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A review of tissue glue use in facial lacerations: potential problems with wound selection in accident and emergency

Lo, Stevena; Aslam, Nadimb

European Journal of Emergency Medicine: October 2004 - Volume 11 - Issue 5 - p 277-279
ORIGINAL ARTICLES
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Objectives: The purpose of this study was to review the types of facial lacerations for which tissue glue was used as a closure method and assess whether current evidence was being followed.

Methods: A retrospective analysis of facial lacerations presenting to an adult Accident and Emergency Department was made over a 6-month period.

Results: Out of 200 facial lacerations, 45 were closed using tissue glue. The mean length of the wounds was 2.05 cm, with a range of 0.5–6 cm; 42 were linear and three were non-linear. Senior house officers closed 16 wounds, middle grade doctors closed 19, emergency nurse practitioners closed seven, and consultants closed three. Six cases were closed against current evidence (13%). This included three lacerations that were non-linear and three lacerations greater than 4 cm in length. Four out of six of these cases were closed by senior house officer grades (80%).

Conclusion: The lack of clarity over the use of tissue glue for facial wounds may be attributable to a lack of awareness and training, and the misinterpretation of randomized trials. Greater awareness is needed of the role of tissue glue, especially among senior house officers.

aAccident and Emergency Department, Wexham Park Hospital, Slough, UK

bDepartment of Trauma, John Radcliffe Hospital, Headington, Oxford, UK

Correspondence and reprint requests to Nadim Aslam, FRCS (Orth), Specialist Registrar in Orthopaedics, Compton Vectis, 49 Marlow Road, High Wycombe, Bucks HP11 1TG, UK

Tel: +44 01494 538585; fax: +44 01865 227250;

e-mail: nadimaslam@hotmail.com

© 2004 Lippincott Williams & Wilkins, Inc.