Wound Management of Accidental Wounds Flashcards
What is the objective in the care of accidental wounds?
To convert the “open wound” into a surgically clean wound that can be closed (ideally within 6-12 hours)
What are the five steps in care of accidental wounds?
Initial management, assess patient, assess wound, manage open wound, close open wound.
If classifying a wound by duration, what is a Class I wound?
Clean laceration, 0-6 hours duration, with minimal contamination.
If classifying a wound by duration, what is a Class II wound?
Wound 6-12 hours duration, with significant contamination.
If classifying a wound by duration, what is a Class III wound?
Wound of >12 hour duration with gross contamination.
What number of bacteria per gram of tissue wound indicate gross contamination?
> 10^6 bacteria per gram of tissue
What is important in the initial management of a wound?
Cover with a sterile dressing to prevent further contamination, achieve haemostasis (pressure), stabilise fractures.
When assessing the patient in wound management, what is important to check/consider?
ABC’s, triage, physical exam, body conidition score, medication, general health. Give appropriate analgesia at earliest time.
When assessing a wound, what is it important to remember about traumatic open wounds?
They are always contaminated or dirty.
What steps are important in the management of an open wound, once assessment of the patient and wound are already done?
Protect using sterile dressing, Prepare and clip the area (protect with KY gel), debridement, may use lavage, and establish drainage.
What is debridement? What types of debridement are there?
The remove of necrotic tissue. Types: Sharp/surgical (using scalpel), Adherent dressings (wet to dry, dry to dry), hydrogel dressings.
What does lavage do to a wound? What type of solution would you use?
Removes foreign material and contaminants, keeps wound hydrated. Use balanced electrolyte solution.
In which 4 circumstances should you not close a wound?
Puncture wound, when you can’t debride or lavage, infection, tension on closure.
Give some circumstances in which closure of an open wound may be indicated
Clean wound, no skin tension, not a crush wound, not infected, granulating wound, won’t heal by second intention.
