Scalp lacerations are common injuries that require prompt and effective treatment to ensure proper healing and minimize complications. Traditionally, sutures have been the standard method for closing these wounds. However, a novel technique known as the Hair Apposition Technique (HAT) has emerged as a promising alternative. This article delves into a comparison of sutures and the hair apposition technique for scalp laceration repair, drawing insights from a comprehensive study.
The hair apposition technique involves a simple yet ingenious approach. After cleaning the wound, hair strands on both sides of the laceration are twisted together to bring the wound edges into close proximity. This apposition is then secured using tissue adhesives, eliminating the need for needles and sutures. To rigorously evaluate the effectiveness of HAT, a multicenter, randomized, prospective trial was conducted, directly comparing it to standard suturing for the repair of scalp lacerations.
In this study, researchers enrolled patients with linear scalp lacerations less than 10 cm in length, excluding severely contaminated wounds, actively bleeding wounds, patients with short hair (less than 3 cm), and hemodynamically unstable individuals. Participants were randomly assigned to receive either HAT or standard suturing. The primary outcome measured was the time taken to complete the wound repair. Secondary outcomes included assessments of wound healing, scarring, complications, and pain levels at a 7-day follow-up.
The results of the study revealed compelling advantages of the hair apposition technique. Notably, wound healing was observed to be more satisfactory in the HAT group (100%) compared to the suture group (95.7%). Furthermore, patients treated with HAT experienced significantly less scarring (6.3% vs. 20.4%) and fewer overall complications (7.3% vs. 21.5%). Pain scores were also considerably lower in the HAT group, with a median pain score of 2 compared to 4 for sutures. Procedure times were dramatically shorter with HAT, averaging 5 minutes compared to 15 minutes for suturing. While not statistically significant (P = .057), there was also a trend towards less wound breakdown in the HAT group. Patient acceptance of HAT was overwhelmingly positive, with 84% expressing willingness to undergo the procedure again in the future.
In conclusion, the hair apposition technique presents itself as a highly acceptable and potentially superior alternative to standard sutures for closing suitable scalp lacerations. Its benefits encompass reduced scarring, fewer complications, faster procedure times, less pain, and high patient satisfaction. Moreover, HAT eliminates the need for shaving the scalp or removing stitches, adding to its convenience. This evidence suggests that the hair apposition technique is a valuable and efficient method for scalp laceration repair, offering advantages over traditional suture methods. For appropriate scalp lacerations, HAT stands as a recommended and effective treatment option.
Reference:
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).
