STERI-STRIPS VS CONVENTIONAL SUTURING IN PEDIATRIC AND FRAIL PATIENTS PRESENTING IN EMERGENCY DEPARTMENT

Abstract

Objective: To compare three months cosmetic outcomes of simple linear lacerations managed with Steri-Strips versus conventional suturing in pediatric and frail older patients presenting in Emergency Department.

Study Design: Prospective comparative cohort study.

Place and Duration of Study: Emergency Department of Combined Military Hospital (CMH), Rawalpindi, from July 2024 to December 2024.

Methodology: Eighty patients were enrolled. Forty children aged < 12 years and 40 frail older adults aged ≥ 65 years with Clinical Frailty Scale score ≥ 5. Eligible patients’ wounds were simple, superficial, linear, low-tension lacerations ≤ 5 cm long and ≤ 0.5 cm wide, presenting within 12 hours. Lacerations were located on face, forehead or forearm. Closure with Steri-Strips or interrupted polypropylene sutures followed routine clinical practice. Primary outcome was scar cosmesis at 3 months, assessed by blinded evaluator using 100-mm visual analogue scale (VAS). Multivariable linear regression was used to account for relevant patient and wound characteristics.

Results: Eighty patients were enrolled including 40 pediatric and 40 frail older patients. Among them, 37 received Steri-Strips and 43 underwent conventional suturing. Three months cosmetic assessment was available for 75 (93.8%) patients. Mean cosmetic VAS score was 83.00 ± 7.72 in Steri-Strips group and 78.79 ± 9.04 in suturing group, with unadjusted mean difference of 4.21 mm (95% CI 0.35 to 8.06, p = 0.033). After adjustment for relevant patient and wound characteristics, mean difference was 3.59 mm (95% CI −0.40 to 7.57, p = 0.077).

Conclusion: For suitable low-tension lacerations, Steri-Strips had three months cosmetic favored outcomes as comparable to conventional suturing.