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Conservative treatment reduced pain and was as effective as sutures in hand lacerations <2 cm

Key Words: hand injuries • suture techniques

The first 150 words of the full text of this article appear below.

Design
Randomised (allocation concealed^*), blinded (primary outcome only),^* controlled trial with 3 months of follow up.

Setting
Emergency department of a university hospital in San Franciso, California, USA.

Patients
95 patients (mean age 39 y, 54% men) who had lacerations distal to the volar wrist crease. Exclusion criteria were lacerations >2 cm long; presentation >8 hours after the injury; inability to attain haemostasis after 15 minutes; neurovascular, tendon, or bone injury; lacerations that were of the nail bed, puncture wounds, or secondary to a bite from any source; complications from diabetes; use of anticoagulants; or prolonged use of steroids. Follow up at 3 months was 85%.

Intervention
Patients were allocated to conservative treatment (n=48) or suturing (n=47). Patients in the conservative treatment group had the area of laceration irrigated with tap water, and a polymixin B antibiotic ointment (containing bacitracin) and a gauze dressing were applied to last 48 hours. Patients in the . . . [Full text of this article]

Amy A Ernst, MD

University of California, Davis
Sacramento, California, USA