Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · Feb 2007
ReviewPrinciples of basic wound evaluation and management in the emergency department.
The primary objectives of basic wound management center around promoting optimal wound healing and cosmesis. These objectives may be achieved through the systematic assessment, preparation, and repair of the laceration supplemented with appropriate patient care instructions. The meticulous and methodical management of traumatic wounds described in this article will assist the emergency physician in decreasing overall complication rates and help improve patient satisfaction.
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Many lacerations seen in the emergency department setting require specific management based on anatomic location. Lacerations of the fingertip, ear, nose, lip, tongue, and eyelid can be complex and require advanced management techniques. Many can be primarily treated by emergency clinicians; however, it is important for the clinician to know when consultation is appropriate for treatment by a specialist. Current literature recommendations are presented for initial management, methods of repair, technical tips to facilitate repair, appropriate consultation, and postoperative care for these complex lacerations.
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Emerg. Med. Clin. North Am. · Feb 2007
Review Case ReportsReducing risk in emergency department wound management.
Although substantial dollar amounts are not involved, wound-care litigation constitutes a significant number of lawsuits to emergency medicine physicians, resulting in an increased drain on the physician's time and exposing the physician to all the psychosocial effects involved in the medicolegal process. The procedures outlined in this article-paying attention to wound-care principles, involving patients in the medical decision-making process, and ensuring appropriate medical follow-up-can, it is hoped, reduce the incidence of medical claims.
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As America's emergency departments witness an increase in care provided to an aging population, the emergency physician increasingly evaluates and treats manifestations of chronic disease. Nonhealing wounds are often a presenting manifestation of chronic disease. ⋯ Emergency physicians should possess a fundamental knowledge in the management of chronic wounds. This article familiarizes the emergency physician with the epidemiology of chronic wounds, the physiology of tissue repair, the pathophysiology involved in wound healing failure, the common types of chronic wounds, and specific management strategies.
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Wound healing is a complex interchange, orchestrated between cellular components that play their respective parts signaled by and mediated by different cellular instruments of healing. When healing is performed well, the final product is a thing of beauty. When healing is delayed, interrupted, or excessive, then unsightly scars of chronic painful wounds that are frustrating to the patient and physician occur.