| Title | Application of tissue adhesives: rapid attainment of proficiency. Stony Brook Octylcyanoacrylate Study Group. | | Author(s) | Hollander JE, Singer AJ | | Institution | Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia 19104-4283, USA. jholland@mail.med.upenn.edu | | Source | Acad Emerg Med 1998 Oct; 5(10):1012-7. | | MeSH | Clinical Competence
Cyanoacrylates
Emergency Medical Services
Esthetics
Female
Follow-Up Studies
Humans
Infant
Male
Prospective Studies
Research Support, Non-U.S. Gov't
Suture Techniques
Sutures
Tissue Adhesives
Wound Healing
Wounds, Penetrating
| | Abstract | OBJECTIVE: To evaluate the 3-month cosmetic outcome following laceration repair with a new tissue adhesive, 2-octylcyanoacrylate, as a function of physician experience with this tissue adhesive.
METHODS: The authors prospectively enrolled consecutive patients >1 year of age with non-bite, non-crush-induced lacerations who presented <6 hours after injury and were treated with 2-octylcyanoacrylate. Structured closed-question data sheets were completed at the time of laceration repair and at 3-month follow-up. Long-term cosmetic appearance (>3 months) was assessed by patients using a 100-mm visual analog scale. The cosmetic outcomes were evaluated as a function of the physician application using ANOVA or chi2 tests, as appropriate. This study had 80% power to detect a 10-mm difference between the 2-octylcyanoacrylate and suture groups (alpha, 0.05).
RESULTS: Seven physicians applied 2-octylcyanoacrylate to 63 patients; 61 patients received sutures. Patients were similar in the 2 groups (age, gender, race, history, and wound characteristics; p > 0.05 for all). At long-term follow-up, the cosmetic outcomes were similar in the 2-octylcyanoacrylate and suture groups according to patients (VAS 83.8 +/- 19.4 mm vs 82.5 +/- 17.6 mm; p = 0.72) and physicians (optimal score, 77% vs 80%; p = 0.67), and independent of physician experience with the 2-octylcyanoacrylate. One wound developed an infection and one wound necessitated reclosure due to dehiscence. Neither occurred with the first application.
CONCLUSIONS: The 3-month cosmetic appearance of wounds treated with 2-octylcyanoacrylate is equivalent to that with sutures and does not improve as physicians become more experienced with use of this tissue adhesive. These data suggest that physicians can develop competence in application of tissue adhesives with a brief training period. | | Language | eng | | Pub Type(s) | Clinical Trial
Journal Article
Randomized Controlled Trial
| | PubMed ID | 9862595 |
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