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Article: Cost-Consequence Analysis Comparing 2-Octyl Cyanoacrylate Tissue Adhesive and Suture for Closure of Simple Lacerations: A Randomized Controlled Trial

TitleCost-Consequence Analysis Comparing 2-Octyl Cyanoacrylate Tissue Adhesive and Suture for Closure of Simple Lacerations: A Randomized Controlled Trial
Authors
Issue Date2009
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/annemed
Citation
Annals Of Emergency Medicine, 2009, v. 53 n. 2, p. 189-197 How to Cite?
AbstractStudy objective: We investigate the cost difference between conventional suture and tissue adhesive methods in simple wound closure. Methods: A cost-consequence analysis was conducted alongside a nonblinded randomized controlled trial comparing 2-octyl cyanoacrylate tissue adhesive with conventional suture in simple lacerations closure in emergency departments (EDs) of a university teaching hospital and a major regional hospital in Hong Kong. One hundred eighty-six adult patients with simple lacerations of length within 8 cm were randomized to receive tissue adhesive (93 patients) or conventional suture (93 patients) for wound closure. The primary outcome measures were the costs to the Hospital Authority and the charges on participants incurred in each treatment method. The secondary outcome measures included the cosmetic visual analog scale, visual analog scale, Wound Evaluation Score, total time spent in each closure method, and the overall patients' satisfaction on the whole process of wound management. Results: The 2 groups had similar baseline characteristics. The tissue adhesive method incurred a higher cost to the Hospital Authority (216.12 [US $27.70] versus 171.33 [US $21.96]; absolute difference 44.79 [US $5.74] [95% confidence interval (CI) 32.76 to 55.95 [US $4.20 to 7.14]]) but a lower charge to patients (109.68 [US $14.06] versus 156.96 [US $20.12]; absolute difference 47.28 [US $6.06] [95% CI, 35.58 to 58.98 [US $4.56 to 7.56]) than the conventional suture method. The mean cosmetic visual analog scale score, visual analog scale score, and Wound Evaluation Score of the 2 groups were similar at various intervals within 3 months after wound closure. Compared with the suture group, the tissue adhesive group had a shorter median procedure time, fewer patients had wound erythema or swelling after wound closure, fewer patients required analgesics on discharge at ED, and there was a higher overall patient satisfaction score. Conclusion: Simple wounds closed by tissue adhesives incur a higher cost to the Hospital Authority than the conventional suture but may be favored by patients because of lower personal charge. © 2008 American College of Emergency Physicians.
Persistent Identifierhttp://hdl.handle.net/10722/60534
ISSN
2015 Impact Factor: 5.008
2015 SCImago Journal Rankings: 1.942
ISI Accession Number ID
Funding AgencyGrant Number
Health and Health Services Research Fund03040071
Funding Information:

By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article, that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. This study was supported by the Health and Health Services Research Fund (project code 03040071). No financial support was received from any commercial source to conduct this study. Competing interests: None declared.

References

 

DC FieldValueLanguage
dc.contributor.authorMan, SYen_HK
dc.contributor.authorWong, EMLen_HK
dc.contributor.authorNg, YCen_HK
dc.contributor.authorLau, PFen_HK
dc.contributor.authorChan, MSen_HK
dc.contributor.authorLopez, Ven_HK
dc.contributor.authorMak, PSKen_HK
dc.contributor.authorGraham, CAen_HK
dc.contributor.authorRainer, THen_HK
dc.date.accessioned2010-05-31T04:13:07Z-
dc.date.available2010-05-31T04:13:07Z-
dc.date.issued2009en_HK
dc.identifier.citationAnnals Of Emergency Medicine, 2009, v. 53 n. 2, p. 189-197en_HK
dc.identifier.issn0196-0644en_HK
dc.identifier.urihttp://hdl.handle.net/10722/60534-
dc.description.abstractStudy objective: We investigate the cost difference between conventional suture and tissue adhesive methods in simple wound closure. Methods: A cost-consequence analysis was conducted alongside a nonblinded randomized controlled trial comparing 2-octyl cyanoacrylate tissue adhesive with conventional suture in simple lacerations closure in emergency departments (EDs) of a university teaching hospital and a major regional hospital in Hong Kong. One hundred eighty-six adult patients with simple lacerations of length within 8 cm were randomized to receive tissue adhesive (93 patients) or conventional suture (93 patients) for wound closure. The primary outcome measures were the costs to the Hospital Authority and the charges on participants incurred in each treatment method. The secondary outcome measures included the cosmetic visual analog scale, visual analog scale, Wound Evaluation Score, total time spent in each closure method, and the overall patients' satisfaction on the whole process of wound management. Results: The 2 groups had similar baseline characteristics. The tissue adhesive method incurred a higher cost to the Hospital Authority (216.12 [US $27.70] versus 171.33 [US $21.96]; absolute difference 44.79 [US $5.74] [95% confidence interval (CI) 32.76 to 55.95 [US $4.20 to 7.14]]) but a lower charge to patients (109.68 [US $14.06] versus 156.96 [US $20.12]; absolute difference 47.28 [US $6.06] [95% CI, 35.58 to 58.98 [US $4.56 to 7.56]) than the conventional suture method. The mean cosmetic visual analog scale score, visual analog scale score, and Wound Evaluation Score of the 2 groups were similar at various intervals within 3 months after wound closure. Compared with the suture group, the tissue adhesive group had a shorter median procedure time, fewer patients had wound erythema or swelling after wound closure, fewer patients required analgesics on discharge at ED, and there was a higher overall patient satisfaction score. Conclusion: Simple wounds closed by tissue adhesives incur a higher cost to the Hospital Authority than the conventional suture but may be favored by patients because of lower personal charge. © 2008 American College of Emergency Physicians.en_HK
dc.languageengen_HK
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/annemeden_HK
dc.relation.ispartofAnnals of Emergency Medicineen_HK
dc.rightsAnnals Of Emergency Medicine. Copyright © Mosby, Inc.en_HK
dc.titleCost-Consequence Analysis Comparing 2-Octyl Cyanoacrylate Tissue Adhesive and Suture for Closure of Simple Lacerations: A Randomized Controlled Trialen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0196-0644&volume=53&spage=189&epage=197&date=2009&atitle=Cost-consequence+Analysis+Comparing+2-octyl+Cyanoacrylate tissue+Adhesive+And+Suture+For+Closure+Of+Simple+Lacerations: a+Randomized+Controlled+Trialen_HK
dc.identifier.emailWong, EML: eliza07@hku.hken_HK
dc.identifier.authorityWong, EML=rp00529en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.annemergmed.2008.03.003en_HK
dc.identifier.pmid18440668-
dc.identifier.scopuseid_2-s2.0-58249129870en_HK
dc.identifier.hkuros163473en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-58249129870&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume53en_HK
dc.identifier.issue2en_HK
dc.identifier.spage189en_HK
dc.identifier.epage197en_HK
dc.identifier.isiWOS:000263225900007-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridMan, SY=19836306400en_HK
dc.identifier.scopusauthoridWong, EML=13205136500en_HK
dc.identifier.scopusauthoridNg, YC=7202471063en_HK
dc.identifier.scopusauthoridLau, PF=7102543487en_HK
dc.identifier.scopusauthoridChan, MS=16933684200en_HK
dc.identifier.scopusauthoridLopez, V=53873899500en_HK
dc.identifier.scopusauthoridMak, PSK=15729141000en_HK
dc.identifier.scopusauthoridGraham, CA=7401504885en_HK
dc.identifier.scopusauthoridRainer, TH=7004489495en_HK

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