Comparison of skin stapling devices and standard sutures for pediatric scalp lacerations: a randomized study of cost and time benefits.
OBJECTIVE
To compare the total costs and the physician time requirements for suture and staple repair of pediatric scalp lacerations.


METHODS
Eighty-eight children, 13 months to 16 years of age, coming to a children's hospital emergency department with simple scalp lacerations were prospectively randomly selected to receive staple or suture repair. Wound lengths, times required for initial wound care and closure, and equipment use were recorded. Patients returned in 1 week for suture or staple removal and wound reevaluation. The two methods were compared in terms of both time expended and costs of equipment and physician compensation.


RESULTS
Forty-five children underwent staple repair and 43 underwent suture repair. There were no differences in age, sex, wound length, number of sutures or staples per centimeter, or physician experience. Stapling resulted in shorter wound closure times (65 vs 397 seconds; p < 0.0001) and shorter overall times for wound care and closure (395 vs 752 seconds; p < 0.0001). Staple repair was less expensive in terms of equipment ($12.55 vs $17.59; p < 0.0001) and total cost based on equipment and physician time ($23.55 vs $38.51; p < 0.0001). The follow-up rate was 91%, with no cosmetic or infectious complications in either group.


CONCLUSIONS
Stapling is faster and less expensive than suturing in the repair of uncomplicated pediatric scalp lacerations, with no additional complications. Physicians who treat children with scalp lacerations should consider the use of stapling devices.
Kanegaye
J T
JT
Division of Emergency Medicine, Childrens Hospital of Los Angeles, California, USA.
Vance
C W
CW
Chan
L
L
Schonfeld
N
N
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000191:economics*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D017060:Patient Satisfaction; D012535:Scalp / Q000293:injuries*; D013528:Surgical Staplers / Q000191:economics*; D013537:Sutures / Q000191:economics*; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing; D014949:Wounds, Nonpenetrating / Q000191:economics / Q000628:therapy*