J E Hollander1, A J Singer, S Valentine, M C Henry. 1. Department of Emergency Medicine, University Medical Center, State University of New York Health Sciences Center, Stony Brook, USA.
Abstract
STUDY OBJECTIVE: More than 11 million patients with traumatic wounds are seen annually in emergency departments. We developed and validated a data registry for traumatic wounds treated in the ED. DESIGN: Prospective, consecutive patient enrollment with a validation cohort of a convenience sample of 100 patients. SETTING: University-affiliated hospital ED. PARTICIPANTS: For all patients with traumatic wounds requiring sutures, wound registry data sheets were completed at the time of initial visit using a closed-question format. Data recorded included demographic characteristics, time from injury to evaluation, pertinent medical history, wound characteristics, type of anesthesia, details of wound-cleansing methods, details of wound closure, and postoperative care. We devised a follow-up tool to evaluate for the presence of infection and short-term cosmetic appearance. Interphysician reliability was assessed for wound description, presence of infection, and cosmetic appearance by use of the kappa statistic. RESULTS: A wound registry data collection instrument that takes less than 1 minute to complete and enables the collection of most wound management techniques used by emergency physicians was found to have substantial interobserver concordance for wound description (kappa range, .55 to .97), wound infection (kappa = 1.0) and overall cosmetic appearance (kappa = .61). CONCLUSION: The wound registry is a reliable data collection instrument that is easy to use. It may be useful as a continuous quality-improvement tool or for standardization of wound surveillance and treatment data to facilitate future prospective studies in wound management.
STUDY OBJECTIVE: More than 11 million patients with traumatic wounds are seen annually in emergency departments. We developed and validated a data registry for traumatic wounds treated in the ED. DESIGN: Prospective, consecutive patient enrollment with a validation cohort of a convenience sample of 100 patients. SETTING: University-affiliated hospital ED. PARTICIPANTS: For all patients with traumatic wounds requiring sutures, wound registry data sheets were completed at the time of initial visit using a closed-question format. Data recorded included demographic characteristics, time from injury to evaluation, pertinent medical history, wound characteristics, type of anesthesia, details of wound-cleansing methods, details of wound closure, and postoperative care. We devised a follow-up tool to evaluate for the presence of infection and short-term cosmetic appearance. Interphysician reliability was assessed for wound description, presence of infection, and cosmetic appearance by use of the kappa statistic. RESULTS: A wound registry data collection instrument that takes less than 1 minute to complete and enables the collection of most wound management techniques used by emergency physicians was found to have substantial interobserver concordance for wound description (kappa range, .55 to .97), wound infection (kappa = 1.0) and overall cosmetic appearance (kappa = .61). CONCLUSION: The wound registry is a reliable data collection instrument that is easy to use. It may be useful as a continuous quality-improvement tool or for standardization of wound surveillance and treatment data to facilitate future prospective studies in wound management.
Authors: Sebastian Freudenberg; Martin Nyonde; Charles Mkony; Fatma Bay; Torsten Wilhelm; Stefan Post Journal: World J Surg Date: 2004-03-17 Impact factor: 3.352