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Are patients willing to remove, and capable of removing, their own nonabsorbable sutures?

Published online by Cambridge University Press:  11 May 2015

Peter Macdonald ,
Nadia Primiani  and
Adam Lund
Peter Macdonald*
Affiliation:
Department of Emergency Medicine, Royal Columbian Hospital, New Westminster, BC
Nadia Primiani
Affiliation:
Department of Family Practice, University of British Columbia, Vancouver, BC
Adam Lund
Affiliation:
Department of Emergency Medicine, University of British Columbia, Vancouver, BC
*
330 East Columbia Street, New Westminster, BC V3L 3W7; peter.macdonald@fraserhealth.ca.

Abstract

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Objectives:

Providing patients with instructions and equipment regarding self-removal of nonabsorbable sutures could represent a new efficiency in emergency department (ED) practice. The primary outcome was to compare the proportion of patients successfully removing their own sutures when provided with suture removal instructions and equipment versus the standard advice and follow-up care. Secondary outcomes included complication rates, number of physician visits, and patient comfort level.

Methods:

This prospective, controlled, single-blinded, pseudorandomized trial enrolled consecutive ED patients who met the eligibility criteria (age > 19 years, simple lacerations, nonabsorbable sutures, immunocompetent). The study group was provided with wound care instructions, a suture removal kit, and instructions regarding suture self-removal. The control group received wound care instructions alone. Outcomes were assessed by telephone contact at least 14 days after suturing using a standardized questionnaire.

Results:

Overall, 183 patients were enrolled (93 in the intervention group; 90 in the control group). Significantly more patients performed suture self-removal in the intervention group (91.5%; 95% CI 85.4–97.5) compared to the control group (62.8%; 95% CI 52.1–73.6) (p < 0.001). Patients visited their physician less often in the intervention group (9.8%; 95% CI 3.3–16.2) compared to the control group (34.6%; 95% CI 24.1–45.2%) (p < 0.001). Complication rates were similar in both groups.

Conclusion:

Most patients are willing to remove, and capable of removing, their own sutures. Providing appropriate suture removal instructions and equipment to patients with simple lacerations in the ED appears to be both safe and acceptable.

Keywords

suturesuture removalwound care
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 14 , Issue 4 , July 2012 , pp. 221 - 227
Copyright
Copyright © Canadian Association of Emergency Physicians 2012

References

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