{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:55:13Z","timestamp":1790934913390,"version":"4.1.0"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T00:00:00Z","timestamp":1617148800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T00:00:00Z","timestamp":1617148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Emerg Med"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Self-cutting is a special type of emergency in hand surgery. Despite its low mortality rate, it is clinically significant because there is a possibility of permanent disability and repeated suicide attempts are likely to occur. Therefore, we aim to understand the characteristics of self-inflicted wrist injuries and share the perspectives from a hand surgeon in order to inform those who face these patients primarily in the emergency room.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We reviewed 17 patients with self-inflicted wrist injuries who were referred to the Department of Hand surgery from the Emergency Medicine Department from 2013 to 2017. We investigated the differences in demographic features (age, gender, psychological diagnosis, alcohol consumption, prior suicide attempts) and clinical features (injury side, injury pattern, anatomical structures, distance from wrist crease).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among the patients, 4 were female and 13 were male. 70.6% of patients (12\/17) had injuries on the left wrist and 94.1% of patients (16\/17) had injuries on the flexor side. The average distance from the wrist crease to the injured site was 3.43\u2009cm and 90.5% (19\/21) of total injuries had an average distance of was less than 5\u2009cm. The most frequently injured structures were palmaris longus tendon (58.5%, 10\/17). 52.9% (9\/17) of patients, among which 6 of the 8 patients with deep injuries and 3 of the 9 patients with superficial injuries, had a history of a psychiatric disorder.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>We conclude that a male with a previously diagnosed psychiatric disorder has a higher chance of inflicting a deeper injury. In addition, self-cutting injuries are highly predictable because most of these injuries occur on the flexor side of the left wrist and are limited to a distance of 5\u2009cm from the wrist crease. In terms of the implements used in self-inflicted injuries, we can predict the type of damage to some degree depending on the type of implement used. In view of these characteristics, more appropriate evaluation can be implemented in the emergency room and those who deal with these patients primarily can cope more effectively for better long-term results.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12873-021-00432-4","type":"journal-article","created":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T09:02:43Z","timestamp":1617181363000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A pilot study of 17 wrist-cutting suicide injuries in single institution: perspectives from a hand surgeon"],"prefix":"10.1186","volume":"21","author":[{"given":"Jong-Ho","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyokyung","family":"Yoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seokchan","family":"Eun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,31]]},"reference":[{"issue":"3","key":"432_CR1","doi-asserted-by":"publisher","first-page":"760","DOI":"10.3390\/ijerph9030760","volume":"9","author":"P Varnik","year":"2012","unstructured":"Varnik P. Suicide in the world. Int J Environ Res Public Health. 2012;9(3):760\u201371. https:\/\/doi.org\/10.3390\/ijerph9030760.","journal-title":"Int J Environ Res Public Health"},{"issue":"3","key":"432_CR2","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1016\/j.apnu.2017.01.001","volume":"31","author":"Y Im","year":"2017","unstructured":"Im Y, Oh WO, Suk M. Risk factors for suicide ideation among adolescents: five-year National Data Analysis. Arch Psychiatr Nurs. 2017;31(3):282\u20136. https:\/\/doi.org\/10.1016\/j.apnu.2017.01.001.","journal-title":"Arch Psychiatr Nurs"},{"issue":"2","key":"432_CR3","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1027\/0227-5910\/a000361","volume":"37","author":"J Kim","year":"2016","unstructured":"Kim J, Kim HJ, Kim SH, Oh SH, Park KN. Analysis of deliberate self-wrist-cutting episodes presenting to the emergency department. Crisis. 2016;37(2):155\u201360. https:\/\/doi.org\/10.1027\/0227-5910\/a000361.","journal-title":"Crisis"},{"issue":"5","key":"432_CR4","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002139","volume":"7","author":"T Kisch","year":"2019","unstructured":"Kisch T, Matzkeit N, Waldmann A, Stang F, Kramer R, Schweiger U, et al. The reason matters: deep wrist injury patterns differ with intentionality (accident versus suicide attempt). Plast Reconstr Surg Glob Open. 2019;7(5):e2139. https:\/\/doi.org\/10.1097\/GOX.0000000000002139.","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"5","key":"432_CR5","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1016\/j.genhosppsych.2012.03.020","volume":"34","author":"SA Ting","year":"2012","unstructured":"Ting SA, Sullivan AF, Boudreaux ED, Miller I, Camargo CA Jr. Trends in US emergency department visits for attempted suicide and self-inflicted injury, 1993-2008. Gen Hosp Psychiatry. 2012;34(5):557\u201365. https:\/\/doi.org\/10.1016\/j.genhosppsych.2012.03.020.","journal-title":"Gen Hosp Psychiatry"},{"issue":"2","key":"432_CR6","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1027\/0227-5910.29.2.73","volume":"29","author":"GL Larkin","year":"2008","unstructured":"Larkin GL, Smith RP, Beautrais AL. Trends in US emergency department visits for suicide attempts, 1992-2001. Crisis. 2008;29(2):73\u201380. https:\/\/doi.org\/10.1027\/0227-5910.29.2.73.","journal-title":"Crisis"},{"issue":"1","key":"432_CR7","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1007\/s00068-015-0599-4","volume":"43","author":"B Ersen","year":"2017","unstructured":"Ersen B, Kahveci R, Saki MC, Tunali O, Aksu I. Analysis of 41 suicide attempts by wrist cutting: a retrospective analysis. Eur J Trauma Emerg Surg. 2017;43(1):129\u201335. https:\/\/doi.org\/10.1007\/s00068-015-0599-4.","journal-title":"Eur J Trauma Emerg Surg"},{"issue":"1","key":"432_CR8","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1142\/S242483552050006X","volume":"25","author":"SH Jeong","year":"2020","unstructured":"Jeong SH, Gu JH, Kim WK. Analysis of self-inflicted lacerations to the wrist: a multi-disciplinary approach to treating. J Hand Surg Asian Pac Vol. 2020;25(1):47\u201353. https:\/\/doi.org\/10.1142\/S242483552050006X.","journal-title":"J Hand Surg Asian Pac Vol"},{"issue":"3","key":"432_CR9","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/j.jflm.2007.08.006","volume":"15","author":"S Fukube","year":"2008","unstructured":"Fukube S, Hayashi T, Ishida Y, Kamon H, Kawaguchi M, Kimura A, et al. Retrospective study on suicidal cases by sharp force injuries. J Forensic Legal Med. 2008;15(3):163\u20137. https:\/\/doi.org\/10.1016\/j.jflm.2007.08.006.","journal-title":"J Forensic Legal Med"},{"key":"432_CR10","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.jad.2015.12.007","volume":"192","author":"R Carroll","year":"2016","unstructured":"Carroll R, Thomas KH, Bramley K, Williams S, Griffin L, Potokar J, et al. Self-cutting and risk of subsequent suicide. J Affect Disord. 2016;192:8\u201310. https:\/\/doi.org\/10.1016\/j.jad.2015.12.007.","journal-title":"J Affect Disord"},{"issue":"2","key":"432_CR11","doi-asserted-by":"publisher","first-page":"35","DOI":"10.3928\/02793695-20120113-02","volume":"50","author":"ML Lilly","year":"2012","unstructured":"Lilly ML, Hermans M, Crawley B. Psychiatric nursing emergency: a simulated experience of a wrist-cutting suicide attempt. J Psychosoc Nurs Ment Health Serv. 2012;50(2):35\u201342. https:\/\/doi.org\/10.3928\/02793695-20120113-02.","journal-title":"J Psychosoc Nurs Ment Health Serv"},{"issue":"3","key":"432_CR12","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1016\/S0165-1781(97)00034-6","volume":"70","author":"I Kemperman","year":"1997","unstructured":"Kemperman I, Russ MJ, Clark WC, Kakuma T, Zanine E, Harrison K. Pain assessment in self-injurious patients with borderline personality disorder using signal detection theory. Psychiatry Res. 1997;70(3):175\u201383. https:\/\/doi.org\/10.1016\/S0165-1781(97)00034-6.","journal-title":"Psychiatry Res"},{"issue":"2","key":"432_CR13","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1016\/j.cpr.2006.08.002","volume":"27","author":"ED Klonsky","year":"2007","unstructured":"Klonsky ED. The functions of deliberate self-injury: a review of the evidence. Clin Psychol Rev. 2007;27(2):226\u201339. https:\/\/doi.org\/10.1016\/j.cpr.2006.08.002.","journal-title":"Clin Psychol Rev"},{"issue":"4","key":"432_CR14","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1111\/j.1440-1819.2004.01271.x","volume":"58","author":"T Matsumoto","year":"2004","unstructured":"Matsumoto T, Yamaguchi A, Chiba Y, Asami T, Iseki E, Hirayasu Y. Patterns of self-cutting: a preliminary study on differences in clinical implications between wrist- and arm-cutting using a Japanese juvenile detention center sample. Psychiatry Clin Neurosci. 2004;58(4):377\u201382. https:\/\/doi.org\/10.1111\/j.1440-1819.2004.01271.x.","journal-title":"Psychiatry Clin Neurosci"},{"issue":"5","key":"432_CR15","doi-asserted-by":"publisher","first-page":"1054","DOI":"10.1016\/j.jhsa.2011.12.040","volume":"37","author":"M Fujioka","year":"2012","unstructured":"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(5):1054\u20138. https:\/\/doi.org\/10.1016\/j.jhsa.2011.12.040.","journal-title":"J Hand Surg Am"}],"container-title":["BMC Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12873-021-00432-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12873-021-00432-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12873-021-00432-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T14:50:14Z","timestamp":1617288614000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcemergmed.biomedcentral.com\/articles\/10.1186\/s12873-021-00432-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,31]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["432"],"URL":"https:\/\/doi.org\/10.1186\/s12873-021-00432-4","relation":{},"ISSN":["1471-227X"],"issn-type":[{"value":"1471-227X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,31]]},"assertion":[{"value":"18 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 March 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 March 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declaration"}},{"value":"The study was approved by Ethics Committee (IRB no. B-2010-642-103) in the Seoul National University Bundang hospital. As this was a retrospective chart review, the requirement to obtain individual consent was waived by the Research Ethics Board.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"40"}}