The Research Critique

This research critique is an article called Comparison of suture types in the closure of scalp wounds written by Joseph Bonham and published in Emergency Nurse. In the emergency room two different types of sutures permanent and non permanent sutures are used as well as glue for lacerations. Scalp wounds are difficult as pressure to wound as well as the hair of the scalp. The research discusses the end result of the research the amount of scaring left after the wound has healed. Protection of Human Participants

The benefits of the participation of this study for participants is to see if there can be a more cost effective way of a emergency room visit for sutures in a laceration. The risk is that the authors only had nine months to complete the study and this did not give ample time to assess the final healed laceration properly. With this quantitative study each of the participants agreed to sign a consent form and then randomly put into two experimental groups. The study was approved by the ethical approval from St James’s Hospital ethics committee, management and senior clinicians before starting. It would have seemed that the participants were asked upon emergency room arrival if they would participate in the study. Upon completion of the health record inclusion and exclusion must be met for participants. Data Collection

The major variable is the participants must have a scalp laceration and gone to the emergency department within a nine month period of time of the study. Two envelopes containing information sheet, two consent forms, a head injury information sheet and tracing sheet and either absorbable sutures and non-absorbable sutures were randomly selected when patients arrived with a scalp laceration. The author did not discuss as to why they chose this method. I would venture to say they did not want the staff in the emergency department to have a influence on the study and it made it more random and less bias. In order for the study to be effective the participants must return to the emergency department for a follow-up visit to assess the healing process of the laceration and possible remove the non-absorbable sutures. Data Management and Analysis

With the beginning of each shift the author would check how many participants were involved in the study. The tracking sheets were double checked against the patient’s records to make sure a follow-up appointment was made. A “C” was labeled for the controlled group or non-absorbable sutures and “E” or experimental group used to identify the absorbable suture participants. When the participant came for a follow-up an assessment sheet was filled out describing the color, surface, contour, distortions, and texture of the scar. Two assessors rated the scar for each participant. It was not stated if each participant was assessed separately for each assessor. The data collected was then entered into a Microsoft excel spreadsheet with all of the paperwork filed in needed later. No statistical software was used for accuracy of the analysis.

Findings/Interpretation of Findings
The author states that one hundred and ten participants presented into the emergency department with scalp lacerations. No data was collected for how many patients did not participate. Most of the participants were men with more men not returning for the follow-up appointment than women. It was found that with both assessors mean scores were seven point nine for the control group and seven point one for the experimental group. This was not a huge difference. I feel that the envelopes should have been more controlled and to make sure that an equal number of participants from each group needed to be assessed. The time factor limited the author’s time for a complete and accurate study. Each participant came in for a follow-up in how many days? It did not state. Most sutures are removed in five to seven days and this is not enough time to properly assess how a scar has healed. The one factor is that all the scars were assessed at approximately the same amount of time. The author does state it could take between six and twelve months for scar maturation.

The benefit to nursing is to be able to address a patient in an emergency setting with absorbable sutures to provide a savings to the patient. The emergency department will also be able to save time to care for other patients as less follow-up care would be needed. The purpose of this study was to address scalp lacerations for an emergency department to make a functional repair. Many other factors are to be considered in scar healing and outcomes and should be addressed in another study for a longer time for follow-up. Further research should continue in regards to the scalp lacerations and sutures to be able to validate the findings. This was a very interesting study.

References

Bonham, J. (2011). Comparison of suture types in the closure of scalp wounds. Emergency Nurse, 19(3), 34-39. Coughlan, M., Cronin, P., & Ryan, F. (2007). Step by step guide to critiquing research. British Journal of Nursing, 16(11), 658-663.