Background: Tissue adhesive is widely used in the emergency department to repair minor lacerations but there exists a debate as to whether it should be used for chin lacerations. The main objective of this study was to evaluate the proportion of wound dehiscence of chin lacerations repaired with tissue adhesive in comparison to sutures.
Methods: This was a retrospective cohort study including all children requiring a facial laceration reparation in a single tertiary care pediatric hospital during a two-year period. The primary outcome was wound dehiscence in the 30 days following reparation. The independent variable of interest was the use of tissue adhesive vs suture. Other variables included size and localization of the laceration. The primary analysis was the association between method of reparation and risk of dehiscence for chin laceration. Other analysis compared risk of dehiscence according to the localization. A random sample of charts was reviewed in duplicate to insure reliability of the chart review and only variables with a good reliability were included in the analysis.
Results: Among the 2,044 children presenting with a facial laceration requiring an intervention, 1,804 (88%) were repaired using tissue adhesive. The laceration was located on the chin in 360 (18%) of patients. The use of tissue adhesive was not statistically associated with a higher risk of dehiscence for all facial lacerations (difference: 0.2; 95%CI: -1.9 to 0.8%), nor for chin lacerations (difference 2.2%; 95%CI: -7.5 to 4.4%). However, the probability of dehiscence was higher for chin laceration in comparison to other localizations (difference of 1.6%; 95%CI: 0.5-3.6%).
Conclusion: While the proportion of dehiscence was higher for chin lacerations compared to other facial localizations, the risk of dehiscence was not statistically different for chin laceration repaired with tissue adhesive or sutures.