According to the 2016 National Hospital Ambulatory Medical Care (NHAMC) Survey, there
were an estimated 145 million visits to emergency departments (ED) during 2016 [
[1]
]. Anywhere from approximately 7 to 9 million lacerations are treated each year in
EDs [
- Rui P.
- Kang K.
- Ashman J.J.
National Hospital Ambulatory Medical Care Survey: 2016 emergency department summary
tables.
https://www.cdc.gov/nchs/data/ahcd/nhamcs_emergency/2016_ed_web_tables.pdf
Date accessed: January 14, 2020
[2]
]. For each injury that requires sutures, there are a wide variety of wound closure
materials, and which material is used depends on many factors. These factors may include
the location of the wound, amount of tension on wound edges, provider preference,
and patient factors [
[2]
]. Previous studies have shown wound evaluation outcome for absorbable versus nonabsorbable
sutures are relatively clinically equivalent [
[3]
]. However, if a patient is treated with nonabsorbable sutures, they are instructed
to return to a medical care provider to have those sutures removed in a timely fashion.
For patients who are uninsured, unable to access an urgent care facility or lacking
a primary care provider, the medical care to remove sutures often occurs in the same
ED where the laceration repair originally occurred. These visits are costly and could
possibly be avoided, saving the health care system valuable medical care dollars.
Providing patients with the necessary equipment and instruction may empower and enable
patients to remove their non-absorbable sutures at home, thereby avoiding a potentially
costly trip to a medical professional. There is very little in the literature that
assesses the willingness to, or rate at which patients remove their own sutures. The
available literature conveys that although some initial anxiety may be present, patients
are willing and able to remove their own sutures after simple procedures and suturing
[
4
,
5
,
6
]. Therefore, this study sought to: 1) estimate the prevalence of suture removal by
patients at home; and 2) determine if ED patients with uncomplicated lacerations were
willing to remove their own sutures.Keywords
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References
- National Hospital Ambulatory Medical Care Survey: 2016 emergency department summary tables.https://www.cdc.gov/nchs/data/ahcd/nhamcs_emergency/2016_ed_web_tables.pdfDate accessed: January 14, 2020
- Updates in emergency department laceration management.Clin Exp Emerg Med. 2019; 6: 97-105
- A comparison of cosmetic outcomes of lacerations on the extremities and trunk using absorbable versus nonabsorbable sutures.Acad Emerg Med. 2014; 21: 637-643
- Self-removal of sutures by emergency department patients.Ann Emerg Med. 2009; 54: S133
- Are patients willing to remove, and capable of removing, their own nonabsorbable sutures?.Can J Emerg Med. 2012; 14: 218-223
- The use of self-removal prolene suture after daycase laparoscopic surgery.Surg Laparosc Endosc Percutan Tech. 2006; 16: 334-337
Article Info
Publication History
Published online: May 15, 2020
Accepted:
May 12,
2020
Received:
April 21,
2020
Identification
Copyright
© 2020 Published by Elsevier Inc.
