Citation

Jeong SH, Gu JH, Kim WK. J. Hand Surg. Asian Pac. Vol. 2020; 25(1): 47-53.

Affiliation

Department of Plastic Surgery, Korea University Guro Hospital, Seoul, Korea.

Copyright

(Copyright © 2020, World Scientific Publishing)

DOI

10.1142/S242483552050006X

PMID

32000597

Abstract

Background: Self-inflicted wrist lacerations have the potential to lead to crippling sequelae and repeated suicidal attempt. To obtain good results, we have treated self-inflicted wrist lacerations using a multidisciplinary team - emergency, hand surgery, psychiatry, and rehabilitation. This study aims to review features of this type of injuries and suggest multidisciplinary team approach as an optimal treatment. Methods: Our multidisciplinary approach can be summarized as follows: initial evaluation, psychological interview, surgery, and rehabilitation. The medical records including wound features, injured structures and psychological data were reviewed retrospectively. Assessment of functional outcomes, and comparative analysis of various psychological parameters were conducted. Results: Most patients resulted in excellent or good functional outcomes. Five patients reattempted wrist cutting with suicidal intent during follow-up. Only 21.3% patients had a suicidal intent and it was not associated with injury severity and functional recovery. Alcohol ingestion and presence of associated injuries was significant different between severity groups. Presence of suicidal intent was irrelevant to injury severity and functional recovery, but relevant to alcohol ingestion, presence of associated injuries and presence of psychiatric diagnosis. Conclusions: In order to minimize catastrophic disability and repeated suicide attempts, a balanced multidisciplinary approach is one of the best methods to obtain excellent functional outcomes and prevent repeated injuries in patients with self-inflicted wrist lacerations.

Language: en

Keywords

Attempted; Lacerations; Suicidal ideation; Suicide; Wrist