Steristrips better than sutures for pre-tibial lacerations
Date First Published:
March 1, 2000
Last Updated:
April 18, 2001
Report by:
Muhammad Ahmad, Specialist Registrar (Manchester STEM)
Search checked by:
Bruce Martin, Manchester STEM
Three-Part Question:
In [elderly patients with pretibial lacerations] are [adhesive strips or sutures] better at [promoting rapid healing and minimising necrosis and infection]?
Clinical Scenario:
A 70 year old woman presents to the Emergency Department with a pretibial flap laceration. The wound will need cleaning and then closing. You wonder whether adhesive strips or sutures should be used to achieve closure.
Search Strategy:
Medline 1966-03/00 using the OVID interface.
Search Details:
{exp tibia OR tibia$.mp OR pretibial.mp OR pre tibial.mp OR shin$.mp} AND [({tape$.mp OR strip$.mp} AND {exp adhesives OR adhesive$.mp}) OR steristrip$.mp] LIMIT to human AND english.
Outcome:
5 papers found of which 4 irrelevant or of insufficient quality for inclusion. The one remaining paper is shown in the table.
Relevant Paper(s):
| Study Title | Patient Group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| The use of sutures or adhesive tapes for primary closure of pretibial lacerations Sutton R, Pritty P. 1985 UK | 45 patients with pretibial flap lacerations. Sutures (22) vs steristrips (23) 31 patients with pretibial linear lacerations. 31 patients with pretibial linear lacerations. Sutures (15) vs steristrips (16) |
PRCT | Healing time | 53 days vs 39 days | Small numbers |
| Number of wounds with necrosis | 16 vs 8 | ||||
| Number of infected wounds | 7 vs 7 | ||||
| Number requiring rescue grafting | 3 vs 3 | ||||
| Healing time | 25 days vs 23 days | ||||
| Number of wounds with necrosis | 3 vs 0 | ||||
| Number of infected wounds | 2 vs 2 | ||||
| Number requiring rescue grafting | none |
Author Commentary:
This study shows that pretibial lacerations heal faster with steristrips and exhibit less necrosis. This effect is more marked for flap lacerations. The study does not address the question of primary grafting of these injuries.
Bottom Line:
Pretibial lacerations should be steristripped rather than sutured.
References:
- Sutton R, Pritty P.. The use of sutures or adhesive tapes for primary closure of pretibial lacerations