Treating Facial Cuts to a Near Scar Less Outcome in Children

Ashish Shrestha, Ang Dali Sherpa
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Abstract

Background: Facial Lacerations constitute an important reason for children (< 18 years) to visit emergency room. While bleeding and pain are the associated acute problems, the long term outcome in terms of a cosmetically acceptable scar is a matter of significant parental concern. The aim of the research is to study the profile of facial lacerations in children and to assess the outcome of repair. Materials and Methods: A retrospective review of children who underwent facial laceration repair between January 2018 and December 2020 was done. The deep ones underwent sutured repair in layers reinforced withtissue adhesive in operation room under intra-venous anesthesia and superficial ones in emergency room with only tissue adhesive following usual wound treatment protocol. Demographics, surgical details and outcomes were studied. All the repaired cuts were followed up at 1 year retrospectively and the cosmetic outcome was evaluated using modified stony brooke scoring system. Results: A total of 40 patients (24 males, 16 females) underwent facial laceration repair at a mean age of 4.7 years (range 1-13 years). Seventeen were deep and 23 were superficial cuts. Only1child in the superficial group with gross wound contamination at presentation developed wound infection. No dissatisfaction was reported in the deep group while parents of 4 children in the superficial group reported dissatisfaction with the final scar. Conclusion: While surface cuts can be treated with irrigations and tissue adhesive in the emergency room, the deeper cuts require layered repair aided by tissue adhesive for optimum scar outcome.
治疗儿童面部割伤至几乎没有疤痕的效果
背景:面部撕裂是18岁以下儿童去急诊室就诊的重要原因。虽然出血和疼痛是相关的急性问题,但就美容可接受的疤痕而言,长期结果是父母非常关心的问题。这项研究的目的是研究儿童面部撕裂伤的特征,并评估修复的结果。材料和方法:对2018年1月至2020年12月期间接受面部撕裂伤修复的儿童进行回顾性审查。深部伤口在手术室静脉麻醉下用组织粘合剂分层缝合修复,浅部伤口在急诊室仅用组织粘合剂缝合修复。研究了人口统计学、手术细节和结果。所有修复的切口在1年时进行回顾性随访,并使用改良的stone-brooke评分系统评估美容效果。结果:共有40名患者(24名男性,16名女性)接受了面部撕裂伤修复,平均年龄4.7岁(1-13岁)。17处为深切口,23处为浅切口。浅表组中只有1名出现严重伤口污染的儿童出现伤口感染。深层组未报告有任何不满,而表层组有4个孩子的父母对最后的疤痕表示不满。结论:虽然表面切口可以在急诊室使用冲洗和组织粘合剂进行治疗,但较深的切口需要组织粘合剂辅助分层修复,以获得最佳的疤痕效果。
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19
审稿时长
16 weeks
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