AUTHOR=Fontana Sonja , Schiestl Clemens M. , Landolt Markus A. , Staubli Georg , von Salis Sara , Neuhaus Kathrin , Mohr Christoph , Elrod Julia 

TITLE=A Prospective Controlled Study on Long-Term Outcomes of Facial Lacerations in Children

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 8 - 2020

YEAR=2021

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2020.616151

DOI=10.3389/fped.2020.616151

ISSN=2296-2360

ABSTRACT=Background: Although skin adhesives have been used for decades to treat skin lacerations, uncertainty remains about long-term results and complications. 

Methods: In this prospective, controlled, single-blinded study, outcomes were assessed by five plastic surgeons with standardized photographs at 6-12 months using a modified Patient and Observer Scar Assessment Scale (POSAS) and Vancouver Scar Scale (VSS); additionally, the POSAS was performed by the patients/caregiver(s) and the physician; pain, requirement of anesthesia, treatment time, costs, complications and Quality of live (Qol) were assessed.

Results: 367 patients were enrolled; 230 were included in the main analysis. 96 wounds were closed using tissue adhesives (group 1); 134 were sutured (group 2). Assessment by the independent observers revealed an improved mean modified overall POSAS-score in group 1 in comparison to group 2 (2.1, 95% CI [1.97-2.25] vs 2.5, 95% CI [2.39-2.63]; p< 0.001, d = 0.58) and mean VSS-score (1.2, 95% CI [0.981-1.34] vs 1.6, 95% CI [1.49-1.79], p< 0.001, d = 0.53). At the early follow-up, dehiscence rate was 12.5% in group 1 and 3.7% in group 2 (p< 0.001), later on 1 dehiscence remained per group. Mild impairment of QoL was found at the early follow-up in both groups, with no impairment remaining later on. Duration of treatment and treatment costs were lower in group 1. 

Conclusion: Both modalities of wound closure yield favorable aesthetic results and complications are rare. Adhesives are more cost-effective and application is less time-consuming, therefore, tissue adhesives offer considerable advantages when used appropriately.