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Does that cut really need stitches?

Suturing versus conservative management of lacerations of the hand: randomised controlled trial BMJ Volume 325, pp 299-300

BMJ

Treating simple lacerations of the hand conservatively instead of with sutures is faster, less painful, and produces similar cosmetic and functional outcomes, finds a study in this week's BMJ.

Researchers identified 91 patients presenting at an emergency department in California with simple lacerations of the hand that would normally be treated with sutures. Patients received either sutures or conservative treatment and were asked to return in 8-10 days for their sutures to be removed or their wound to be assessed. Patients also rated the pain of their treatment using a standard pain rating scale.

The mean time to resume normal activities was the same in both groups. Patients treated conservatively reported less pain and treatment time was 14 minutes shorter. There was also no difference in cosmetic appearance after three months.

The goal of wound care and closure is to have a resultant functional and cosmetically acceptable scar, with low morbidity and high patient satisfaction and comfort, say the authors. These goals can be achieved by treating simple lacerations of the hand conservatively instead of with sutures. The time saving has implications for health policy, they add.

Although these results cannot be generalised to cosmetically sensitive areas such as the face, the authors conclude: "We were impressed with how inconspicuous most scars were after three months and at the high level of patients' satisfaction with the appearance of their wound."

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