Tongue lacerations in children: to suture or not?
AIMS OF THE STUDY Tongue lacerations are common in children, occurring mostly from falls or sports injuries. Optimal treatment of tongue lacerations is a challenge for paediatricians due to contradictory recommendations and a lack of current guidelines. It remains unclear which tongue la...
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2018-10-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/2532 |
| _version_ | 1797979691539234816 |
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| author | Michelle Seiler Sandra Letizia Massaro Georg Staubli Clemens Schiestl |
| author_facet | Michelle Seiler Sandra Letizia Massaro Georg Staubli Clemens Schiestl |
| author_sort | Michelle Seiler |
| collection | DOAJ |
| description |
AIMS OF THE STUDY
Tongue lacerations are common in children, occurring mostly from falls or sports injuries. Optimal treatment of tongue lacerations is a challenge for paediatricians due to contradictory recommendations and a lack of current guidelines. It remains unclear which tongue lacerations should be sutured and which would benefit from spontaneous healing, which is a promising alternative. In recent years, the treatment of choice in our paediatric emergency department (ED) has shifted from generally suturing the wounds to more frequently advising secondary wound healing. The aim of this study was to analyse tongue lacerations treated at our ED in order to develop guidance for the optimal management of tongue lacerations in children.
METHODS
This retrospective study was conducted to assess tongue lacerations at the ED of a University Children’s Hospital Zurich from January 2010 to August 2015. All families were contacted for informed consent and photo documentation of the healed tongue. Clinical records of all the patients included were reviewed and different variables were defined and analysed.
RESULTS
A total of 73 children with tongue lacerations were included (75.3% boys, mean age ± standard deviation 4.0 ± 2.6 years). The mean size of the lacerations was 12.4 ± 8.3 mm, with affected tongue borders in 51 cases (69.9%) and a through-and-through laceration in 23 patients (31.5%). A primary wound closure was performed in 12 children (16.4%). These wounds were significantly larger than those of the secondary wound healing group (21 ± 10 mm compared to 10.8 ± 6.8 mm), presented gaping wound edges with the tongue at rest more frequently (91.7% compared to 32.8%), and showed through-and-through lacerations more often (91.7% compared to 19.7%). The group with wound suturing needed longer to recover (median 13 days compared to 6.2 days) and had a higher rate of complications (25 vs 3.3%).
CONCLUSIONS
Suturing is not required in gaping tongue lacerations less than 2 cm long that do not involve the tip of the tongue. The Zurich Tongue Scheme was developed as a guide for clinicians when deciding which tongue lacerations need suturing.
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| first_indexed | 2024-04-11T05:42:49Z |
| format | Article |
| id | doaj.art-c636402eab59483cb232b4fdf5c3d81f |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-11T05:42:49Z |
| publishDate | 2018-10-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-c636402eab59483cb232b4fdf5c3d81f2022-12-22T04:42:27ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972018-10-01148434410.4414/smw.2018.14683Tongue lacerations in children: to suture or not?Michelle Seiler0Sandra Letizia Massaro1Georg Staubli2Clemens Schiestl3Paediatric Emergency Department, University Children’s Hospital Zurich, SwitzerlandPaediatric Emergency Department, University Children’s Hospital Zurich, SwitzerlandPaediatric Emergency Department, University Children’s Hospital Zurich, SwitzerlandDivision of Plastic and Reconstructive Surgery, University Children’s Hospital Zurich, Switzerland AIMS OF THE STUDY Tongue lacerations are common in children, occurring mostly from falls or sports injuries. Optimal treatment of tongue lacerations is a challenge for paediatricians due to contradictory recommendations and a lack of current guidelines. It remains unclear which tongue lacerations should be sutured and which would benefit from spontaneous healing, which is a promising alternative. In recent years, the treatment of choice in our paediatric emergency department (ED) has shifted from generally suturing the wounds to more frequently advising secondary wound healing. The aim of this study was to analyse tongue lacerations treated at our ED in order to develop guidance for the optimal management of tongue lacerations in children. METHODS This retrospective study was conducted to assess tongue lacerations at the ED of a University Children’s Hospital Zurich from January 2010 to August 2015. All families were contacted for informed consent and photo documentation of the healed tongue. Clinical records of all the patients included were reviewed and different variables were defined and analysed. RESULTS A total of 73 children with tongue lacerations were included (75.3% boys, mean age ± standard deviation 4.0 ± 2.6 years). The mean size of the lacerations was 12.4 ± 8.3 mm, with affected tongue borders in 51 cases (69.9%) and a through-and-through laceration in 23 patients (31.5%). A primary wound closure was performed in 12 children (16.4%). These wounds were significantly larger than those of the secondary wound healing group (21 ± 10 mm compared to 10.8 ± 6.8 mm), presented gaping wound edges with the tongue at rest more frequently (91.7% compared to 32.8%), and showed through-and-through lacerations more often (91.7% compared to 19.7%). The group with wound suturing needed longer to recover (median 13 days compared to 6.2 days) and had a higher rate of complications (25 vs 3.3%). CONCLUSIONS Suturing is not required in gaping tongue lacerations less than 2 cm long that do not involve the tip of the tongue. The Zurich Tongue Scheme was developed as a guide for clinicians when deciding which tongue lacerations need suturing. https://www.smw.ch/index.php/smw/article/view/2532tongue lacerationsecondary wound healingpediatric emergency departmentZurich Tongue Schemesecondaryhealing |
| spellingShingle | Michelle Seiler Sandra Letizia Massaro Georg Staubli Clemens Schiestl Tongue lacerations in children: to suture or not? Swiss Medical Weekly tongue laceration secondary wound healing pediatric emergency department Zurich Tongue Scheme secondary healing |
| title | Tongue lacerations in children: to suture or not? |
| title_full | Tongue lacerations in children: to suture or not? |
| title_fullStr | Tongue lacerations in children: to suture or not? |
| title_full_unstemmed | Tongue lacerations in children: to suture or not? |
| title_short | Tongue lacerations in children: to suture or not? |
| title_sort | tongue lacerations in children to suture or not |
| topic | tongue laceration secondary wound healing pediatric emergency department Zurich Tongue Scheme secondary healing |
| url | https://www.smw.ch/index.php/smw/article/view/2532 |
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