Comparison of wound care practices in pediatric and adult lacerations repaired in the emergency department.
Publication/Presentation Date
2-1-1998
Abstract
OBJECTIVE: We compared emergency physician's wound care practices in young children (< or = 5 years) and adults (> or = 18 years) and the effect of these different practices on infection rate and cosmetic appearance.
DESIGN: Cross sectional study.
SETTING: University hospital emergency department that rarely uses conscious sedation.
PARTICIPANTS: Consecutive patients who presented with lacerations over a four-year period.
METHODS: Structured closed question data sheets that assessed 26 separate wound characteristics were prospectively completed at initial presentation and at suture removal. Infection and cosmetic appearance were assessed with previously validated scales. chi(2) tests were used for categorical variables, t tests for continuous variables.
RESULTS: We evaluated 3624 patients: 853 children and 2771 adults. Wounds in children were more likely to be on the head (86 vs 38%, P < 0.01); linear (88 vs 77%, P < 0.01); shorter (1.9 vs 3.0 cm, P < 0.01); less often contaminated (4 vs 11%, P < 0.01); and more commonly caused by blunt injury (69 vs 37%, P < 0.01). With respect to treatment, lacerations in children were less likely to receive irrigation (53 vs 77%; P < 0.001) but slightly more likely to be scrubbed (50 vs 45%, P = 0.01). The two groups received similar numbers of sutures per centimeter (2.6 vs 2.3). Using logistic regression, the differences in irrigation were not explained by the differences in laceration characteristics. Despite less frequent irrigation, children had lower wound infection rates (2.1 vs 4.1%; P = 0.004) and better cosmetic appearances (optimal score, 75 vs 64%, P = 0.0003).
CONCLUSIONS: Emergency physicians at our institution are less likely to irrigate lacerations in children than adults; however, children had a lower infection rate and more favorable cosmetic outcome.
Volume
14
Issue
1
First Page
15
Last Page
18
ISSN
0749-5161
Published In/Presented At
Hollander, J. E., Singer, A. J., & Valentine, S. (1998). Comparison of wound care practices in pediatric and adult lacerations repaired in the emergency department. Pediatric emergency care, 14(1), 15–18. https://doi.org/10.1097/00006565-199802000-00004
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
9516624
Department(s)
Administration and Leadership
Document Type
Article