Tissue Adhesives for Traumatic Lacerations: A Systematic Review of Randomized Controlled Trials*
Bibliographic record
Abstract
Abstract Objective: To summarize the best available evidence for the effect of tissue adhesives (TAs) in managing traumatic lacerations in children and adults. Methods: A search was conducted using the Cochrane Controlled Trials Register, Medline, and EMBase for relevant studies. The authors also searched the citations of selected studies and contacted relevant authors and manufacturers. The search included randomized controlled trials (RCTs) comparing a TA versus standard wound closure (sutures, staples, adhesive strips) (SWC) or two TAs for acute, linear, low‐tension, traumatic lacerations in an emergency or primary care setting. Data were extracted by one reviewer and checked for accuracy by a second reviewer. Two reviewers independently assessed masked copies for quality. Outcomes of cosmesis (subgroups of age, wound location, and need for deep sutures), pain, procedure time, ease of use, and complications were analyzed separately for two comparisons: 1) TA versus SWC; and 2) TA versus TA. Results: Eight studies compared a TA with SWC. No significant difference was found for cosmesis at any time point examined. Subgroup analysis was possible only for age; no significant difference was found. Pain scores [Parent Visual Analogue Scale weighted mean difference (VAS WMD) =−15.7 mm; 95% CI =−21.9 to −9.5] and procedure time (WMD =−5.7 minutes; 95% CI =−8.2 to −3.1) significantly favored TAs. Small, statistically significant risk differences were found for dehiscence [favoring SWC; number needed to harm (NNH) = 25; 95% CI = 14 to 100] and erythema (favoring TAs; NNH = 8; 95% CI = 4 to 100). Only one study compared two TAs (butylcyanoacrylate versus octylcyanoacrylate) for pediatric facial lacerations. No significant difference was found for cosmesis, pain, procedure time, or complications. Conclusions: TAs are an acceptable alternative to SWC for simple traumatic lacerations. No difference in cosmesis was found between TAs and SWC, or between different TAs. Tissue adhesives offer the benefits of decreased procedure time and less pain, compared with SWC. A small increased rate of dehiscence with TAs must be considered when choosing the closure method (NNH = 25).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.023 | 0.082 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.017 | 0.014 |
| Bibliometrics | 0.011 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".