new article looked at timing to suturing lacerations and outcome (see\u00a0\u00a0doi:10.1136\/emermed-2012-202143).\u00a0 they assessed 2700 consecutive patients after suturing traumatic lacerations, with results:<\/p>\n
–69 developed wound infections (not surprisingly these people had less good cosmetic outcome, occ needing scar revision)<\/p>\n
–predictors for infection were largely the usual suspects:<\/p>\n
–diabetes (RR 2.70)<\/p>\n
–contaminated lacerations (RR 2.0)<\/p>\n
–lacerations longer than 5 cm (RR 2.9)<\/p>\n
–lower extremity lacerations (RR 4.1)<\/p>\n
–and, not<\/b> associated with increased infection rate<\/p>\n
–deeper lacerations requiring deep stitches<\/p>\n
–suturing after 12 hours vs <12 h, with average times for these groups being 2 vs 16 hours (actually the ones with more delayed closure did better!!). the delayed ones were more likely to be on an extremity. no diff in use of prophylactic antibiotics<\/p>\n
so, yet another dogma challenged (i had posted a preliminary report with similar findings, but much smaller study, a couple of years ago). one issue raised in the article is that the above predictors (diabetes, contaminated lac, one longer than 5 cm, lower extrem lac) all\u00a0 had infection rates in the 5-10% range (actually, the contaminated ones were 4.5%, the rest were higher), and that might be above a threshold to give prophylactic antibiotics.\u00a0 a thought….<\/p>\n
geoff<\/p>\n","protected":false},"excerpt":{"rendered":"
delayed suturing of lacerations not harmful […]<\/p>\n