title: Review of emergency department wound management in soft tissue trauma - is there a plan?
abstract: OBJECTIVE
  To assess current acute wound management in English emergency departments.
  
  
  METHODS
  All English emergency departments including minor injury units (n=207) were successfully contacted and a telephone questionnaire was completed. This considered wound treatment policy; management including cleansing, analgesia, dressing selection, suturing, referral patterns, medical photography and antibiotic use.
  
  
  RESULTS
  There was a 100% response. Only 40% of departments had a wound treatment policy. Most had implemented staff training, however the nature and timing of this was variable. Wound cleansing was performed by all departments. Most administered analgesia. Suturing was selectively performed by all departments. There was great diversity regarding dressing selection. The most common reasons for referral to specialist units were the complexity of injury and cosmetically sensitive areas. Photographs were regularly taken in one third of units questioned.
  
  
  CONCLUSIONS
  This study confirmed an absence of a standard protocol for early soft tissue wound management in the emergency department setting. Key areas that could be improved are dressing simplification, more defined referral criteria and introduction of standardised protocols with structured teaching programmes. We propose a simple approach to management of acute soft tissue wounds that can be applied to most situations.
  
  
  BACKGROUND
  There were no external sources of funding for this study. The authors have no conflicts of interest to declare.
authors.forename: A P
authors.initials: AP
authors.lastname: Jones
authors.forename: A R
authors.initials: AR
authors.lastname: Barnard
authors.forename: K
authors.initials: K
authors.lastname: Allison
authors.forename: H
authors.initials: H
authors.lastname: Wright
mesh_terms: D000698:Analgesia / Q000379:methods; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001458:Bandages; D002985:Clinical Protocols / Q000592:standards*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D004739:England; D006801:Humans; D007318:Inservice Training; D016134:Organizational Policy; D010781:Photography; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D014947:Wounds and Injuries / Q000628:therapy*
chemical_list: D000900:Anti-Bacterial Agents