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Nailbed repair and patient satisfaction in children
1Department of Plastic & Reconstructive Surgery, St George's Hospital, London, UK. sipearce707@hotmail.com
Insights
Paediatric nail bed injuries, often from finger trapping, show good outcomes and high patient satisfaction after timely repair. A change to an
Area of Science:
- Paediatric Orthopaedics
- Hand Surgery
- Trauma Surgery
Background:
- Nail bed injuries are common in paediatric hand trauma.
- Assessing injury frequency and repair outcomes is crucial for clinical practice.
Purpose of the Study:
- To audit the frequency and outcomes of nail bed repairs in a busy paediatric hand trauma clinic.
- To evaluate patient/parent satisfaction and complication rates following surgical repair.
Main Methods:
- Retrospective review of 46 consecutive nail bed repairs over six months.
- Analysis of patient demographics, injury details, surgical procedures, and aftercare.
- Telephone interviews for patient/parent satisfaction and complication assessment with a minimum 15-month follow-up.
Main Results:
- Trapping fingers in doors was the most common injury mechanism, typically occurring indoors and affecting the middle finger.
- Repairs were predominantly day-cases performed under general anaesthesia by registrars within 24 hours using synthetic absorbable sutures.
- High patient satisfaction (8.9/10) and a low complication rate (7%) were observed, with no further surgical intervention required. High follow-up clinic default rates were noted.
Conclusions:
- Nail bed repairs in children yield good outcomes and high patient satisfaction with a low complication rate.
- The findings led to a practice change towards an 'opt-in' follow-up system in the unit.
Introduction:
We performed an audit to assess frequency of injury to the nail bed and outcomes after repair in a busy paediatric hand trauma clinic.
Subjects And Methods:
This retrospective study examines 46 consecutive nail bed repairs over a 6-month period. All notes were reviewed for patient demographics, details of the injury including the operation and aftercare. Telephone interviews were used to assess patient/parent satisfaction and complications.
Results:
The commonest mechanism of injury was trapping a finger in a door. The accident usually occurred indoors and most frequently affected the middle finger. The majority of repairs were carried out under general anaesthetic, by registrars, using absorbable synthetic sutures, within 24 h of the injury as a day-case. Outcome data with a minimum of 15 months follow-up, showed a high satisfaction rate (8.9/10) and low complication rate (7%), none of which required further surgery. There was a high failure rate of attendance in the follow-up clinic whilst the outcomes of those attending were good.
Conclusions:
Outcomes and patient satisfaction were good with a low complication rate resulting in a change of practice in our unit to an 'opt-in' system for follow-up.
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