Hair apposition technique for scalp laceration repair: a randomized controlled trial comparing physicians and nurses (HAT 2 study)

Am J Emerg Med. 2008 May;26(4):433-8. doi: 10.1016/j.ajem.2007.07.008.

Abstract

Objectives: The hair apposition technique (HAT) is a new method of closing scalp lacerations in which hairs on either side of the wound are twisted together and secured with a tissue adhesive. We aimed to compare the effectiveness, complications, and benefits of HAT performed by nurses or doctors in a randomized, prospective trial.

Methods: We conducted the study in the ED from November 2002 to February 2005. Subjects were randomized to receive HAT either by doctors or nurses. All wounds were evaluated 7 days later. The outcomes wound infection, wound healing, bleeding, and overall complications were measured, setting +/-5% in the differences of the outcomes between the doctors and nurses as equivalence.

Results: There were 88 and 76 patients in the doctor and nurse groups, respectively. There were no significant differences in all short-term outcomes between the doctors and nurses except for length of the procedure. The doctors had a shorter mean duration of procedure than the nurses (9.0 +/- 5.6 vs 12.8 +/- 7.5 minutes, P = .001).

Conclusion: The HAT can be safely performed by trained nurses with equivalent outcomes as doctors.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Topical
  • Adult
  • Clinical Competence
  • Female
  • Hair*
  • Humans
  • Lacerations / surgery*
  • Male
  • Nurses
  • Pain Measurement
  • Physicians
  • Prospective Studies
  • Suture Techniques*
  • Tissue Adhesives / administration & dosage*
  • Treatment Outcome

Substances

  • Tissue Adhesives