Surgical Management of Acute Wounds in the ED

Author: Olajide Kamal Badmus, Riad Hosein / Editor: Lauren Fraser / Reviewer: Olajide Kamal Badmus / Codes: / Published: 02/09/2021 / Reviewed: 21/11/2024

*This work is dedicated to Riad Hoseins wife, Najma Mirza, who sadly passed away after a short illness. She gave him the idea of the module over dinner.

This learning session focuses on improving the practitioners’ skills and knowledge of wound management in an emergency department (ED) setting. We start with an emphasis on wound definition, classification, and a brief description of wound healing, including relevant anatomy and physiology.

The wound management principally covers appropriate steps, such as assessment, preparation and definitive treatment, including surgical skill set needed in the emergency management of wounds. It describes the main steps required in achieving proper wound closure to attain the optimal cosmetic outcome.

The surgical skills section shows video clips intended to expand our understanding of various types and qualities of equipment used in wound suturing, skills in instrument handling, various types of wound closures as well as instrument and hand tying techniques.

We also highlight post wound care management and guidance towards appropriate speciality and follow-up care.

Learning objectives:

To understands the basis of wound healing
To identify the types of suturing material and instruments their relevant use in different scenarios
To be able to achieve the necessary suturing skills needed for wound closure

START MODULE

References

Badawy A. Basic surgical skills final. Slideshare, 2016.
Enoch S, Leaper DJ. Basic science of wound healing. Surgery – Oxford International Edition, Volume 26, Issue 2, 31 – 37, 2008.
Cave G, Harrop-Griffiths W, Harvey M, et al. (n.d.). Management of severe local anaesthetic toxicity. Association of Anaesthetists, 2010.
Health England, P. (2019a). Post exposure management for Tetanus Prone Wounds.
Health England, P. (2019b). Tetanus-prone wounds* Puncture-type injuries acquired in a contaminated environment and likely therefore to contain tetanus spores* e.g. gardening injuries Wounds containing foreign bodies* Compound fractures Wounds or burns with systemic sepsis Certain animal bites and scratches**.
Kumar S, Leaper DJ. Classification and management of acute wounds. Surgery (Oxford), 23(2), 4751, 2005.
Mankowitz SL. Laceration Management. Journal of Emergency Medicine, 53(3), 369382, 2017.
Parrish WR, Roides B. Physiology of Blood Components in Wound Healing: an Appreciation of Cellular Co-Operativity in Platelet Rich Plasma Action. J Exerc Sports Orthop 4(2):1-14, 2017.
Simon BC, Hern HG. Wound Management Principles. ClinicalKey. Rosens Emergency Medicine: Concepts and Clinical Practice. 2018; Chapter 52.
Usatine RP, Coates WC. Laceration and Incision Repair. ClinicalKey. Pfenninger and Fowlers Procedures for Primary Care, 2020; Chapter 19.