Management of Incisional Self-Harm of the Upper Limb: A Systematic Review
Summary: Background: The incidence of incisional self-harm of the upper limbs is increasing, and recurrence rates are high. It is not known whether different wound treatment strategies (dressings only vs. surgery) or the operative setting (main theatre vs. non-main theatre) affect wound or mental h...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | JPRAS Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352587823000049 |
| _version_ | 1797823258471432192 |
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| author | Arun Somanathan Alice Lee Conrad J. Harrison Jeremy N. Rodrigues |
| author_facet | Arun Somanathan Alice Lee Conrad J. Harrison Jeremy N. Rodrigues |
| author_sort | Arun Somanathan |
| collection | DOAJ |
| description | Summary: Background: The incidence of incisional self-harm of the upper limbs is increasing, and recurrence rates are high. It is not known whether different wound treatment strategies (dressings only vs. surgery) or the operative setting (main theatre vs. non-main theatre) affect wound or mental health-related outcomes. Methods: Four electronic databases (Ovid MEDLINE, OVID EMBASE, PsycINFO and CENTRAL) were searched from inception to 14/09/2021 for studies which describe the management of incisional self-harm wounds of the upper limb(s) in adults and children. Dual-author screening and data extraction were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: In total, 19 studies (1477 patients) were included. Overall, the evidence was limited by a paucity of comparative data on wound management strategy and setting, and poor-quality outcome reporting. Only four studies clearly identified the operative setting for definitive wound management (two in main operating theatres, one in the emergency department and one using both settings, depending on injury severity). Few studies inconsistently reported surgical outcomes (n=9) or mental health outcomes (n=4), hindering evidence synthesis. Conclusion: Further investigation is needed to determine the most cost-effective management strategies and settings for these injuries. |
| first_indexed | 2024-03-13T10:21:26Z |
| format | Article |
| id | doaj.art-043bb188c1194c92ad65b46e2f5dd089 |
| institution | Directory Open Access Journal |
| issn | 2352-5878 |
| language | English |
| last_indexed | 2024-03-13T10:21:26Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JPRAS Open |
| spelling | doaj.art-043bb188c1194c92ad65b46e2f5dd0892023-05-20T04:30:19ZengElsevierJPRAS Open2352-58782023-06-01367684Management of Incisional Self-Harm of the Upper Limb: A Systematic ReviewArun Somanathan0Alice Lee1Conrad J. Harrison2Jeremy N. Rodrigues3Oxford University Medical School, University of Oxford, Oxford, UKDepartment of Surgery and Cancer, Imperial College London, London, UK; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford, UKNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford, UKClinical Trials Unit, University of Warwick, Coventry, UK; Department of Plastic Surgery, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust; Corresponding author: Professor Jeremy Rodrigues, Department of Plastic Surgery, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Telephone: 01296 315000.Summary: Background: The incidence of incisional self-harm of the upper limbs is increasing, and recurrence rates are high. It is not known whether different wound treatment strategies (dressings only vs. surgery) or the operative setting (main theatre vs. non-main theatre) affect wound or mental health-related outcomes. Methods: Four electronic databases (Ovid MEDLINE, OVID EMBASE, PsycINFO and CENTRAL) were searched from inception to 14/09/2021 for studies which describe the management of incisional self-harm wounds of the upper limb(s) in adults and children. Dual-author screening and data extraction were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: In total, 19 studies (1477 patients) were included. Overall, the evidence was limited by a paucity of comparative data on wound management strategy and setting, and poor-quality outcome reporting. Only four studies clearly identified the operative setting for definitive wound management (two in main operating theatres, one in the emergency department and one using both settings, depending on injury severity). Few studies inconsistently reported surgical outcomes (n=9) or mental health outcomes (n=4), hindering evidence synthesis. Conclusion: Further investigation is needed to determine the most cost-effective management strategies and settings for these injuries.http://www.sciencedirect.com/science/article/pii/S2352587823000049self-harmhand surgeryoutcomestendon repairnerve repair |
| spellingShingle | Arun Somanathan Alice Lee Conrad J. Harrison Jeremy N. Rodrigues Management of Incisional Self-Harm of the Upper Limb: A Systematic Review JPRAS Open self-harm hand surgery outcomes tendon repair nerve repair |
| title | Management of Incisional Self-Harm of the Upper Limb: A Systematic Review |
| title_full | Management of Incisional Self-Harm of the Upper Limb: A Systematic Review |
| title_fullStr | Management of Incisional Self-Harm of the Upper Limb: A Systematic Review |
| title_full_unstemmed | Management of Incisional Self-Harm of the Upper Limb: A Systematic Review |
| title_short | Management of Incisional Self-Harm of the Upper Limb: A Systematic Review |
| title_sort | management of incisional self harm of the upper limb a systematic review |
| topic | self-harm hand surgery outcomes tendon repair nerve repair |
| url | http://www.sciencedirect.com/science/article/pii/S2352587823000049 |
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