Level of training, wound care practices, and infection rates.
This prospective, nonrandomized descriptive study compares the traumatic wound infection rates in patients based on level of training of emergency department (ED) practitioners. Wounds were evaluated in 1,163 patients. A wound registry data sheet was prospectively completed on all patients sutured in the ED. All practitioners were assigned a unique identification number. Follow-up data was obtained at the time of the return visit. Patients failing to return were contacted by telephone. Data were analyzed for patient wound infection rates by practitioner level of training. Patient wound infection rates by practitioner level of training were: medical students, 0/60 (0%); all resident physicians, 17/547 (3.1%); physician assistants, 11/305 (3.6%); and attending physicians 14/251 (5.6%), P was not significant. Comparison of junior (medical students and interns) to senior practitioners (all other practitioners) found no difference in infection rates (8/262 [3.1%] v 34/901 [3.8%], P = .58). In conclusion, carefully selected patients sutured by closely supervised medical students and junior residents have infection rates as low as those sutured by more experienced practitioners.
Singer
A J
AJ
Department of Emergency Medicine, University Medical Center, State University of New York, Stony Brook 11794-7400, USA.
Hollander
J E
JE
Cassara
G
G
Valentine
S M
SM
Thode
H C
HC
Henry
M C
MC
D000293:Adolescent; D000328:Adult; D002648:Child; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology*; D004522:Educational Status; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education* / Q000592:standards; D009518:New York / Q000453:epidemiology; D011446:Prospective Studies; D013536:Suture Techniques / Q000592:standards*; D014946:Wound Infection / Q000453:epidemiology* / Q000209:etiology*; D014947:Wounds and Injuries / Q000628:therapy*