Office management of minor wounds.
OBJECTIVE
To review office interventions for minor wounds not requiring sutures, such as abrasions, bites, and lacerations.


METHODS
Most information on minor wound management comes from descriptive studies. Few comparative studies examine the effectiveness of topical antisepsis for minor wounds. Several clinical trials have demonstrated that tissue adhesives produce short- and long-term cosmetic results equivalent to those achieved with suture materials.


RESULTS
Sterile saline is the least toxic solution for wound irrigation. Chlorhexidine (2%) and povidone iodine (10%) have been the most investigated antiseptic solutions. Systemic antibiotics are unnecessary for wounds unlikely to be infected. All bite wounds require special attention. Primary closure of bite wounds is indicated in certain circumstances: less than 12-hour-old nonpuncture wounds, uninfected wounds, and low-risk lesions (such as on the face). In spite of their many advantages, skin tapes should be used for low-tension wounds only. The popularity of tissue adhesives has greatly increased. Since the advent of newer products (with increased bonding strength and flexibility), adhesives are used to manage most lacerations except those in areas of high tension (e.g., joints) and on mucosal surfaces.


CONCLUSIONS
Minor wounds not requiring sutures can be managed easily in the office.
Gouin
S
S
Department of Pediatrics and Division of Emergency Medicine, University of Montreal, Quebec. sergegouin@aol.com
Patel
H
H
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001458:Bandages; D005194:Family Practice; D006801:Humans; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use; D014014:Tissue Adhesives / Q000627:therapeutic use; D014947:Wounds and Injuries / Q000628:therapy*
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D012462:Saline Solution, Hypertonic; D014014:Tissue Adhesives