A new tissue adhesive for laceration repair in children☆,☆☆,★,★★,♢
Section snippets
METHODS
This study was approved by the Institutional Review Committee at our facility. The investigating team included four pediatric emergency medicine attending physicians. Each physician viewed an instructional video on the use of 2-OCA and was then allowed to use sample vials on his own skin. All children presenting to T.C. Thompson Children's Hospital Emergency Department between February and June l996 were eligible to participate in the study. Patients were excluded if they were younger than 1
RESULTS
A total of 270 children out of 353 with lacerations met previous defined exclusion criteria; for 28 the parent or guardian refused study participation. Eighty-three children were enrolled with 85 wounds: the 2-OCA group (n = 42) and the suture/staple group (n = 43, one stapled patient). No wounds received steri-strips. No differences in patient or wound characteristics were seen between groups (Table). Seventy-nine lacerations occurred on the face, and six lacerations occurred on the
DISCUSSION
Tissue adhesives are based on cyanoacrylate technology first developed in the 1940s. The first adhesive, Methyl-2-cyanoacrylate, was used as a surgical adhesive by Coover et al.10 in 1959 but was found to be tissue toxic. Subsequent generations of cyanoacrylates were developed over the years (ethyl-2-cyanoacrylate, isobutyl-2-cyanoacrylate), but clinical trials revealed these adhesives to also be toxic to tissues.11 Histoacryl Blue (N-Butyl-2-Cyanoacrylate) has been available for 20 years and
References (19)
- et al.
A randomized, controlled trial comparing a tissue adhesive with suturing in the repair of pediatric lacerations
Ann Emerg Med
(1993) - et al.
Appearance scales to measure cosmetic outcomes of healed lacerations
Am J Emerg Med
(1995) - et al.
Laceration repair using a tissue adhesive in a children's emergency department
Pediatrics
(1996) - et al.
Long-term appearance of lacerations repaired using a tissue adhesive
Pediatrics
(1997) - et al.
A randomized trial comparing octylcyanoacrylate tissue adhesive and sutures in the management of lacerations
JAMA
(1997) Visual analogue scales
- et al.
Computer programs for epidemiologic analysis (PEPI). Version 2
(1995) SPSS for Windows: Base System User's Guide. Release 6.0
(1993)
Cited by (79)
Tissue adhesive and adhesive tape for pediatric wound closure: A systematic review and meta-analysis
2021, Journal of Pediatric SurgeryComplications following chin laceration reparation using tissue adhesive compared to suture in children
2019, InjuryCitation Excerpt :Cyanoacrylate tissue adhesive is widely used in EDs to repair minor lacerations [5]. This tissue adhesive is a liquid monomer that undergoes an exothermic reaction when exposed to the moisture of the skin [6]. The reaction changes the polymers and forms a resistant tissue bond, permitting normal healing of the skin [7].
A Comparison of Wound Closure Techniques for Total Knee Arthroplasty
2011, Journal of ArthroplastyAdhesive Use in Oral and Maxillofacial Surgery
2010, Oral and Maxillofacial Surgery Clinics of North AmericaThe cyanoacrylate topical skin adhesives
2008, American Journal of Emergency MedicineCitation Excerpt :Wound closure was faster using the adhesive, whereas the rates of wound infection, dehiscence, and optimal cosmetic results at 3 months were comparable. Similar results (using both the butyl- and octylcyanoacrylates) have been reported in a wide variety of clinical settings and specialties including general surgery, plastic surgery, neurosurgery, cardiothoracic surgery, pediatric surgery, urology, otolaryngology, ophthalmology, obstetrics, gynecology, orthopedics, and interventional cardiology [14-32]. A recent meta-analysis comparing tissue adhesives to sutures has concluded that the use of the cyanoacrylate topical adhesives is associated with similar rates of wound infection and cosmetic outcome after repairing surgical incisions [33].
- ☆
From the Department of Emergency Services, T.C. Thompson Children's Hospital, University of Tennessee College of Medicine-Chattanooga Unit, Chattanooga, Tennessee; the Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia; and the Department of Surgery, Section of Emergency Medicine, University of Michigan, Ann Arbor, Michigan.
- ☆☆
Funded in part by a grant from Closure Medical Corporation.
- ★
Closure Medical Corporation is the manufacturer of 2-Octylcyanoacrylate, and Ethicon, Inc. is the distributor. No author has any financial relationship with Ethicon, Inc. or Closure Medical Corporation.
- ★★
Reprint requests: Thomas B. Bruns, MD, Department of Emergency Services, T.C. Thompson Children's Hospital, 910 Blackford St., Chattanooga, TN 37403.
- ♢
0022-3476/98/$5.00 + 0 9/22/89717