Authors (including presenting author) :
Chow YF(1)(2)
Affiliation :
(1)Accident and Emergency Department, Tseung Kwan O Hospital, (2)Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong
Introduction :
Conventionally, sutured scalp and forehead lacerations are covered with dressings. However, these dressings could cause discomfort. In other health services, leaving them uncovered is a common practice. Patients’ satisfaction with this approach has been investigated previously, but the interpretations were overly general.
Objectives :
This study aimed (1) to investigate patients’ perceived health status towards covered and uncovered sutured scalp or forehead wounds, and (2) to investigate the infection rate of covered and uncovered sutured scalp or forehead wounds.
Methodology :
From October 2021 to February 2022, a randomized controlled, single-blinded, prospective study was conducted in the Accident and Emergency Department (AED), of Tseung Kwan O Hospital. Patients aged 18 - 80 years old with scalp or forehead wounds requiring suturing were randomly allocated to the control and intervention groups.
In the control group (N=12), subjects were advised to keep their dressings in place until the removal of stiches (ROS). Patients in the intervention group (N=14) were advised to remove the dressings 12 hours after suturing. EQ-5D-5L is a health status instrument used to quantify health related quality of life (QoL). The index value of EQ-5D-5L (index) was collected twice in each subject, firstly before suturing; this served as a baseline determination. The same questionnaire was completed after ROS, rating the condition whenever the stitches were in place.
Result & Outcome :
There were 26 recruited cases with 2 cases dropped off. 24 patients were included in data analysis. The two groups were comparable in terms of gender (p=0.64), the location of the wound (p=0.41), and the number of stitches (p=0.64). There was no difference in median index between the two groups at baseline.
The mean index was 0.951 and 0.877 before injury and after ROS respectively. After ROS, the median index was lower in the control group than the intervention group (0.885 vs 1, p = 0.003). The change in index (-0.08 vs 0, p = 0.001) was significantly higher in the control group than the interventional group. No wound infection nor second attendance for wound infection were noted.
The above data reflect a higher health related QoL for patients with uncovered sutured wounds, with no apparent increase in wound infection. Our findings support the early removal of dressings for sutured scalp and forehead wounds at 12 hours following suturing in the AED setting.
