[General principles of wound management in emergency departments].

[General principles of wound management in emergency departments].
Anaesthesist. 2016 Apr 8;
Authors: Zacher MT, Högele AM, Hanschen M, von Matthey F, Beer AK, Gebhardt F, Biberthaler P, Kanz KG
Abstract
Wound management is one of the major tasks in emergency departments. The surrounding intact skin but not the wound itself should be disinfected before starting definitive wound treatment. Hair should first be removed by clipping to 1-2 mm above the skin with scissors or clippers as shaving the area with a razor damages the hair follicles and increases the risk of wound infections. Administration of local anesthetics should be performed directly through the exposed edges of the wound. After wound examination, irrigation is performed with Ringer's solution, normal saline or distilled water. The next step is débridement of contaminated and devitalized tissue. There are several wound closure techniques available, including adhesive tapes, staples, tissue adhesives and numerous forms of sutures. Management of specific wounds requires particular strategies. A bleeding control problem frequently occurs with scalp lacerations. Superficial scalp lacerations can be closed by alternative wound closure methods, for example by twisting and fixing hair and the use of tissue adhesives, i.e. hair apposition technique (HAT). For strongly bleeding lacerations of the scalp, the epicranial aponeurosis should be incorporated into the hemostasis. After...

Source: Der Anaesthesist - April 7, 2016 Category: Anesthesiology Authors: Zacher MT, Högele AM, Hanschen M, von Matthey F, Beer AK, Gebhardt F, Biberthaler P, Kanz KG Tags: Anaesthesist Source Type: research