Hair apposition technique for scalp laceration repair: a randomized controlled trial comparing physicians and nurses (HAT 2 study)

Objectives

The hair apposition technique (HAT) is a new method of closing scalp lacerations in which hairs on either side of the wound are twisted together and secured with a tissue adhesive. We aimed to compare the effectiveness, complications, and benefits of HAT performed by nurses or doctors in a randomized, prospective trial.

Methods

We conducted the study in the ED from November 2002 to February 2005. Subjects were randomized to receive HAT either by doctors or nurses. All wounds were evaluated 7 days later. The outcomes wound infection, wound healing, bleeding, and overall complications were measured, setting ±5% in the differences of the outcomes between the doctors and nurses as equivalence.

Results

There were 88 and 76 patients in the doctor and nurse groups, respectively. There were no significant differences in all short-term outcomes between the doctors and nurses except for length of the procedure. The doctors had a shorter mean duration of procedure than the nurses (9.0 ± 5.6 vs 12.8 ± 7.5 minutes, P = .001).

Conclusion

The HAT can be safely performed by trained nurses with equivalent outcomes as doctors.