384 - Outcomes of Pediatric Facial Laceration Repair Using 5-0 Fast Absorbing Gut Sutures with and without Steri-Strips: A Randomized Controlled Trial

Facial lacerations are common in the Pediatric Emergency Department. Goals for repair include optimizing cosmetic outcomes, avoiding complications, and limiting patient anxiety. Absorbable sutures have been shown in the literature to be comparable to non-absorbable sutures. However, there are limited data on the use of adhesive strips (Steri-Strips™) in combination with absorbable sutures. Some physicians use Steri-Strips™ over the top of absorbable sutures for added reinforcement.  This randomized controlled trial hypothesized that the use of Steri-Strips™ overlying 5-0 fast absorbing gut sutures would lead to improved cosmetic outcomes over the use of sutures alone.

Objective:

The goal of this study was to compare the cosmetic outcome of pediatric simple facial lacerations repaired with 5-0 fast absorbing gut sutures versus 5-0 fast absorbing gut sutures with overlying Steri-Strips™.

Design/Methods:

Patients 0-18 years old presenting to Dell Children’s Pediatric Emergency Department with simple, linear facial lacerations requiring repair with sutures were eligible for enrollment. Exclusion criteria included lacerations requiring subspecialty care, contaminated wounds, bites, lacerations over 12 hours old, or greater than 5cm in length. Patients with the following were also excluded: underlying hematologic disorders, immunodeficiencies, pregnancy, diabetes, chronic steroid use, or allergies to topical anesthetic. Participants were randomly assigned to either arm. Families were contacted at 2 weeks to discuss complications. At 2 months, participants were sent a secure link to upload photos of the scar electronically. The scars were then evaluated using a Visual Analog Scale (VAS) by a blinded PEM Physician and Pediatric Plastic Surgeon.

Results:

61 patients were enrolled, with 40 photos received. The VAS scores for the fast absorbing gut sutures with overlying Steri-Strips™ group were similar to the fast absorbing gut sutures alone group (52.8mm vs 45.1mm, p=0.22). The Lin Correlation Coefficient was 0.79, indicating strong agreement between the raters. There was no significant difference in time to completion or ease of repair. There was only one complication due to infection in the fast absorbing gut sutures alone group. There was no reported wound dehiscence.

Conclusion(s):

Using Steri-Strips™ overlying fast absorbing gut sutures leads to a similar cosmetic outcome as using fast absorbing gut sutures alone for simple facial laceration repair. This approach may be useful for added reinforcement in wound closure.