Citation

Oakley B, Uzoigwe C, Millward T, O'Brien M, Bainbridge C, Johnson N. J. Hand Surg. Eur. Vol. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, SAGE Publishing)

DOI

10.1177/17531934221138433

PMID

36437501

Abstract

Self-harm is a significant and increasing healthcare problem that is often met with prejudice and stigma, even by healthcare staff (Kilroy-Findley, 2015; MIND, 2016; NICE, 2022; Saunders et al., 2012). It is exceedingly common, with approximately one in ten adolescents reported as having self-harmed (NICE, 2022). Those who frequently self-harm require the input of hand surgery services, usually due to lacerations from self-cutting and foreign body soft tissue insertion (FBSTI) (Rogers et al., 2009).

Of those who self-harm, over 50% will repeatedly do so in the future. Self-harm also remains the strongest risk factor for a subsequent suicide attempt (Hawton et al., 2012; Madge et al., 2008) with a 19-fold increased risk of suicide and a 3.6 fold increased risk in all-cause mortality (Kapur et al., 2015). This is a significant burden of disease, estimated to cost health services from £200 up to £10,000 per patient, per year (Hunt, 2017; Rogers et al., 2009).

The management of patients who self-harm requires collaboration between the psychiatric and surgical services. Despite the integral role of the hand surgery team in the management of such patients, self-harm receives very little attention in the surgical literature and there are no clear guidelines nor consensus on the surgical management of these patients. This article aims to better equip hand surgeons when managing patients who have self-harmed by summarizing the available evidence and guidelines on both the nature of self-harm and its management...

Language: en