# Clinical efficacy, postoperative complication risks, and parental satisfaction in pediatric patients receiving tension-reducing suture treatment for facial lacerations

## TL;DR

Tension-reducing sutures in children with facial cuts lead to better healing, less scarring, and higher parental satisfaction compared to traditional sutures.

## Contribution

Demonstrates the clinical benefits of tension-reducing sutures in pediatric facial laceration repair.

## Key findings

- Tension-reducing sutures showed a higher primary healing rate (88.5%) compared to conventional sutures (73.8%).
- Tension-reducing sutures resulted in lower scar scores at 1 and 3 months post-surgery.
- Parental satisfaction was significantly higher in the tension-reducing suture group (93.4%) compared to the conventional group (80.3%).

## Abstract

To evaluate the clinical efficacy, postoperative complication risks, and parental satisfaction of tension-reducing sutures in pediatric patients with facial lacerations.

A retrospective cohort analysis was conducted on 122 pediatric patients (aged 1–12 years) with facial lacerations who met predefined inclusion criteria (e.g., aged 1–12 years, wound length 1–5 cm, etc.; see Methods for details) and underwent surgical treatment at our hospital between January 2020 and August 2024. Based on the surgical technique received, the patients were divided into the tension-reducing suture group n = 61) and the conventional suture group (n = 61). The two groups were compared regarding baseline clinical characteristics, clinical efficacy, scar formation, surgical features, postoperative complications, and parental satisfaction.

The primary healing rate (Grade A) in the tension-reducing suture group was 88.5% (54/61), significantly higher than that in the conventional suture group (73.8%, 45/61), with a statistically significant difference (χ2 = 4.340, p = 0.037). At postoperative 1 month [(4.25 ± 1.16) vs. (4.80 ± 1.21)] and 3 months [(3.69 ± 1.03) vs. (4.08 ± 1.10)], the Vancouver Scar Scale (VSS) scores in the tension-reducing suture group were significantly lower than those in the conventional suture group (t = −2.594, −2.044; p = 0.011, 0.043). The tension-reducing suture group had longer operative time [(55.08 ± 11.23) min vs. (50.16 ± 10.46) min], more suture layers [(2.85 ± 0.54) vs. (2.61 ± 0.58)], and more sutures [(41.48 ± 8.42) vs. (38.49 ± 6.20)] compared to the conventional suture group (t = 2.502, 2.406, 2.229; p = 0.014, 0.018, 0.028). No significant difference was observed in intraoperative blood loss between the two groups (p > 0.05). The postoperative complication rate was 4.9% (3/61) in the tension-reducing suture group and 14.8% (9/61) in the conventional suture group, with no statistically significant difference (χ2 = 3.327, p = 0.068). Parental overall satisfaction was 93.4% (57/61) in the tension-reducing suture group and 80.3% (49/61) in the conventional suture group, showing a statistically significant difference (χ2 = 4.604, p = 0.032).

Tension-reducing suture technique is more conducive to promoting primary wound healing and reducing scar formation in pediatric patients. Additionally, this suturing method was associated with a trend towards fewer complications while improving parental satisfaction with surgical outcomes.