Wound Care Differences in Paediatric Emergency Department: A Questionnaire Based one-centre study Before Developing and Implementing Minor-Trauma Care SOP
Abstract Background: Paediatric minor traumas/wounds are one of the most common reasons to visit paediatric emergency department (PED). In this study we evaluated how different specialty physicians in PED treat wounds and what methodologies they used before developing a unified wound care SOP.Methods: A prospective Questionnaire based one centre study was conducted in PED of Hospital of Lithuanian University of Health Sciences Kauno Klinikos. All the physicians/fellows working in PED were asked to voluntarily fill anonymous questionnaire after each patient who required wound management.Results: In total, 166 questionnaires were collected and 148 were analysed. Mean age of the patients was 5.91 [3.13-8.13] years. Average laceration length was 1.75 [1.0-2.0] cm. The main injury area was forehead (28.4%), hairy part of the head composed 22.3% of all the wounds. Wounds did not differ in length treated by EM and surgical physicians; GP and paediatricians managed smaller wounds. Most wounds were cleaned with chlorhexidine gluconate or combination with hydrogen peroxide. 33.8% of wounds were sutured. In 12.8% suturing was combined with Steri-Strips™. In 43.2% of the cases no needle methods were used. Suturing was most often chosen by the surgical specialty clinician/fellow (66.7%). 48% of the patients were given anaesthesia (mostly locally). 8.7% of suturing cases received no anaesthesia at all. 4 children were prescribed antibiotics for aftercare. The check-up date for sutures removal was associated with location of the wound. Conclusion: this study revealed differences between various specialty physicians and fellows working in PED with regard to wound management starting with wound cleaning to laceration aftercare and recommendations. Thus, it led to a wound care SOP development seeking unified and evidence-based methodology of wound management and aftercare in PED.