Management of acute and traumatic wounds: main aspects of care in adults and children.
The emergency department physician's goals for wound care are fourfold: to do no further harm, to restore function of injured tissue, and to interfere as little as possible with the patient's quality of life, thus facilitating an expedient return to normal activities. Some years ago, when it was first realized that substandard wound care could have a substantial negative impact on these primary goals, wound assessment and management were included in the total patient care plan and no longer delegated to junior doctors or nurses. After the patient has been stabilized, the wounds can be assessed and cleansed, and decisions about repair and follow-up treatment can be made. Wound care should support the natural healing process; i.e., such care should provide a moist dressing/wound interface, absorb or remove excess exudate, provide thermal insulation, prevent contamination, and provide an environment conducive to the body's natural defense mechanisms. Furthermore, dressings should cause little or no discomfort to the patient and be able to remain in place for a number of days to facilitate the healing process and reduce the cost of care.
Wijetunge
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DB
Department of Emergency Medicine, St. George's Hospital and Medical School, Tooting, London.
D000328:Adult; D001458:Bandages; D002648:Child; D006801:Humans; D014945:Wound Healing; D014946:Wound Infection / Q000517:prevention & control; D014947:Wounds and Injuries / Q000628:therapy*