The management and outcome of lacerations in urban children

M. Douglas Baker, Michael Lanuti

Research output: Contribution to journalArticlepeer-review

Abstract

We prospectively studied the management and outcome of 2,834 children, aged 1 month to 18 years, who presented to the emergency department of the Children's Hospital of Philadelphia for laceration repair. Patients with bite wounds were excluded from the study. Eight percent (239) of all patients had complications on initial evaluation; the most common was the presence of a foreign body (55). Infection on presentation was diagnosed in 22 cases (0.8%). All of these patients had delayed their initial care beyond 18 hours (range, 18 to 288 hours; mean, 18 hours). Other factors significantly associated with infection on presentation included occurrence of the injury outdoors (16; P < .001), injury due to broken "street" glass (seven; P < .02), and injury of an extremity (18; P < .01). The rate of prerepair infection was not influenced by the size of the wound. Infections developed subsequent to initial repair in 34 cases (1.2%). Factors associated with development of subsequent infection included use of prophylactic antibiotics, use of subcutaneous sutures, laceration length of more than 5.0 cm, glass or ice as a causative agent, and upper- or lower-extremity involvement. The majority of injuries were repaired by ED personnel without surgical consultation. Postrepair infection rates were not influenced by the specialty of the physician managing the case. Although our study was not designed to specifically test the issue, prophylactic antibiotics were of no proven benefit in reducing infection rates in any group of patients analyzed.

Original languageEnglish (US)
Pages (from-to)1001-1005
Number of pages5
JournalAnnals of emergency medicine
Volume19
Issue number9
DOIs
StatePublished - Sep 1990
Externally publishedYes

Keywords

  • lacerations, pediatric

ASJC Scopus subject areas

  • Emergency Medicine

Fingerprint Dive into the research topics of 'The management and outcome of lacerations in urban children'. Together they form a unique fingerprint.

Cite this