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Sutures Not Needed for Most Hand Cuts

By HospiMedica staff writers
Posted on 21 Aug 2002
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A study has shown that patients with hand lacerations less than 2 cm in length treated with antibiotic ointment and a gauze dressing have less pain and shorter treatment time than patients who have sutures. The study was published in the August 10, 2002, issue of the British Medical Journal.

Researchers identified 91 patients who came to the emergency department with uncomplicated lacerations of the hand (less than 2 cm in length) that would normally be treated with sutures. Those randomized to suture treatment had their cuts anesthetized and cleansed and the skin closed with 4-0 or 5-0 monofilament suture and standard sterile techniques. Those randomized to receive conservative treatment only received tap water irrigation and had the same antibiotic ointment and gauze dressing applied for 48 hours.

After eight to 10 days, patients returned for their sutures to be removed or their wound to be assessed. They also rated the pain of their treatment using a standard pain rating scale.
Patients treated conservatively reported less pain, and treatment time was 14 minutes shorter. The average time to resume normal activities was the same for both groups. After three months, there was no difference in cosmetic appearance between the suture group and the conservative group.

"We were impressed with how inconspicuous most scars were three months after suture-free treatment,” said James Quinn, M.D., associate professor in the division of emergency medicine at the University of California, San Francisco (USA) and lead author of the study. The researchers point out that large wounds need sutures and that their study results cannot be generalized to cosmetically sensitive areas such as the face.




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