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Closure of pretibial lacerations
  1. Muhammad Ahmad,
  2. Bruce Martin
  1. Department of Emergency Medicine, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL

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    Report by Muhammad Ahmad, Specialist Registrar Search checked by Bruce Martin, Specialist Registrar

    Clinical scenario

    A 70 year old woman presents to the emergency department with a pretibial flap laceration. The wound will need cleaning and then closing. You wonder whether adhesive strips or sutures should be used to achieve closure.

    Three part question

    In [elderly patients with pretibial lacerations] are [adhesive strips or sutures] better at [promoting rapid healing and minimising necrosis and infection]?

    Search strategy

    Medline 1966–03/00 using the OVID interface. {exp tibia OR tibia$.mp OR pretibial.mp OR pre tibial.mp OR shin$.mp} AND [({tape$.mp OR strip$.mp} AND {exp adhesives OR adhesive$.mp}) OR steristrip$.mp] LIMIT to human AND english.

    Search outcome

    Altogether five papers were found of which four were irrelevant or of insufficient quality for inclusion. The one remaining paper is shown in table 7.

    Table 7

    Comment

    This study shows that pretibial lacerations heal faster with steristrips and exhibit less necrosis. This effect is more marked for flap lacerations. The study does not address the question of primary grafting of these injuries.

    Clinical bottom line

    Pretibial lacerations should be steristripped rather than sutured.

    Report by Muhammad Ahmad, Specialist Registrar Search checked by Bruce Martin, Specialist Registrar

    References

    View Abstract

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