J Korean Soc Surg Hand.  2015 Mar;20(1):1-7. 10.12790/jkssh.2015.20.1.1.

Clinical Characteristic and Psychiatric Features of Self-Inflicted Wrist Laceration: A Single Institute Retrospective Study

• Cho HE
• Roh SG
• Lee NH
• Yang KM

• KMID: 2194119
• DOI: http://doi.org/10.12790/jkssh.2015.20.1.1

Abstract

PURPOSE
Self-inflicted wrist laceration is a common injury in the department of hand surgery. The aim of this study was to investigate the clinical characteristics and psychiatric features of self-inflicted wrist laceration using categorization according to wound severity.
METHODS
We reviewed 71 patients from 2002 through 2012. All of the patients were grouped into four groups. Data regarding the following characteristics were collected: age, gender, size, structure involved, instruments used, history of previous self-inflicted injury, comorbidities in psychiatric and presentation of follow-up outpatient appointment to the department of plastic surgery and psychiatry.
RESULTS
In these patients, approximately 64% of patients were female. About 80% of patients cut their wrist using a knife. And in grade 3-4 injury, percentage of glass injury was relatively high (22%), compared with other grades (3%). Unlike previous studies, patients in grade 3-4 tended to cut their wrist repeatedly. Focusing on psychiatric problems, approximately one quarter of patients had a previous history of self-infliction. In all patient groups, mood disorder was the most common disorder in patients who had a previous psychiatric disorder. But after operation, more than two thirds of patients had not visited department of psychiatry again.
CONCLUSION
We identified some other differences among their characteristics. All patients in group also should be evaluated and surgically treated properly. A multidisciplinary approach is required for patients with wrist laceration due to self-injury in comparison to those with laceration due to other causes. Because many of them have previous self-injury experiences and psychiatric disease.

Keyword

Self mutilation; Wrist; Laceration; Suicide

MeSH Terms

Comorbidity
Female
Follow-Up Studies
Glass
Hand
Humans
Lacerations*
Mood Disorders
Outpatients
Retrospective Studies*
Self Mutilation
Suicide
Surgery, Plastic
Wounds and Injuries
Wrist*

Figure

• 

  Fig. 1. Previous history of self-inflicted wrist laceration patients (%): approximately one quarter of patients had a previous history of self-infliction.

• 

  Fig. 2. Psychiatric and plastic surgery department follow-up arrangements (%): after operation, more than two thirds of patients had not visited department of psychiatry again. f/u, follow-up.

Reference

References

1. Fujioka M, Murakami C, Masuda K, Doi H. Evaluation of superficial and deep self-inflicted wrist and forearm lacerations. J Hand Surg Am. 2012; 37:1054–8.

2. Maloney C, Shah S, Ferguson DG. Acute management of the self-cutter. Arch Emerg Med. 1987; 4:39–45.

3. Rashid A, Brennen MD. Psychiatric assessment of patients with self-inflicted lacerations to the wrist and forearm admitted to a nonpsychiatric ward: the experience of a regional plastic surgery unit. J Plast Reconstr Aesthet Surg. 2006; 59:266–71.

4. Goldwyn RM, Cahill JL, Grunebaum HU. Self-inflicted injury to the wrist. Plast Reconstr Surg. 1967; 39:583–9.

5. Jaquet JB, van der Jagt I, Kuypers PD, Schreuders TA, Kalmijn AR, Hovius SE. Spaghetti wrist trauma: functional recovery, return to work, and psychological effects. Plast Reconstr Surg. 2005; 115:1609–17.