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Evidence summaries

Suturation Versus Conservative Treatment of Hand Lacerations

Similar cosmetic and functional outcomes appear to result from either conservative treatment or suturing of small uncomplicated lacerations of the hand, but conservative treatment is faster and less painful. Level of evidence: "B"

A randomised controlled trial 1 assessed the difference in clinical outcome between lacerations of the hand closed with sutures and those treated conservatively (tap water irrigation, ointment and dressing applied for 48 hours). Cases with uncomplicated lacerations of the hand who would normally require sutures were included (full thickness < 2 cm; without tendon, joint, fracture, or nerve complications). 91 patients with 95 lacerations were enrolled and results were rated on a previously validated visual analogue scale.

Participants treated with sutures and those treated conservatively did not differ significantly in the assessment of cosmetic appearance by independent blinded doctors after three months: 83 mm v 80 mm, (mean difference 3 (95% confidence interval 1 to 8) mm) on the visual analogue scale. The mean time to resume normal activities was the same in both groups (3.4 days). Patients treated conservatively had less pain (difference 18 (12 to 24) mm) and treatment time was 14 (10 to 18) min shorter.

    References

    • Quinn J, Cummings S, Callaham M, Sellers K. Suturing versus conservative management of lacerations of the hand: randomised controlled trial. BMJ 2002 Aug 10;325(7359):299. [PubMed]

Primary/Secondary Keywords