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Tissue adhesive, adhesive tape, and sutures for skin closure of paediatric surgical wounds: prospective randomized clinical trial( )

BACKGROUND: Tissue adhesive, adhesive tape, and sutures are used to close surgical incisions. However, it is unclear which produces the best results in children, and whether combination wound closure is better than sutures alone. METHODS: In this parallel randomised controlled trial (ANZCTR: ACTRN12...

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Autores principales: Tandon, Sarthak, Ensor, Nicholas D, Pacilli, Maurizio, Laird, Ashleigh J, Bortagaray, Juan I, Stunden, Robert J, Nataraja, Ramesh M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10364679/
https://www.ncbi.nlm.nih.gov/pubmed/35913888
http://dx.doi.org/10.1093/bjs/znac254
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author Tandon, Sarthak
Ensor, Nicholas D
Pacilli, Maurizio
Laird, Ashleigh J
Bortagaray, Juan I
Stunden, Robert J
Nataraja, Ramesh M
author_facet Tandon, Sarthak
Ensor, Nicholas D
Pacilli, Maurizio
Laird, Ashleigh J
Bortagaray, Juan I
Stunden, Robert J
Nataraja, Ramesh M
author_sort Tandon, Sarthak
collection PubMed
description BACKGROUND: Tissue adhesive, adhesive tape, and sutures are used to close surgical incisions. However, it is unclear which produces the best results in children, and whether combination wound closure is better than sutures alone. METHODS: In this parallel randomised controlled trial (ANZCTR: ACTRN12617000158369), children (aged 18 years or less) undergoing elective general surgical or urological procedures were randomized to skin closure with sutures alone, sutures and adhesive tape, or sutures and tissue adhesive. Participants were assessed 2 weeks, 6 weeks, and more than 6 months after operation. Outcomes included wound cosmesis (clinician- and parent-rated) assessed using four validated scales, parental satisfaction, and wound complication rates. RESULTS: 295 patients (333 wounds) were recruited and 277 patients (314 wounds) were included in the analysis. Tissue adhesive wounds had poorer cosmesis at 6 weeks: median 10-point VAS score 7.7 with sutures alone, 7.5 with adhesive tape, and 7.0 with tissue adhesive (P = 0.014). Respective median scores on a 100-point VAS were 80.0, 77.2, and 73.8 (P = 0.010). This difference was not sustained at over 6 months. There was no difference in parent-rated wound cosmesis at 6 weeks (P = 0.690) and more than 6 months (P = 0.167): median score 9.0 with sutures alone, 10.0 with adhesive tape, and 10.0 with tissue adhesive at both stages. Parental satisfaction was similar at all points, with a median score of 5 (very satisfied) for all groups. There was one instance of wound dehiscence in the tissue adhesive group and no wound infections. CONCLUSION: Short-term wound cosmesis was poorer with tissue adhesive although it is unclear whether this difference is sustained in the long-term. There were no differences between techniques for the study outcomes. REGISTRATION NUMBER: ACTRN12617000158369 (ANZCTR) (https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372177&isReview=true).
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spelling pubmed-103646792023-07-31 Tissue adhesive, adhesive tape, and sutures for skin closure of paediatric surgical wounds: prospective randomized clinical trial( ) Tandon, Sarthak Ensor, Nicholas D Pacilli, Maurizio Laird, Ashleigh J Bortagaray, Juan I Stunden, Robert J Nataraja, Ramesh M Br J Surg Randomized Clinical Trial BACKGROUND: Tissue adhesive, adhesive tape, and sutures are used to close surgical incisions. However, it is unclear which produces the best results in children, and whether combination wound closure is better than sutures alone. METHODS: In this parallel randomised controlled trial (ANZCTR: ACTRN12617000158369), children (aged 18 years or less) undergoing elective general surgical or urological procedures were randomized to skin closure with sutures alone, sutures and adhesive tape, or sutures and tissue adhesive. Participants were assessed 2 weeks, 6 weeks, and more than 6 months after operation. Outcomes included wound cosmesis (clinician- and parent-rated) assessed using four validated scales, parental satisfaction, and wound complication rates. RESULTS: 295 patients (333 wounds) were recruited and 277 patients (314 wounds) were included in the analysis. Tissue adhesive wounds had poorer cosmesis at 6 weeks: median 10-point VAS score 7.7 with sutures alone, 7.5 with adhesive tape, and 7.0 with tissue adhesive (P = 0.014). Respective median scores on a 100-point VAS were 80.0, 77.2, and 73.8 (P = 0.010). This difference was not sustained at over 6 months. There was no difference in parent-rated wound cosmesis at 6 weeks (P = 0.690) and more than 6 months (P = 0.167): median score 9.0 with sutures alone, 10.0 with adhesive tape, and 10.0 with tissue adhesive at both stages. Parental satisfaction was similar at all points, with a median score of 5 (very satisfied) for all groups. There was one instance of wound dehiscence in the tissue adhesive group and no wound infections. CONCLUSION: Short-term wound cosmesis was poorer with tissue adhesive although it is unclear whether this difference is sustained in the long-term. There were no differences between techniques for the study outcomes. REGISTRATION NUMBER: ACTRN12617000158369 (ANZCTR) (https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372177&isReview=true). Oxford University Press 2022-08-01 /pmc/articles/PMC10364679/ /pubmed/35913888 http://dx.doi.org/10.1093/bjs/znac254 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Randomized Clinical Trial
Tandon, Sarthak
Ensor, Nicholas D
Pacilli, Maurizio
Laird, Ashleigh J
Bortagaray, Juan I
Stunden, Robert J
Nataraja, Ramesh M
Tissue adhesive, adhesive tape, and sutures for skin closure of paediatric surgical wounds: prospective randomized clinical trial( )
title Tissue adhesive, adhesive tape, and sutures for skin closure of paediatric surgical wounds: prospective randomized clinical trial( )
title_full Tissue adhesive, adhesive tape, and sutures for skin closure of paediatric surgical wounds: prospective randomized clinical trial( )
title_fullStr Tissue adhesive, adhesive tape, and sutures for skin closure of paediatric surgical wounds: prospective randomized clinical trial( )
title_full_unstemmed Tissue adhesive, adhesive tape, and sutures for skin closure of paediatric surgical wounds: prospective randomized clinical trial( )
title_short Tissue adhesive, adhesive tape, and sutures for skin closure of paediatric surgical wounds: prospective randomized clinical trial( )
title_sort tissue adhesive, adhesive tape, and sutures for skin closure of paediatric surgical wounds: prospective randomized clinical trial( )
topic Randomized Clinical Trial
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10364679/
https://www.ncbi.nlm.nih.gov/pubmed/35913888
http://dx.doi.org/10.1093/bjs/znac254
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