Rapid Responses from bmj.com

doi:10.1136/bmjusa.02100005

BMJ, doi: 10.1136/bmjusa.02100005, (Published 26 January 2003)

Letters

Rapid Responses from bmj.com

Setting precedents for the treatment of hand lacerations

Stitch marks $---$ I can tell the difference

Patient knowledge as a confounding factor

Why am I not convinced?

Editor's summary

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

From BMJ USA 2002;October:558

As of September 19, 2002, this article had generated 32 Rapid Responses (http://bmj.com/cgi/eletters/325/7359/299) from whichthe following edited excerpts are taken. $---$ Editor

Setting precedents for the treatment of hand lacerations

EDITOR $---$ It is not stated who assessed the wounds, but I assume it was the authors. I am sure that they have great experiencein hand assessment, but it has been reported that up to 49% ofhand and forearm lacerations result in subclinical deep injuries.Even hand surgeons miss 16% of tendon injuries. My major concernis that this study might set a precedent for junior staff to treatall such injuries with minimaldeference.

Although the study quantified the patients' subjective assessment of the pain of treatment, there was no mention of the occasionallydisabling symptom of scar tenderness. Theoretically, an unsuturedlaceration will have a greater tendency to granulation tissueformation, with the possibility of a greater degree of disorganizedreinnervation. . . . [Full text of this article]