Document Detail

A randomized controlled trial comparing the hair apposition technique with tissue glue to standard suturing in scalp lacerations (HAT study).
MedLine Citation:
PMID:  12085068     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVE: We evaluate a new technique of treating scalp lacerations, the hair apposition technique (HAT). After standard cleaning procedures, hair on both sides of a laceration is apposed with a single twist. This is then held with tissue adhesives. HAT was compared with standard suturing in a multicenter, randomized, prospective trial. METHODS: All linear lacerations of the scalp less than 10 cm long were included. Severely contaminated wounds, actively bleeding wounds, patients with hair strand length less than 3 cm, and hemodynamically unstable patients were excluded. Patients were randomized to receive either HAT or standard suturing, and the time to complete the wound repair was measured. All wounds were evaluated 7 days later in a nonblinded manner for satisfactory wound healing, scarring, and complications. RESULTS: There were 96 and 93 patients in the study and control groups, respectively. Wound healing trended toward being judged more satisfactory in the HAT group than standard suturing (100% versus 95.7%; P =.057; effect size 4.3%; 95% confidence interval 0.1% to 8.5%). Patients who underwent HAT had less scarring (6.3% versus 20.4%; P =.005), fewer overall complications (7.3% versus 21.5%; P =.005), significantly lower pain scores (median 2 versus 4; P <.001), and shorter procedure times (median 5 versus 15 minutes; P <.001). There was a trend toward less wound breakdown in the HAT group (0% versus 4.3%; P =.057). When patients were asked whether they were willing to have HAT performed in the future, 84% responded yes, 1% responded no, and 15% were unsure. CONCLUSION: HAT is equally acceptable and perhaps superior to standard suturing for closing suitable scalp lacerations. Advantages include fewer complications, a shorter procedure time, less pain, no need for shaving or removal of stitches, similar or superior wound healing, and high patient acceptance. HAT has become our technique of choice for suitable scalp lacerations.[Ong Eng Hock M, Ooi SBS, Saw SM, Lim SH. A randomized controlled trial comparing the hair apposition technique with tissue glue to standard suturing in scalp lacerations (HAT study).
Marcus Ong Eng Hock; S B S Ooi; S M Saw; S H Lim
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  Annals of emergency medicine     Volume:  40     ISSN:  0196-0644     ISO Abbreviation:  Ann Emerg Med     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-06-26     Completed Date:  2002-07-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  19-26     Citation Subset:  AIM; IM    
Department of Emergency Medicine, Singapore General Hospital, Singapore.
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MeSH Terms
Aged, 80 and over
Child, Preschool
Cicatrix / physiopathology
Follow-Up Studies
Lacerations / therapy*
Middle Aged
Patient Satisfaction
Prospective Studies
Scalp / injuries*
Suture Techniques*
Tissue Adhesives*
Treatment Outcome
Wound Healing / physiology
Reg. No./Substance:
0/Tissue Adhesives
Comment In:
Ann Emerg Med. 2002 Jul;40(1):27-9   [PMID:  12085069 ]
Evid Based Nurs. 2003 Jan;6(1):17   [PMID:  12546035 ]
Summary for patients in:
J Fam Pract. 2002 Oct;51(10):818   [PMID:  12401146 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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