Wound Care

Lacerations, contusions, abrasions and other soft-tissue injuries are known as wounds and special care is needed for them. Wound such as these cause an increase in the amount of bacteria and care for them needs to be done in a chronological order: inspection; reassurance, sedation and analgesia; anesthesia; preparation, irrigation and debridement; wound closure determination; suture closure; dressings; tetanus prophylaxis evaluation; antibiotics; instructions to patients and lastly follow-up.

The Procedure
Inspection is used to determine the magnitude of the injury and whether bleeding is controlled. Reassurance, sedation, analgesia is done to calm and reassure patient and family and increase patient comfort. Anesthesia is used preceding manipulation of the wound. Preparation, irrigation and debridement use a balanced salt solution to dislodge dirt and facilitate identification of devitalized tissue for debridement. Wound closure determination occurs when significant time (more than 24 hours) has passed since the injury is heavily contaminated, closure may be delayed three to five days (except for facial wounds). Suture closure is the process using appropriate suture and needle type, and stitch type. Dressings are used to enhance wound-healing environment. Tetanus prophylaxis evaluation differentiates between tetanus booster and full three-injection prophylaxis. Antibiotics are used for seriously contaminated wounds, all animal and human bites, and delayed treatment.

Before and After
Follow-ups are needed to re-evaluate the injury after 24-48 hours with repeat visits according to type of wound and patient compliance.