Economic comparison of a tissue adhesive and suturing in the repair of pediatric facial lacerations

Osmond, Martin H.; Klassen, Terry P; Quinn, Jim V.

doi:10.1016/s0022-3476(95)70203-2

Cited by 139 publications

(66 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Absorbable suture prices vary and are not always less expensive than nonabsorbable sutures, but analysis that has factored in patient missed days of work and ED overhead costs has found the use of dissolving material to be more cost-effective. 16 Finally, for younger patients suture removal can be anxiety-provoking and stressful, 17 so avoiding this follow-up procedure is beneficial for the pediatric population.…”

mentioning

confidence: 99%

A Comparison of Cosmetic Outcomes of Lacerations on the Extremities and Trunk Using Absorbable Versus Nonabsorbable Sutures

Tejani

Sivitz

Rosen

et al. 2014

Academic Emergency Medicine

View full text Add to dashboard Cite

Objectives: The primary objective was to compare the cosmetic outcomes of traumatic trunk and extremity lacerations repaired using absorbable versus nonabsorbable sutures. The secondary objective was to compare complication rates between the two groups.Methods: This was a randomized controlled trial comparing wounds repaired with Vicryl Rapide and Prolene sutures. Pediatric and adult patients with lacerations were enrolled in the study. At a 10-day follow-up, the wounds were evaluated for infection and dehiscence. After 3 months, patients returned to have the wounds photographed. Two plastic surgeons blinded to the method of closure rated the cosmetic outcome of each wound using a 100-mm visual analog scale (VAS). Using a noninferiority design, a VAS score of 13 mm or greater was considered to be a clinically significant difference. We used a Student's t-test to compare differences between mean VAS scores and odds ratios (ORs) to compare differences in complication rates between the two groups.Results: Of the 115 patients enrolled, 73 completed the study including 35 in the Vicryl Rapide group and 38 in the Prolene group. The mean (AESD) age of patients who completed the study was 22.1 (AE15.5) years, and 39 were male. We found no significant differences in the age, race, sex, length of wound, number of sutures, or layers of repair in the two groups. The observer's mean VAS for the Vicryl Rapide group was 54.1 mm (95% confidence interval [CI] = 44.5 to 67.0 mm) and for the Prolene group was 54.5 mm (95% CI = 45.7 to 66.3 mm). The resulting mean difference was 0.5 mm (95% CI = -12.1 to 17.2 mm; p = 0.9); thus noninferiority was established. Statistical testing showed no differences in the rates of complications between the two groups, but a higher percentage of the Vicryl Rapide wounds developed complications. Conclusions:The use of absorbable sutures for the repair of simple lacerations on the trunk and extremities should be considered as an alternative to nonabsorbable suture repair.ACADEMIC EMERGENCY MEDICINE 2014;21:637-643

show abstract

mentioning

confidence: 99%

A Comparison of Cosmetic Outcomes of Lacerations on the Extremities and Trunk Using Absorbable Versus Nonabsorbable Sutures

Tejani

Sivitz

Rosen

et al. 2014

Academic Emergency Medicine

View full text Add to dashboard Cite

show abstract

“…[1][2][3] No follow-up appointment for suture removal is required, and one study has shown TAs to be a cost-effective alternative to sutures. 4 There is an increasing amount of literature supporting the use of TAs for various minor lacerations, [5][6][7][8][9][10] including a number of randomized controlled trials (RCTs) that support TAs in their respective study populations. [11][12][13][14][15][16][17][18][19][20][21][22][23][24] However, due to the wide variation in study parameters, there are no generalizable, definitive answers about the effectiveness of TAs.…”

mentioning

confidence: 99%

Tissue Adhesives for Traumatic Lacerations: A Systematic Review of Randomized Controlled Trials

et al. 2003

Self Cite

View full text Add to dashboard Cite

Objective: To summarize the best available evidence for the effect of tissue adhesives (TAs) in managing traumatic lacerations in children and adults. Methods: A search was conducted using the Cochrane Controlled Trials Register, Medline, and EMBase for relevant studies. The authors also searched the citations of selected studies and contacted relevant authors and manufacturers. The search included randomized controlled trials (RCTs) comparing a TA versus standard wound closure (sutures, staples, adhesive strips) (SWC) or two TAs for acute, linear, low-tension, traumatic lacerations in an emergency or primary care setting. Data were extracted by one reviewer and checked for accuracy by a second reviewer. Two reviewers independently assessed masked copies for quality. Outcomes of cosmesis (subgroups of age, wound location, and need for deep sutures), pain, procedure time, ease of use, and complications were analyzed separately for two comparisons: 1) TA versus SWC; and 2) TA versus TA. Results: Eight studies compared a TA with SWC. No significant difference was found for cosmesis at any time point examined. Subgroup analysis was possible only for age; no significant difference was found. Pain scores [Parent Visual Analogue Scale weighted mean difference (VAS WMD) ¼ ÿ15.7 mm; 95% CI ¼ ÿ21.9 to ÿ9.5] and procedure time (WMD ¼ ÿ5.7 minutes; 95% CI ¼ ÿ8.2 to ÿ3.1) significantly favored TAs. Small, statistically significant risk differences were found for dehiscence [favoring SWC; number needed to harm (NNH) ¼ 25; 95% CI ¼ 14 to 100] and erythema (favoring TAs; NNH ¼ 8; 95% CI ¼ 4 to 100). Only one study compared two TAs (butylcyanoacrylate versus octylcyanoacrylate) for pediatric facial lacerations. No significant difference was found for cosmesis, pain, procedure time, or complications. Conclusions: TAs are an acceptable alternative to SWC for simple traumatic lacerations. No difference in cosmesis was found between TAs and SWC, or between different TAs. Tissue adhesives offer the benefits of decreased procedure time and less pain, compared with SWC. A small increased rate of dehiscence with TAs must be considered when choosing the closure method (NNH ¼ 25).

show abstract

“…Kanegaye et al [1] reported that stapling was less expensive than suturing in the repair of uncomplicated pediatric scalp lacerations. Osmond et al [7] reported that the cost of tissue adhesives was high. Farion et al [8] reported that the cost of the tissue adhesives was equal to the cost of traditional suturing.…”

Section: Discussionmentioning

confidence: 99%

“…Various suture techniques including standard suturing (suturing with string and needle), stapling, and tissue adhesives were used depending on the physician preference and available resources. Previous studies have examined the effectiveness of suturing different strings in different parts of the body as well as the effectiveness of skin staples or tissues adhesiveness [3][4][5][6][7][8][9]. However no studies have compared various methods with respect of cost and patient satisfaction.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Different Suture Techniques

Kavalcı¹,

Çevik²,

Durukan³

et al. 2015

Ann Clin Anal Med

View full text Add to dashboard Cite

ÖzetAmaç: Travmalar acil servise sık başvuru nedenlerindendir. Sütür, skalp kesisi olan hastaların tedavisinde sıklıkla gereklidir. Bu çalışmada skalp kesisi olan hastalarda farklı sütür tekniklerinin yara iyileşmesi, hasta memnuniyeti ve maliyet üzerine etkisinin araştırılması amaçlanmıştır. Gereç ve Yöntem:Çalışmaya toplam 60 hasta alındı. Hastalar geleneksel sütür (Grup 1), stapler (Grup 2) ve doku yapıştırıcı grubu (Grup 3) olarak üç gruba ayrıldı. Grupların karşılaştırılmasında χ 2 ve Kruskal-Wallis testleri kullanıldı. p<0.05 değeri istatistiksel olarak anlamlı kabul edildi. Bulgular: Hastaların 2/3'ü erkekti. En fazla hasta memnuniyeti 3. gruptaydı (p<0.05). Maliyet açısından en ucuzu doku yapıştırıcılardı (p<0.05). Tartışma: Yaygın geleneksel inanışın tersine doku yapıştırıcı ve stapler gibi alternatif sütür teknikleri pahalı değildir. En fazla hasta memnuniyeti doku yapıştırıcı kullanılan gruptaydı. Anahtar KelimelerAcil; Stapler; Doku Yapıştırıcı Abstract Aim: Traumas are frequent causes of presentation to emergency departments. Suturing is usually required in treatment of patients with scalp laceration. This study aimed to investigate different suture methods with respect of patient satisfaction, wound healing, and treatment cost in patients with scalp laceration. Material and Method: A total of 60 patients were included in the study. The patients were divided into 3 groups; traditional suturing (Group 1), stapling (Group 2), and the tissue adhesive (Group 3) groups. ChiSquare and Kruskal-Wallis tests were used for comparison of the groups. A p value less than 0.05 was considered statistically significant. Results: Twothirds of the patients were male. The patient satisfaction was highest in the Group 3 (p<0.05). Tissue adhesive group had the lowest treatment cost (p<0.05).Discussion: In contrast to existing traditional belief, the alternative suture methods, i.e. tissue adhesives and staples are not expensive. The patient satisfaction was highest in the tissue adhesive group.

show abstract

Economic comparison of a tissue adhesive and suturing in the repair of pediatric facial lacerations

Cited by 139 publications

References 6 publications

A Comparison of Cosmetic Outcomes of Lacerations on the Extremities and Trunk Using Absorbable Versus Nonabsorbable Sutures

A Comparison of Cosmetic Outcomes of Lacerations on the Extremities and Trunk Using Absorbable Versus Nonabsorbable Sutures

Tissue Adhesives for Traumatic Lacerations: A Systematic Review of Randomized Controlled Trials

Comparison of Different Suture Techniques

Contact Info

Product

Resources

About