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Absorbable sutures in paediatric lacerations
  1. Robert Evans, Resident Physician,
  2. Jeff Jones, Research Director
  1. Grand Rapids MERC/MSU, USA

    Abstract

    A short cut review was carried out to establish whether absorbable sutures offered any benefits over non-absorbable sutures in the treatment of childhood facial lacerations. A total of 31 papers were found, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of this best paper are tabulated. We conclude that absorbable sutures appear to be as good as, and show a trend towards benefit in the treatment of paediatric lacerations.

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    Report by Robert Evans, Resident PhysicianChecked by Jeff Jones, Research DirectorGrand Rapids MERC/MSU, USA

    Three part question

    In [paediatric patients with traumatic lacerations], does [the use of absorbable sutures compared with non-absorbable sutures] [increase the rates of complications and long term cosmesis]?

    Clinical scenario

    A 10 year old boy presents after a suffering a laceration on his lower leg from a snow skiing accident. It cannot be closed using glue. You would like to save the child the pain and discomfort of suture removal. You wonder if absorbable sutures would increase the rate of complications or scarring.

    Search strategy

    Medline 1966–November 2005 using the OVID interface; Cochrane Library, 2005: [(exp lacerations or laceration.mp) AND (exp sutures/or suture.mp) AND (exp treatment outcome/ OR exp cosmetic techniques/ OR exp wound infection/)]. LIMIT to human AND English AND “all child (0 to 18 years)”. Cochrane Database of Systematic Reviews: [Suture and absorbable]

    Search outcome

    Medline: 31 papers found of which 30 were irrelevant or of insufficient quality (see table 3 for the single best paper). Cochrane: 23 papers found, no new additional references found.

    Table 3

    Comment(s)

    The use of absorbable sutures in children has the benefit of avoiding the emotional and physical trauma and cost of suture removal. The only prospective randomised controlled trial showed no difference between absorbable sutures and non-absorbable sutures in the rate of complications as well as cosmesis. However, too many patients were lost to long term follow up.

    CLINICAL BOTTOM LINE

    Absorbable sutures appear to be as good as, and show a trend towards benefit, in paediatric laceration.

    Report by Robert Evans, Resident PhysicianChecked by Jeff Jones, Research DirectorGrand Rapids MERC/MSU, USA

    References

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