Tissue Adhesive as an Alternative to Sutures in Pediatric Eye Emergency

Study Objective: To compare the efficacy, safety, and patient experience between cyanoacrylate tissue adhesive and conventional sutures for periorbital wound closure in children. Methods: A prospective comparative study evaluated 145 pediatric patients with periorbital trauma treated with tissue adhesive (n=70) or conventional suturing (n=75) based on clinical assessment from September 2023 to October 2024. Primary outcomes were wound healing grades (grade I/II/III) and complication rates; secondary outcomes included procedure time (median, seconds), pain scores (mean, Wong-Baker FACES), Frankl behavioral compliance scores (mean), and parental satisfaction. Statistical analysis used t tests, Mann-Whitney U tests, and χ 2 tests. Results: The adhesive group had significantly shorter procedure time (184 vs. 692 s, P <0.001), lower pain scores (2.8 vs. 5.6, P <0.001), and higher compliance (Frankl 3.1 vs. 2.3, P <0.01). No significant differences were observed in grade I healing rates (97.1% vs. 93.3%) or complication rates (2.9% vs. 4.0%, P =0.24). Conclusions: In pediatric periorbital trauma, use of tissue adhesive was associated with reduced treatment time and pain scores, with similar healing outcomes compared with sutures, suggesting it may serve as a viable alternative.