Tongue lacerations in children: to suture or not?

Bibliographic Details
Title:	Tongue lacerations in children: to suture or not?
Authors:	Michelle Seiler, Sandra Letizia Massaro, Georg Staubli, Clemens Schiestl
Source:	Swiss Medical Weekly, Vol 148, Iss 4344 (2018)
Publisher Information:	SMW supporting association (Trägerverein Swiss Medical Weekly SMW), 2018.
Publication Year:	2018
Collection:	LCC:Medicine
Subject Terms:	tongue laceration, secondary wound healing, pediatric emergency department, Zurich Tongue Scheme, secondary, healing, Medicine
More Details:	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.
Document Type:	article
File Description:	electronic resource
Language:	English
ISSN:	1424-3997
Relation:	https://www.smw.ch/index.php/smw/article/view/2532; https://doaj.org/toc/1424-3997
DOI:	10.4414/smw.2018.14683
Access URL:	https://doaj.org/article/c636402eab59483cb232b4fdf5c3d81f
Accession Number:	edsdoj.636402eab59483cb232b4fdf5c3d81f
Database:	Directory of Open Access Journals

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RecordInfo	BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.4414/smw.2018.14683 Languages: – Text: English Subjects: – SubjectFull: tongue laceration Type: general – SubjectFull: secondary wound healing Type: general – SubjectFull: pediatric emergency department Type: general – SubjectFull: Zurich Tongue Scheme Type: general – SubjectFull: secondary Type: general – SubjectFull: healing Type: general – SubjectFull: Medicine Type: general Titles: – TitleFull: Tongue lacerations in children: to suture or not? Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Michelle Seiler – PersonEntity: Name: NameFull: Sandra Letizia Massaro – PersonEntity: Name: NameFull: Georg Staubli – PersonEntity: Name: NameFull: Clemens Schiestl IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 10 Type: published Y: 2018 Identifiers: – Type: issn-print Value: 14243997 Numbering: – Type: volume Value: 148 – Type: issue Value: 4344 Titles: – TitleFull: Swiss Medical Weekly Type: main
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