Efficacy of nurses suturing pediatric dermal lacerations in an emergency department.
OBJECTIVE
To assess the efficacy of nurses suturing pediatric dermal lacerations in an emergency department.


METHODS
Prospective study.


METHODS
Pediatric ED.


METHODS
Suturing nurses completed a comprehensive training program provided by physicians at our institution and at a national wound management workshop; both included instruction in wound assessment, preparation, anesthesia, repair, and care after repair. A survey of physician and parent satisfaction with wound repair and for wound healing complications was performed at the time of suture removal in 61 children whose dermal laceration was repaired by suturing nurses.


RESULTS
The laceration was located on the face in 40 patients, the scalp in 14, and an extremity in 7. A total of 343 sutures was required (18 lacerations required a layered closure). Pediatricians graded wound repair as "very good" in 32 cases (53%) and "excellent" in 29 cases (47%). Parents rated themselves as "very satisfied" with the wound repair procedure in 60 cases (98%) and with the wound repair outcome in 59 cases (97%). There were no wound-healing complications. Suturing nurses took a total of 72 hours to repair lacerations. In comparison, of 20 lacerations repaired by an ED attending physician, 11 (55%) were graded as "excellent" and 9 (45%) as "very good," with no wound-healing complications (P = NS).


CONCLUSIONS
Nurses who complete a standardized training program in wound management and repair are capable of providing high-quality, definitive care for children with dermal lacerations, thus allowing physicians to use their time more effectively in managing general patient care in the ED.
Pediatric Emergency Department, Children's Hospital of St Paul, Minnesota.
W A
WA
Bonadio
M
M
Carney
D
D
Gustafson
D000758:Anesthesia / Q000379:methods; D002648:Child; D004636:Emergency Service, Hospital / Q000592:standards*; D005151:Facial Injuries / Q000451:nursing* / Q000601:surgery; D006801:Humans; D009741:Nursing Staff, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D011446:Prospective Studies; D012535:Scalp / Q000293:injuries; D012867:Skin / Q000293:injuries*; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D000078329:Workforce; D014945:Wound Healing; D014950:Wounds, Penetrating / Q000451:nursing* / Q000601:surgery