Management of Facial Lacerations in the Pediatric Population

Abstract

Introduction: Pediatric facial lacerations require special consideration for growth, scar appearance, and psychological impact. This literature review synthesizes evidence on optimal closure techniques.

Methods: A search of pediatric plastic surgery literature identified studies comparing tissue adhesives, absorbable sutures, and non-absorbable sutures. Inclusion: children aged 0-18 years with facial lacerations. Outcomes: scar scale scores (Vancouver, POSAS), infection, and dehiscence.

Results: Thirty-three studies were analyzed. Tissue adhesives resulted in comparable cosmetic outcomes to sutures for wounds <4 cm with low tension. Absorbable sutures showed similar scar quality to non-absorbable for deep dermal closure. Infection rates were lowest with tissue adhesives (2% versus 5% for sutures). Dehiscence was rare (<3%) across all methods. Younger age (<5 years) correlated with better scar outcomes.

Discussion: Tissue adhesives offer painless application and avoid suture removal, ideal for young children. Sutures remain superior for high-tension wounds. Long-term scar management with silicone gel showed benefit.

Conclusions: Technique selection should balance wound characteristics, child cooperation, and parent preference. All methods yield excellent outcomes when properly applied.