Should hand cuts be stitched

Recent research has shown that similar cosmetic and functional outcomes result from either conservative treatment or suturing of small uncomplicated lacerations of the hand, but conservative treatment is faster and less painful. Lacerations are common simple problems but their treatment requires tremendous resources. Suturing is the most popular method of securely closing wounds, although it has many disadvantages: sutures require the use of needles to inject painful anaesthetics, are time consuming, have the greatest tissue reactivity of any wound closure device, are costly, and are inconvenient for patients. Researchers at the Division of Emergency Medicine, University of California undertook a study to determine whether the conservative management of hand lacerations produced similar clinical outcomes to wounds that were sutured. Patients with lacerations of the hand that would normally be treated with sutures were taken for the study. Patients were excluded if their lacerations were longer than 2 cm. It was found that participants treated with sutures and those treated conservatively did not differ significantly in the assessment of cosmetic appearance. The mean time to resume normal activities was the same in both groups (3.4 days). However, patients treated conservatively had less pain and treatment time for them was shorter. The goal of wound care and closure is to have a resultant functional and cosmetically acceptable scar with low morbidity and high patient satisfaction and comfort. These goals can be achieved by treating simple lacerations of the hand conservatively instead of with sutures. The time saving has implications for health policy.