Randomized feasibility trial of replacing or discarding the nail plate after nail-bed repair in children
| Autor: | A Greig, M D Gardiner, A Sierakowski, C J Zweifel, R M Pinder, D Furniss, J A Cook, D Beard, N Farrar, C D Cooper, A Jain, R Agha, W Albadry, Y Cemal, P Chadha, D Collins, H Creasy, A Din, M Ferreira, F Maggiulli, A Mitsakos, A Molina, T Pampiglione, M Pywell, K Richards, Y Tavsanoglu, R Tejero, S Vamadeva, R Wang, M Wordsworth, W Holmes, J Haeney, N Brierley, E Pardoe, C Naylor, T Laing, I Delikonstantinou, N Whybro, H Gerrish, E Gammin |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Reconstructive surgery medicine.medical_specialty Adolescent Trial protocol Pain Pilot Projects 030230 surgery law.invention 03 medical and health sciences Postoperative Complications 0302 clinical medicine Randomized controlled trial law medicine Humans Surgical Wound Infection Prospective Studies 030212 general & internal medicine Child Prospective cohort study skin and connective tissue diseases Hand injury integumentary system business.industry Infant Original Articles Plastic Surgery Procedures Nail plate medicine.disease Anti-Bacterial Agents Surgery medicine.anatomical_structure Nails Child Preschool Nail (anatomy) Feasibility Studies Original Article Female Complication business |
| Zdroj: | The British Journal of Surgery |
| ISSN: | 1365-2168 0007-1323 |
| Popis: | Background Nail‐bed injuries are the most common hand injury in children. Surgical dogma is to replace the nail plate after repairing the nail bed. Recent evidence suggests this might increase infection rates and returns to clinic. The aim of this feasibility trial was to inform the design and conduct of a definitive trial comparing replacing or discarding the nail plate after nail‐bed repair. Methods This study recruited participants from four hand units in the UK between April and July 2015. Participants were children under the age of 16 years with a nail‐bed injury requiring surgery. They were randomized to either having the nail plate replaced or discarded after nail‐bed repair. The follow‐up method was also allocated randomly (postal versus clinic). Information was collected on complications at 2 weeks and 30 days, and on nail‐plate appearance at 4 months using the Zook classification. Two possible approaches to follow‐up were also piloted and compared. Results During the recruitment phase, there were 156 potentially eligible children. Sixty were randomized in just over 3 months using remote web‐based allocation. By 2 weeks, there were two infections, both in children with replaced nail plates. The nail‐replaced group also experienced more complications. There was no evidence of a difference in return rates between postal and clinic follow‐up. Conclusion Recruitment was rapid and nail‐bed repair appeared to have low complication and infection rates in this pilot trial. The findings have led to revision of the definitive trial protocol, including the mode and timing of follow‐up, and modification of the Zook classification. Informs the RCT |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text