Koutsomanis A, Hidalgo Diaz JJ, Vernet P, Séverac F, Liverneaux P, Facca S. Development of a clinical path for the emergency care of hand bite injuries without signs of infection.
Orthop Traumatol Surg Res 2017;
103:203-207. [PMID:
28027982 DOI:
10.1016/j.otsr.2016.12.003]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 11/13/2016] [Accepted: 12/06/2016] [Indexed: 02/02/2023]
Abstract
HYPOTHESIS
The care of bite injuries has not currently reached a consensus, including in our department. The goal of this study was to evaluate our current care of bite injuries by an assessment of professional practices (APP), then formulate and validate a flowchart to standardize our practices.
MATERIAL AND METHODS
During a first round of file reviewing, 30 files were randomly selected and then evaluated using a 15 item auditing form (group 1). A flowchart was then designed to standardize the care of hand bite injuries and released in our department. Six months later, 30 new files were randomly selected and evaluated using the same auditing form (group 2).
RESULTS
When comparing the results of the 15 items before and after the release of the flowchart, 7 items reached 100% in group 2. The wounds were described more precisely, signs of severity were systematically researched and the antibiotic treatment was standardized. Two items decreased but did not reach 0%: systematic prescription of bacteriologic swabs and X-rays. Using these results the flowchart was improved.
DISCUSSION AND CONCLUSION
Our results showed an improvement of the care of hand bites for 11 items, including 5 that were statistically significant. This flowchart enabled to standardize our practices and could be used in other emergency departments.
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