• Am J Emerg Med · May 2019

    Observational Study

    What are the key elements in suture education? Comparison of cosmetic appearances after facial lacerations repaired by junior residents and experts.

    • Jin Hong Min, Yeon Ho You, Yong Chul Cho, Won Joon Jeong, Jung Soo Park, Se Kwang Oh, Sung Uk Cho, Yong Nam In, Chi Hwan Kwack, and In Sool Yoo.
    • Department of Emergency Medicine, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, Republic of Korea.
    • Am J Emerg Med. 2019 May 1; 37 (5): 817-822.

    PurposeThe technical factors which improve cosmetic outcomes and which need to be emphasized in education of junior residents have yet to be described. We compared cases in which suturing was performed by either junior emergency medicine residents or experts, in order to determine the focus of future education and training.MethodsWound registry data was reviewed and retrospectively analyzed from September 2015 to February 2016. Only patients who visited the emergency room with facial lacerations were enrolled, and their wound registry data sheets were reviewed. Practitioners were divided into junior resident and expert groups. We assessed the progress using the Stony Brook Scar Evaluation Scale (SBSES) 5-10 days following suturing.ResultsSixty-six patients were enrolled; 43 (65.2%) were men. The median (interquartile range) cosmetic scores (SBSES scale) for suturing performed by junior residents or experts were 3 (2-4) and 5 (4-5), respectively (p = 0.001). The percentage of maximum scores for each SBSES category was significantly lower in the junior resident group than in the expert group for width (68% vs. 86%), hatch marks (68% vs. 93%), and overall appearance (41% vs. 80%) (all p < 0.001).ConclusionsThere were significant differences in scar widths and hatch marks, which were attributable to the skill level of the practitioner who performed the suturing of facial lacerations. Junior residents should be educated about maintenance of proper tension, atraumatic technique, and performing appropriate trimming or debridement.Copyright © 2018 Elsevier Inc. All rights reserved.

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