Elsevier

Annals of Emergency Medicine

Volume 17, Issue 12, December 1988, Pages 1284-1302
Annals of Emergency Medicine

Special contribution
Principles of emergency wound management

https://doi.org/10.1016/S0196-0644(88)80354-8Get rights and content

Every traumatic wound treated in the emergency department is a result of a finite energy source that caused tissue disruption. The dynamics of this exchange of energy will determine the magnitude of injury. Disruption of the body covering leaves the once-sterile underlying integument exposed to contamination. The contaminants are derived from either the victim (endogenous) or the exogenous energy source. The presence of a contaminant such as bacteria makes the care of the wound an exercise in microbiology. Other contaminants, such as dirt, also may reside in the recesses of the wound. Emergency physicians must understand the consequences of tissue trauma. A study of the mechanism of injury will provide a reliable indication of damages. Whether the tissue injury will be limited to the initial wounding depends on the outcome of the interaction between the contaminants and the wound. In the event that the contaminants are very reactive, a relatively insignificant wound may become a catastrophe. This circumstance can be averted by the implementation of a well-devised plan based on the biology of wound healing and infection.

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    Presented at the ACEP Winter Symposium Clinical Advances Track in San Diego, California, March 1988.

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    Copyright © 1988 Published by Mosby, Inc.