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Ann Emerg Med. 2005 Sep;46(3):237-42.

Cost-effectiveness of hair apposition technique compared with standard suturing in scalp lacerations.

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Department of Emergency Medicine, Singapore General Hospital, Singapore.



We have previously described a prospective, randomized, multicenter, clinical trial comparing the hair apposition technique, a new technique of treating scalp lacerations with tissue adhesives, with standard suturing. We found the hair apposition technique to be a better technique for closing suitable scalp lacerations. In this study, we aim to compare the cost-effectiveness of the hair apposition technique and standard suturing.


All costs related to each method were calculated, including equipment and staff time. On the basis of the previous randomized controlled trial, differential costs caused by complications were also calculated. The incremental effectiveness of the hair apposition technique was assessed in terms of complications avoided. Expected values of costs and outcomes were obtained through Monte Carlo simulation.


The hair apposition technique was dominant over standard suturing in that it was more effective and resulted in a cost savings of USD 28.50 (95% confidence interval USD 16.30 to USD 43.40) per patient compared with standard suturing because of reduced equipment needs, shorter medical staff time required, no need for another visit to remove sutures, and lower complication rates. The probability of the hair apposition technique being both cost saving and more effective was 98.9%.


The hair apposition technique is more cost-effective compared with standard suturing and could lead to large cost savings, given the common occurrence of scalp lacerations in most health systems.

[Indexed for MEDLINE]

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