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Treatment of scalp lacerations with a hair apposition technique reduced scarring, pain, and procedure duration compared with suturing

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 QUESTION: Is a new technique of treating scalp lacerations (the hair apposition technique [HAT]) as effective as standard suturing for wound healing, complications, and pain?


Randomised (allocation concealed*), unblinded,* controlled trial with follow up at 1 week.


The emergency departments (EDs) of 2 tertiary care hospitals in Singapore.


189 patients of any age (mean age 32 y, 74% men) with linear non-stellate lacerations of the scalp that were <10 cm in length and with scalp hair >3 cm in length. Exclusion criteria were severely contaminated wounds, actively bleeding wounds that did not stop bleeding after ≥5 minutes of applied pressure, and unstable vital signs or neurological status requiring priority resuscitation. 188 patients (99%) were included in the analysis.


96 patients were allocated to the HAT. Wounds were cleansed according to standard procedure, and no local anaesthetics were given. The wound was closed by bringing together the hair on both sides of the wound and …

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  • Source of funding: tissue adhesive (Histoacryl Blue) provided by B Braun (Melsungen, Germany).

  • For correspondence: Dr M E H Ong, Singapore General Hospital, Singapore. gaeoeh{at}

  • Abstract and commentary also appear in Evidence-Based Nursing.

  • * See glossary. .