7 research outputs found
Developmental and behavioral outcomes of uncomplicated monochorionic diamniotic twins born in the third trimester
Effectiveness of nail bed repair in children with or without replacing the fingernail : NINJA multicentre randomized clinical trial
Background
Surgery for nail bed injuries in children is common. One of the key surgical decisions is whether to replace the nail plate following nail bed repair. The aim of this RCT was to assess the clinical effectiveness and cost-effectiveness of nail bed repair with fingernail replacement/substitution compared with repair without fingernail replacement.
Methods
A two-arm 1 : 1 parallel-group open multicentre superiority RCT was performed across 20 secondary-care hospitals in the UK. The co-primary outcomes were surgical-site infection at around 7 days after surgery and cosmetic appearance summary score at a minimum of 4 months.
Results
Some 451 children presenting with a suspected nail bed injury were recruited between July 2018 and July 2019; 224 were allocated to the nail-discarded arm, and 227 to the nail-replaced arm. There was no difference in the number of surgical-site infections at around 7 days between the two interventions or in cosmetic appearance. The mean total healthcare cost over the 4 months after surgery was €84 (95 per cent c.i. 34 to 140) lower for the nail-discarded arm than the nail-replaced arm (P < 0.001).
Conclusion
After nail bed repair, discarding the fingernail was associated with similar rates of infection and cosmesis ratings as replacement of the finger nail, but was cost saving
NINJA trial:should the nail plate be replaced or discarded after nail bed repair in children? Protocol for a multicentre randomised control trial
Effectiveness of nail bed repair in children with or without replacing the fingernail: the NINJA multicentre randomised controlled trial
Background: Surgery for nail bed injuries in children is common.. One of the key
surgical decisions is whether to replace the nail plate, following nail bed repair. The aim
of this study was to perform a randomized clinical trial to assess the clinical and cost
effectiveness of nail bed repair with fingernail replacement/substitution compared to
repair without fingernail replacement.
Method: A two-arm 1:1 parallel group open multicentre superiority randomised
controlled trial was performed across 20 secondary care hospitals in the United
Kingdom. The co-primary outcomes were surgical site infection at around 7 days
following surgery and cosmetic appearance summary score at a minimum of 4 months.
Results: Some 451 children presenting with a suspected nail bed injury were recruited
between July 2018 to July 2019, with 224 patients allocated to the nail discarded arm,
and 227 to the nail replaced arm. There was no difference in the number of surgical site
infections between the two interventionsn at around 7 days or cosmetic appearance.
The mean total healthcare cost over the four months following surgery was £75 lower
for the nail discarded arm than the nail replaced arm (95% confidence interval £30,
£124; p<0.001).
Conclusions: Following nail bed repair, discarding the fingernail was associated with
similar rates of infection and cosmesis ratings with replacement of the finger nail but is
cost saving