Electronic follow-up of facial lacerations in the emergency department

• Published in: Journal of telemedicine and telecare Vol. 17; no. 3; p. 133
• Main Authors: Walker, Tom W M, O'Connor, Norma, Byrne, Sinead, McCann, Patrick J, Kerin, Michael J
• Format: Journal Article
• Language: English
• Published: England 01.04.2011
• Subjects: Adolescent; Adult; Aged; Cell Phone; Child; Child, Preschool; Cicatrix; Electronic Mail; Emergency Service, Hospital; Facial Injuries - therapy; Feasibility Studies; Female; Humans; Internet; Lacerations - therapy; Male; Middle Aged; Patient Compliance - statistics & numerical data; Patient Satisfaction; Photography; Remote Consultation - utilization; Sutures; Wound Healing; Young Adult
• ISSN: 1758-1109
• DOI: 10.1258/jtt.2010.100307

It is often difficult for emergency department staff to follow up the primary closure of simple facial lacerations. This is important to allow closure of the feedback loop. Consecutive patients who were sutured by a single operator using the same technique were asked to send a photograph of the laceration six months and 12 months afterwards. The patients had Internet access and a digital camera, or a mobile phone with a camera. They were given a leaflet with the details of the email address or mobile number to send the picture to. A reminder telephone call was made to each patient at six months and 12 months, and the email address or mobile number to send the picture to was given again. In each telephone call patients were asked to grade the healing on a 5-point scale from 1 = very happy to 5 = very unhappy. At 13 months all patients were re-contacted and reminded again. Fifty patients were included in the study (33 males). The cause of injury was sport in 17 patients, assault in 18 and accidents in 15. At six months, 23 patients stated that they were happy and 27 were very happy with the scar. The mean score was 1.5. At 12 and 13 months, four patients were happy and 46 very happy. The mean score was 1.1. Twenty-four patients said they would use a computer/camera to send in the follow-up image, and 26 patients had a mobile phone with a camera and said they would use that. Despite the reminders, no patients sent a photograph. The results provide no evidence to support the use of photographs sent by email or text message for the follow-up of facial lacerations sutured in the emergency department.