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Management of incisional self-harm of the upper limb : a systematic review
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Somanathan, Arun, Lee, Alice, Harrison, Conrad J. and Rodrigues, Jeremy N. (2023) Management of incisional self-harm of the upper limb : a systematic review. JPRAS Open, 36 . pp. 76-84. doi:10.1016/j.jpra.2023.01.003 ISSN 2352-5878.
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Official URL: http://dx.doi.org/10.1016/j.jpra.2023.01.003
Abstract
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.
Item Type: | Journal Article | ||||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||||
Journal or Publication Title: | JPRAS Open | ||||||||
Publisher: | Elsevier | ||||||||
ISSN: | 2352-5878 | ||||||||
Official Date: | June 2023 | ||||||||
Dates: |
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Volume: | 36 | ||||||||
Page Range: | pp. 76-84 | ||||||||
DOI: | 10.1016/j.jpra.2023.01.003 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Open Access (Creative Commons) |
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