Instructing the patient

Patients leaving the Emergency Department after wound management and suturing need a specific set of instructions for ongoing wound care and routine follow-up. As well, they need to be cautioned about possible complications.

Wound care will vary, but in general patients should be told to keep the area clean and dry. The wound may be gently cleaned with plain water or diluted hydrogen peroxide to remove crusting and debris. Dressings that have become wet or dirty should be changed.

If there is significant swelling associated with the wound, elevation of the affected area will improve patient comfort. In areas under stress, such as over joints, splinting for a few days can improve comfort and aid in healing.

Instructions for suture removal need to be given in each case. The length of time sutures are left in depends on the amount of tension in the tissues in the area of the wound, balanced against the fact that sutures will cause additional scarring when left in too long.

The following guidelines for suture removal are generally accepted:

Face 4-5 days. Replace with Steri-stripsTM
Scalp and trunk
7-10 days
Arms and legs
10-14 days
Joints 14 days

The most common and important complication for patients to be aware of is infection. Signs and symptoms of infection include increased pain, swelling, redness, fever or red streaks spreading proximally. Patients should be cautioned about the potential for infection and encouraged to return to the Emergency Department if any signs of infection are noted.