Nice non-inferiority study out of Australia looking at incidence of surgical infections in groups randimized to usual 48 hrs of dry dressings and group allowed to get sutures wet with bathing.
48 patients with subungual hematoma. Randomized to standard nail removal and laceration repair versus trephination. Long term cosmetic result was the same, regardless of hematoma size or presence of tuft fracture. Trephination relieved pain. Average of 4 months for new nail to grow. No incidence of infection.
52 children with nail bed laceration. Randomized to nail removal and laceration repair vs trephination for pain relief, or no intervention at all. No long term cosmetic difference regardless of even the presence of an underlying tuft fracture if overlying nail is intact. Significant cost savings in conservative management.
A summary of common things we seen in the ER along with an evidence based approach to its management. Covers wound care, antibiotics after bites, bronchitis, strep throat and plain films.
