Episode 940: Laceration Repair Methods

Episode 940: Laceration Repair Methods

Contributor: Aaron Lessen, MD

Educational Pearls:

  • If a patient sustains a cut, the provider has several options on how to close the wound. If they choose to suture the wound closed, it involves needles both in the form of injecting numbing medication (lidocaine) as well as with the suture itself. Other techniques are "needleless," like closing the wound with adhesive strips (Steri-Strips) or skin adhesive (Dermabond). But which method is best?

  • A recent study looked to compare guardian-perceived cosmetic outcomes of pediatric lacerations repaired with absorbable sutures, Dermabond, and Steri-Strips. It also assessed pain and satisfaction with the procedure from both guardian and provider perspectives.

  • Participants: 55 patients were enrolled; 30 completed the 3-month follow-up.

    • Cosmetic Ratings (Median and IQR):

      • Sutures: 70.5 (59.8–76.8)

      • Dermabond: 85 (73–90)

      • Steri-Strips: 67 (55–78)

      • (P = 0.254, no statistically significant difference)

    • Satisfaction and Pain:

      • No significant differences in guardian or provider satisfaction

      • Pain levels were comparable across all methods

  • Even though there was no statistically significant difference in guardian-perceived cosmetic outcomes, the Dermabond did have the highest ratings at the end of the study.

References

  • Barton, M. S., Chaumet, M. S. G., Hayes, J., Hennessy, C., Lindsell, C., Wormer, B. A., Kassis, S. A., Ciener, D., & Hanson, H. (2024). A Randomized Controlled Comparison of Guardian-Perceived Cosmetic Outcome of Simple Lacerations Repaired With Either Dermabond, Steri-Strips, or Absorbable Sutures. Pediatric emergency care, 40(10), 700–704. https://doi.org/10.1097/PEC.0000000000003244

Summarized by Jeffrey Olson MS3 | Edited by Meg Joyce, MS1 & Jorge Chalit, OMS3

Donate: https://emergencymedicalminute.org/donate/

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Episode 937: Pneumomediastinum

Episode 937: Pneumomediastinum

Contributor: Megan Hurley MD Educational Pearls: What is the mediastinum? The thoracic cavity is separated into different compartments by membranes The lungs exist in their own pleural cavities, a...

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Episode 936: Etomidate vs. Ketamine for Rapid Sequence Intubation

Episode 936: Etomidate vs. Ketamine for Rapid Sequence Intubation

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Episode 935: Pregnancy Extremis - TOLDD

Episode 935: Pregnancy Extremis - TOLDD

Contributor: Aaron Lessen MD Educational Pearls: Pregnant patients at high risk of cardiac arrest, in cardiac arrest, or in extremis require special care A useful mnemonic to recall the appropriat...

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Episode 934: Subendocardial Ischemia

Episode 934: Subendocardial Ischemia

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Episode 933: Benign Convulsions with Gastroenteritis

Episode 933: Benign Convulsions with Gastroenteritis

Contributor: Alec Coston MD Educational Pearls: Causes of seizures in a fairly well-appearing child with diarrhea: Electrolyte abnormalities: hypocalcemia, hyponatremia Also hyperkalemia which...

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Episode 932: Induction Agent Hypotension

Episode 932: Induction Agent Hypotension

Contributor: Aaron Lessen MD Educational Pearls: Induction agent selection during rapid sequence intubation involves accounting for hemodynamic stability in the post-intubation setting Many emerge...

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Episode 931: Naloxone in Cardiac Arrest

Episode 931: Naloxone in Cardiac Arrest

Contributor: Aaron Lessen MD Educational Pearls: Can opioids cause cardiac arrest? Opioids can cause respiratory suppression and the subsequent low oxygen levels can lead to arrhythmias and eventual...

18 Marras 20243min

Episode 930: Holding Costs

Episode 930: Holding Costs

Contributor: Aaron Lessen MD Educational Pearls: A study evaluated the patient-care impact and financial costs of holding patients in the ED, a nationwide issue Prospective, observational study o...

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