title: Emergency management of difficult wounds: part I.
abstract: Emergency physicians treat millions of wounds annually in the United States. In 2004 approximately 6.4 million open wounds were seen in United States emergency departments, representing approximately 5.8% of all visits. This article discusses difficult traumatic wounds that emergency physicians encounter on a daily basis, including mammalian bites, puncture and high-pressure wounds, and crush injuries, with special emphasis given to individuals at high risk for infectious complications. Information is provided on epidemiology, pathophysiology, management, and treatment of various complicated wounds. The authors highlight available guidelines, provide the best evidence available, and provide recommendations when data are limited.
authors.affiliation: Department of Emergency Medicine, Madigan Army Medical Center, Building 9040 Fitzsimmons Drive, Tacoma, WA 98431, USA.
authors.forename: Vincent
authors.initials: V
authors.lastname: Ball
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Younggren
mesh_terms: D000818:Animals; D001733:Bites and Stings / Q000145:classification / Q000453:epidemiology / Q000628:therapy*; D001734:Bites, Human / Q000382:microbiology*; D002415:Cats; D004285:Dogs; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D015601:Injury Severity Score; D013742:Tetanus / Q000209:etiology / Q000517:prevention & control*; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000145:classification / Q000382:microbiology / Q000628:therapy*