Nailbed repair and patient satisfaction in children

Abstract

Introduction: We performed an audit to assess frequency of injury to the nail bed and outcomes after repair in a busy paediatric hand trauma clinic.

Subjects and methods: This retrospective study examines 46 consecutive nail bed repairs over a 6-month period. All notes were reviewed for patient demographics, details of the injury including the operation and aftercare. Telephone interviews were used to assess patient/parent satisfaction and complications.

Results: The commonest mechanism of injury was trapping a finger in a door. The accident usually occurred indoors and most frequently affected the middle finger. The majority of repairs were carried out under general anaesthetic, by registrars, using absorbable synthetic sutures, within 24 h of the injury as a day-case. Outcome data with a minimum of 15 months follow-up, showed a high satisfaction rate (8.9/10) and low complication rate (7%), none of which required further surgery. There was a high failure rate of attendance in the follow-up clinic whilst the outcomes of those attending were good.

Conclusions: Outcomes and patient satisfaction were good with a low complication rate resulting in a change of practice in our unit to an 'opt-in' system for follow-up.

Figure 1

Age distribution.

Figure 2

Frequency of finger affected.