BEST EVIDENCE TOPIC REPORT

1. BEST EVIDENCE TOPIC REPORT  STAPLES VS SUTURES FOR SCALP LACERATIONS Andy Ratchford SpR A&E October 1999 Topic chosen as staples are not available in SRH as a method for wound closure. In my experience staples are especially useful for the following scalp wounds : children with simple wounds adults intoxicated and unco-operative the elderly (especially long lacerations) Topic chosen as staples are not available in SRH as a method for wound closure. In my experience staples are especially useful for the following scalp wounds : children with simple wounds adults intoxicated and unco-operative the elderly (especially long lacerations)

2. CLINICAL SCENARIOAn 80 year old lady attends A&E with a simple scalp wound. You wonder whether to close the wound with staples or sutures.  THREE PART QUESTION In [simple scalp wounds] are [surgical staples as good as sutures] for [ease, speed and cost of wound closure]? �simple� = linear/ curvilinear, not stellate, not requiring a deep layer of sutures, < 12 hrs old, smooth edged (not needing debridement) scalp = hair bearing regions of head �simple� = linear/ curvilinear, not stellate, not requiring a deep layer of sutures, < 12 hrs old, smooth edged (not needing debridement) scalp = hair bearing regions of head

3. SEARCH STRATEGYMedline 1966 to 10/99 (Healthgate and Pubmed interface), Cochrane Database, Best Evidence database SEARCH OUTCOME 88 papers found, 80 irrelevant, 2 nursing overviews. Other 6 papers are shown in the table. Mesh headings not included as unsure of correct documentation for these. Mesh headings not included as unsure of correct documentation for these.