying
Richard Thompson1,2, Matthew Wilkinson1,2, Patrick D Combs3,4
1Department of Pediatrics, The University of Texas at Austin Dell Medical School, Dell Children's Medical Center, Austin, TX.
Objectives:
A randomized controlled trial was designed to compare 2 methods of repairing simple pediatric facial lacerations. We hypothesized that wounds repaired with 5-0 fast-absorbing gut sutures and overlying adhesive strips would be superior with regard to cosmetic outcome compared with 5-0 fast-absorbing gut sutures alone.
Methods:
Patients 0 to 17 years old presenting to the emergency department with simple, linear facial lacerations requiring repair with sutures were eligible for enrollment. Patients were randomly assigned to repair with either 5-0 fast-absorbing gut sutures with overlying adhesive strips or 5-0 fast-absorbing gut sutures alone. Families were contacted by phone at 2 weeks to discuss complications. At 2 months, participants were sent a secure link to upload photos of the scar electronically. The scars were then evaluated using a Visual Analog Scale (VAS) by a blinded Pediatric Emergency Medicine Physician and Pediatric Plastic Surgeon.
Results:
A total of 120 patients were enrolled, and 81 photos were received. The VAS scores for the fast-absorbing gut sutures with overlying adhesive strips group were similar to the fast-absorbing gut sutures alone group (53.9 vs. 54.5 mm, P =0.87). The Lin Correlation Coefficient was 0.74, indicating strong agreement between the raters. There was no significant difference in time to completion or ease of repair. There was only one complication due to infection in the fast-absorbing gut sutures alone group, and one reported partial wound dehiscence in the same group.
Conclusions:
Using adhesive strips overlying fast-absorbing gut sutures leads to a similar cosmetic outcome as using fast-absorbing gut sutures alone for simple facial laceration repair. While this technique did not show improved cosmesis or increased complications, it could be considered in select patients or may not be necessary.
