Outcomes of laceration suture repair in the emergency department

Abstract

Objective To assess patient satisfaction with laceration management, post‐ED care, cosmesis and complication rates. Methods We undertook a prospective observational study of adult patients with lacerations sutured in two EDs over a 4‐month period. ED data included participant demographics, laceration characteristics and management. A telephone survey was undertaken approximately 14 days post‐ED discharge. Patient satisfaction with post‐ED pain management, advice on wound care and follow up, overall management and wound cosmesis were evaluated using a six‐item satisfaction scale (very dissatisfied to very satisfied). Details of wound infection, dehiscence and suture failure were recorded. Results Eighty‐nine patients participated. The number (% [95% confidence interval]) of patients very satisfied with their laceration management were: post‐ED pain management 55 (62.5% [51.5–72.4]), wound care advice 51 (57.3% [46.4–67.6]), follow‐up advice 39 (43.8% [33.5–54.7]), overall management 61 (68.5% [57.7–77.7]) and cosmetic appearance 46 (51.7% [40.9–62.3]). Infection, dehiscence and suture failure occurred in 5 (5.6%), 8 (9.0%) and 8 (9.0%) cases, respectively. These complications were not associated with being very satisfied overall (P = 0.96). Patients very satisfied with post‐ED pain management, wound care advice, follow‐up advice or wound cosmesis were much more likely to be very satisfied overall (P < 0.001). Conclusions Most patients are very satisfied with their laceration management. However, there is scope for improvement, especially for follow‐up and wound care advice. Complications are infrequent and not associated with overall satisfaction.