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Tissue Adhesive as an Alternative to Sutures in Pediatric Eye Emergency: A Clinical Prospective Comparative Cohort
Jing Huang1, Feng Chen1, Jin Zhou1
1Department of Ophthalmology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University.
Insights
Cyanoacrylate tissue adhesive offers faster, less painful periorbital wound closure in children compared to sutures, with similar healing and safety outcomes. This makes it a promising alternative for pediatric trauma.
Area of Science:
- Pediatric ophthalmology
- Wound management
- Surgical adhesives
Background:
- Periorbital wound closure in children presents unique challenges.
- Conventional suturing can be time-consuming and distressing for pediatric patients.
- Evaluating novel closure methods is crucial for improving patient experience and outcomes.
Purpose of the Study:
- To compare cyanoacrylate tissue adhesive with conventional sutures for periorbital wound closure in pediatric patients.
- To assess efficacy, safety, and patient experience, including pain and compliance.
- To determine the viability of tissue adhesive as an alternative to sutures.
Main Methods:
- Prospective comparative study of 145 pediatric patients with periorbital trauma.
- Treatment groups: tissue adhesive (n=70) vs. conventional suturing (n=75).
- Outcomes measured: wound healing, complications, procedure time, pain scores, behavioral compliance, and parental satisfaction.
Main Results:
- Tissue adhesive group showed significantly shorter procedure times (184s vs. 692s) and lower pain scores (2.8 vs. 5.6).
- Higher behavioral compliance (Frankl score 3.1 vs. 2.3) was observed with tissue adhesive.
- No significant differences in Grade I healing rates (97.1% vs. 93.3%) or complication rates (2.9% vs. 4.0%) were found.
Conclusions:
- Cyanoacrylate tissue adhesive is associated with reduced treatment time and pain in pediatric periorbital trauma.
- Similar wound healing and complication rates support its efficacy compared to sutures.
- Tissue adhesive presents a viable, patient-friendly alternative for periorbital wound closure in children.
Study Objective:
To compare the efficacy, safety, and patient experience between cyanoacrylate tissue adhesive and conventional sutures for periorbital wound closure in children.
Methods:
A prospective comparative study evaluated 145 pediatric patients with periorbital trauma treated with tissue adhesive (n=70) or conventional suturing (n=75) based on clinical assessment from September 2023 to October 2024. Primary outcomes were wound healing grades (grade I/II/III) and complication rates; secondary outcomes included procedure time (median, seconds), pain scores (mean, Wong-Baker FACES), Frankl behavioral compliance scores (mean), and parental satisfaction. Statistical analysis used t tests, Mann-Whitney U tests, and χ 2 tests.
Results:
The adhesive group had significantly shorter procedure time (184 vs. 692 s, P <0.001), lower pain scores (2.8 vs. 5.6, P <0.001), and higher compliance (Frankl 3.1 vs. 2.3, P <0.01). No significant differences were observed in grade I healing rates (97.1% vs. 93.3%) or complication rates (2.9% vs. 4.0%, P =0.24).
Conclusions:
In pediatric periorbital trauma, use of tissue adhesive was associated with reduced treatment time and pain scores, with similar healing outcomes compared with sutures, suggesting it may serve as a viable alternative.
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