@article{ref1,
title="The surgical management of patients who deliberately self-harm",
journal="Annals of the Royal College of Surgeons of England",
year="2009",
author="Rogers, B. A. and Pease, F. and Ricketts, D. M.",
volume="91",
number="1",
pages="59-62",
abstract="INTRODUCTION: Deliberate self-harm is a common problem that often requires orthopaedic treatment. Patients with injuries due to deliberate self-harm are often referred to our unit. This study assessed the type of treatment required and the cost of treatment. PATIENTS AND METHODS: We undertook a retrospective survey of deliberate self-harm patients with known ICD-10 psychiatric disorders admitted for orthopaedic care from a medium-secure, female-only, psychiatric unit. Data were collected on admission rate, duration of stay, surgical interventions and complications. RESULTS: Over a 36-month period there were 73 admissions for 15 patients (mean age, 25.1 years) requiring 65 operative interventions, a mean of 4.3 (range, 0-9) per patient. Over 50% of patients were admitted more than 3 times, totalling 416 hospital bed-days and 80% had methicillin-resistant Staphylococcus aureus (MRSA) isolated. The orthopaedic treatment costs for these patients was 453,000 pounds during the period studied. DISCUSSION: The significant resources required to manage this patient cohort demonstrates the need for a co-ordinated management policy. We recommend day-case surgery for infected wounds only. Postoperatively, wounds should be protected with plaster of Paris. All patients with deliberate self-harm should be regarded as being infected with MRSA.<p /><p>Language: en</p>",
language="en",
issn="0035-8843",
doi="10.1308/003588409X359204",
url="http://dx.doi.org/10.1308/003588409X359204"
}