391 Management of Patients Presenting to the Emergency Department with Hand Lacerations

Aim The audit aimed to assess the adherence to The British Society of Surgery of the Hand (BSSH) guidelines for triaging patients with hand lacerations in the Emergency Department (ED) and to evaluate the impact of adherence on patient outcomes. Method A retrospective audit was conducted on 120 consecutive patients who presented to the ED with hand lacerations during the last year. Data was collected from Clinical Patient Administration System (CPAS) and iSoft Clinical Manager (iCM). The BSSH guidelines were used as reference. Results The audit included data from 120 consecutive patients who presented with hand lacerations over the past year. With 23 patients being female and 97 being male, various mechanisms of injury, including sharp objects, machinery, animal bites, and others were documented. The triage assessments according to BSSH guidelines were conducted, and adherence to the guidelines was noted in 79%, while in 21% it was not. The average time to assessment was 208 minutes98.3% of patients received adequate wound cleaning. 56.6% received tetanus administration whilst 68.3% received appropriate antibiotic prescription. 30.8% were referred to hand surgery.25.8% experienced complications, with tendon injury being the most common. 97.5% received appropriate wound closure whilst 99.1% received appropriate dressing. 75.8% received appropriate pain management. 92.5% had a follow up scheduled at an appropriate clinic. Conclusions The audit highlights both successes and areas for improvement in adherence to BSSH guidelines for hand lacerations in the Emergency Department. While there is commendable adherence, efforts will focus on implementing and refining guidelines to ensure consistent and optimal patient care.