Wounds Diag.

Question 1

-Mechanism of injury
-Dirty or clean wound?
Helps determine infection and scarring risk as well as likelihood of damage to underlying structures
-Presence of foreign body
-Consider an xray if you aren’t sure
-Don’t put your finger in an open wound to explore
-Retained foreign bodies increase risk of delayed wound healing and infection
-Wound extent
-Base of the wound should be identified
-Neurovascular or tendon injury
-Assess circulation and sensation
-If overlying a tendon must assess tendon function – typically requires further wound exploration by a specialist
-Cosmetic significance
-Where is the wound? How large is it? How old is the patient?
-Age of injury

Answer 1

General Principles of Wound Assessment

Question 2

Benefits:
Max bonding strength at 2 minutes
As strong as healed tissues at 7 days post repair
No need for local anesthetic
Faster repair time
Patient preference
Water-resistant
No removal required
No difference in infection rates
Great in pediatric patients – no needles!
Good cosmetic result

Answer 2

Dermabond Benefits

Question 3

Jagged or stellate (irregular) lacerations
Hard to approximate wound edges
Bites, puncture wounds, crush wounds
Contaminated wounds
Mucosal surfaces
High-moisture areas
Axillae, perineum
Hands, feet, joints
Unless immobilized
Very close to the eyelids

Answer 3

Dermabond Contraindications

Question 4

time to primary closure

Answer 4

in a clean, non contaminated wound is 12-18 hours

Question 5

head and neck wounds

Answer 5

consider closure for up to 24 hours