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

Abstract

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. RÉ SUMÉObjectifs: Le fait de donner des instructions aux patients sur la faç on d'enlever eux-mê mes les points de suture non ré sorbables et de leur fournir le maté riel né cessaire repré senterait un nouveau moyen d'efficience aux services des urgences. Le principal critè re d'é valuation visait à comparer la proportion de patients ayant ré ussi à bien enlever leurs propres points de suture aprè s avoir reç u des instructions approprié es sur la façon de le faire et le maté riel né cessaire, avec celle ayant reç u les conseils et les soins de suivi habituels. Les critè res d'é valuation secondaires comprenaient le taux de complications, le nombre de consultations mé dicales, et le degré de confort des patients. Mé thodes: Il s'agit d'un essai comparatif, prospectif, mené à simple insu et selon un sché ma pseudoalé atoire chez des patients consé cutifs, traité s à l'urgence, qui ré pondaient aux critè res de sé lection (â ge . 19 ans, lacé rations simples, points de suture non ré sorbables, compé tence immunitaire). Le groupe expé rimental a reç u des instructions sur les soins de la plaie, une trousse pour enlever les points de suture, et des instructions sur la faç on de les enlever eux-mê mes. Le groupe té moin a reç u des instructions sur les soins de la plaie seulement. Les ré su...

A Comparison of Cosmetic Outcomes of Lacerations on the Extremities and Trunk Using Absorbable Versus Nonabsorbable Sutures

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A proposal for a self removal suture (DZ suture) in dermatologic surgery

“…This has been demonstrated in patients discharged from emergency department (2) and patients have also showed satisfaction (3). This has been demonstrated in patients discharged from emergency department (2) and patients have also showed satisfaction (3).…”

“…Most patients are willing to remove, and capable of removing, their own sutures. This has been demonstrated in patients discharged from emergency department (2) and patients have also showed satisfaction (3).…”

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