Outcomes of laceration suture repair in the emergency department.
complication
emergency department
laceration
satisfaction
suture
Journal
Emergency medicine Australasia : EMA
ISSN: 1742-6723
Titre abrégé: Emerg Med Australas
Pays: Australia
ID NLM: 101199824
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
revised:
09
07
2020
received:
18
05
2020
accepted:
10
07
2020
pubmed:
28
8
2020
medline:
2
10
2021
entrez:
27
8
2020
Statut:
ppublish
Résumé
To assess patient satisfaction with laceration management, post-ED care, cosmesis and complication rates. We undertook a prospective observational study of adult patients with lacerations sutured in two EDs over a 4-month period. ED data included participant demographics, laceration characteristics and management. A telephone survey was undertaken approximately 14 days post-ED discharge. Patient satisfaction with post-ED pain management, advice on wound care and follow up, overall management and wound cosmesis were evaluated using a six-item satisfaction scale (very dissatisfied to very satisfied). Details of wound infection, dehiscence and suture failure were recorded. Eighty-nine patients participated. The number (% [95% confidence interval]) of patients very satisfied with their laceration management were: post-ED pain management 55 (62.5% [51.5-72.4]), wound care advice 51 (57.3% [46.4-67.6]), follow-up advice 39 (43.8% [33.5-54.7]), overall management 61 (68.5% [57.7-77.7]) and cosmetic appearance 46 (51.7% [40.9-62.3]). Infection, dehiscence and suture failure occurred in 5 (5.6%), 8 (9.0%) and 8 (9.0%) cases, respectively. These complications were not associated with being very satisfied overall (P = 0.96). Patients very satisfied with post-ED pain management, wound care advice, follow-up advice or wound cosmesis were much more likely to be very satisfied overall (P < 0.001). Most patients are very satisfied with their laceration management. However, there is scope for improvement, especially for follow-up and wound care advice. Complications are infrequent and not associated with overall satisfaction.
Identifiants
pubmed: 32844572
doi: 10.1111/1742-6723.13600
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
242-249Informations de copyright
© 2020 Australasian College for Emergency Medicine.
Références
Mankowitz SL. Laceration management. J. Emerg. Med. 2017; 53: 369-82.
Lloyd JD, Marque MJ 3rd, Kacprowicz RF. Closure techniques. Emerg. Med. Clin. North Am. 2007; 25: 73-81.
Edlich RF, Rodeheaver GT, Thacker JG et al. Revolutionary advances in the management of traumatic wounds in the emergency department during the last 40 years: part II. J. Emerg. Med. 2010; 38: 201-7.
Walker TWM, O'Connor N, Byrne S, McCann PJ, Kerin MJ. Electronic follow-up of facial lacerations in the emergency department. J. Telemed. Telecare 2011; 17: 133-6.
Singer AJ, Mach C, Thode HC Jr, Hemachandra S, Shofer FS, Hollander JE. Patient priorities with traumatic lacerations. Am. J. Emerg. Med. 2000; 18: 683-6.
Keeton H, Crouch R, Lowe K. What is important to patients in wound management. Emerg. Med. J. 2015; 32: 153-4.
Farion KJ, Osmond MH, Hartling L et al. Tissue adhesives for traumatic lacerations: a systematic review of randomized controlled trials. Acad. Emerg. Med. 2003; 10: 110-8.
Quinn JV, Polevoi SK, Kohn MA. Traumatic lacerations: what are the risks for infection and has the ‘golden period’ of laceration care disappeared? Emerg. Med. J. 2014; 31: 96-100.
Quinn J, Cummings S, Callaham M, Sellers K. Suturing versus conservative management of lacerations of the hand: randomised controlled trial. BMJ 2002; 325: 299-300.
Lowe T, Paoloni R. Sutured wounds: factors associated with patient-rated cosmetic scores. Emerg. Med. Australas. 2006; 18: 259-67.
Singer AJ, Church AL, Forrestal K, Werblud M, Valentine SM, Hollander JE. Comparison of patient satisfaction and practitioner satisfaction with wound appearance after traumatic wound repair. Acad. Emerg. Med. 1997; 4: 133-7.
Berwald N, Khan F, Zehtabchi S. Antibiotic prophylaxis for ED patients with simple hand lacerations: a feasibility randomized controlled trial. Am. J. Emerg. Med. 2014; 32: 768-71.
Singer AJ, Gulla J, Hein M, Marchini S, Chale S, Arora BP. Single-layer versus double-layer closure of facial lacerations: a randomized controlled trial. Plast. Reconstr. Surg. 2005; 116: 363-8.
Man SY, Wong EML, Ng YC et al. Cost-consequence analysis comparing 2-octyl cyanoacrylate tissue adhesive and suture for closure of simple lacerations: a randomized controlled trial. Ann. Emerg. Med. 2009; 53: 189-97.
Karaduman S, Yuruktumen A, Guryay SM, Bengi F, Fowler JR Jr. Modified hair apposition technique as the primary closure method for scalp lacerations. Am. J. Emerg. Med. 2009; 27: 1050-5.
Hollander JE, Singer AJ, Valentine S, Henry MC. Wound registry: development and validation. Ann. Emerg. Med. 1995; 25: 675-85.
Max MB, Donovan M, Miaskowski CA et al. Quality improvement guidelines for the treatment of acute pain and cancer pain. JAMA 1995; 274: 1874-80.
Hollander JE, Singer AJ, Valentine SM, Shofer FS. Risk factors for infection in patients with traumatic lacerations. Acad. Emerg. Med. 2001; 8: 716-20.
Chisholm CD, Cordell WH, Rogers K, Woods JR. Comparison of a new pressurized saline canister versus syringe irrigation for laceration cleansing in the emergency department. Ann. Emerg. Med. 1992; 21: 1364-7.
Jenkins MG, Murphy DJ, Little C, McDonald J, McCarron PA. A non-inferiority randomized controlled trial comparing the clinical effectiveness of anesthesia obtained by application of a novel topical anesthetic putty with the infiltration of lidocaine for the treatment of lacerations in the emergency department. Ann. Emerg. Med. 2014; 63: 704-10.
Macdonald P, Primiani N, Lund A. Are patients willing to remove, and capable of removing, their own nonabsorbable sutures? CJEM 2012; 14: 218-23.
Hollander JE, Blasko B, Singer AJ, Valentine S, Thode HC Jr, Henry MC. Poor correlation of short- and long-term cosmetic appearance of repaired lacerations. Acad. Emerg. Med. 1995; 2: 983-7.
Campbell SG, McCarvill EM, Magee KD et al. The consent and prescription compliance (COPRECO) study: does obtaining consent in the emergency department affect study results in a telephone follow-up study of medication compliance? Acad. Emerg. Med. 2008; 15: 932-8.
Shill J, Taylor DM, Ngui B et al. Factors associated with high levels of patient satisfaction with pain management. Acad. Emerg. Med. 2012; 19: 1212-5.
Taylor DM, Fatovich DM, Finucci DP et al. Best-practice pain management in the emergency department: a cluster-randomised, controlled, intervention trial. Emerg. Med. Australas. 2015; 27: 549-57.