Assessment of repair of facial lacerations

A survey of senior nurses in 100 randomly selected large (< 30 000 new patients/year) UK Accident & Emergency Departments (AED) was undertaken to investigate which grade of staff/specialty sutured facial lacerations and to obtain an inter-specialty perspective of standards of care. Of the 80 hospitals whose AED senior nurse responded, half had resident oral and maxillofacial surgeons but only 20% had resident plastic surgeons. Lacerations were mainly sutured by AED doctors (55% of hospitals), oral and maxillofacial surgeons (21%), plastic surgeons (12%) and AED nurses (11%). Overall the highest standard of care was considered to be provided by oral and maxillofacial and plastic surgery registrars and the lowest by nurses and consultants. Overall, oral and maxillofacial surgery services were ranked first, plastic surgery second and A&E third. Monofilament polypamide was the most favoured suture material, but polybutester and polypropylene were also widely used.