Biological Glue as an Alternative to Suction Drainage in Tissue-Expanded Flaps in Children: Cost-Effectiveness Study.

Introduction Biological glue is already used as a hemostatic agent and tissue adhesive in plastic surgery. This study evaluates the use of this glue as an alternative to suction drainage for the adhesion of tissue-expanded flaps in pediatric patients. Methods This is a retrospective, multicenter case-control study on 48 flap procedures conducted on 42 children (5 months-12 years of age) between 2004 and 2017, comparing a "glue" group (n = 24) with a control group (n = 24), in which a classic redon drain was used. The control patients were matched according to age, etiology, location of the lesion, and the size of the expander. The primary end point was the duration of hospital stay. Results The conditions were 24 cases of congenital nevus, 14 of cicatricial alopecia, and 10 of sebaceous hamartoma. Twenty-nine lesions were located on the scalp, 15 on the back, 2 on the thigh, and 2 on the buttocks. The average surgical durations (48 +/- 24 vs 63 +/- 32 minutes,P= 0.13) and average room occupancy time (126 +/- 21 vs 139 +/- 44 minutes,P= 0.29) were similar between the glue group and the control group. However, the average duration of hospital stay was lower in the glue group (1.5 +/- 1.5 days) than in the control group (3.6 +/- 1.3 days,P< 0.0001). The complication rates between the groups were similar. Conclusions The application of glue on expanded flaps is as reliable as suction drainage with the advantage of reducing the duration of hospital stay and potentially enabling outpatient treatment for certain patients.