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


CONCLUSIONS
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.
Lo
Steven
S
Accident and Emergency Department, Wexham Park Hospital, Slough, UK.
Aslam
Nadim
N
D000059:Accidents; D000328:Adult; D000368:Aged; D004630:Emergencies; D004636:Emergency Service, Hospital; D004954:Esthetics; D005151:Facial Injuries / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D022125:Lacerations / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome; D006113:United Kingdom; D014945:Wound Healing / Q000502:physiology
D014014:Tissue Adhesives