Suturing v conservative management of hand lacerations

doi:10.1136/bmj.325.7372.1113

BMJ 2002;325:1113 ( 9 November )

Letters

Suturing v conservative management of hand lacerations

All lacerations need to be examined thoroughly

Hand lacerations should be explored before conservative treatment

Incisions are not lacerations

Authors' reply

All lacerations need to be examined thoroughly

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

EDITOR $---$ Quinn et al show that conservative treatment is faster and less painful for small uncomplicated lacerations of thehand.¹ However, we think that lacerations to the hand, no matterhow small, must be examined thoroughly to exclude injuries totendons, nerves, or joints. The authors make no comment on themechanism of injury, which is extremely important. A knife stablaceration or glass injury to the hand would make explorationof the wound mandatory. An unimpressive skin wound may hide aremarkable amount of damage to deep structures.² Similarly,injuries caused by thin slivers of glass produce unimpressiveskin wounds but commonly divide flexor tendons and nerves in theforearm.³

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In emergency settings we think that it is crucial to take a good history from the patient about the mechanism of injury andto examine the patient thoroughly before deciding on further managementof hand lacerations, albeit suturing . . . [Full text of this article]

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Relevant Article

Suturing versus conservative management of lacerations of the hand: randomised controlled trial: James Quinn, Steven Cummings, Michael Callaham, and Karen Sellers
BMJ 2002 325: 299. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

Ernst, A. A (2003). Conservative treatment reduced pain and was as effective as sutures in hand lacerations <2 cm. Evid. Based Med. 8: 60-60 [Full text]