Principle of wound management
Principal steps in the management of an acute wound
| Steps | Core issues and activities |
| Assessment |
Accurate history: the magnitude of trauma, contamination. Diagnosis and stratification Associated injuries: neurovascular, musculoskeletal, visceral Need for referral/multidisciplinary approach/triage |
| Preparation |
Patient Consent Prophylaxis antibiotic tetanus(if required) Analgesia/anaesthesia/sedation and associated monitoring if required |
| Patient | Cooperative patient |
| Kit |
Suture pack Needle holder Tissue forceps tooth and non-tooth Scissors Swabs Saline Antiseptic solution Sutures appropriate GlovesGood lighting Good magnification PPE as required Appropriate height of the bed |
| Staff |
Let nurses know about management plans. Let the ED physician in charge (EPIC) know about the management plans |
| Definitive treatment |
Exploration Irrigation Debridement Haemostasis Closure: when, how, where, which first? Drainage Referral/multidisciplinary approach |
| After-care |
Dressings Removal of sutures/splints Wound care advice Surveillance for complications Physiotherapy and rehabilitation |