Chapter References

1. Stussman BJ: National Hospital Ambulatory Medical Care Survey: 1994 Emergency Department Summary. Hyattsville, MD: National Center for Health Statistics, 1996; DHHS publication (PHS) 96-1250. (Advance Data from Vital and Health Statistics, no. 275.)

2. Hollander JE, Singer AJ, Valentine S, Henry MC: Wound registry: Development and validation. Ann Emerg Med 25:675, 1995.

3. Harker C, Matheson AB, Ross JA, Seaton A: Occupational accidents presenting to the accident and emergency department. Arch Emerg Med 9:185, 1992.

4. Layne LA, Castillo DN, Stout N, Cutlip P: Adolescent occupational injuries requiring hospital emergency department treatment: A nationally representative sample. Am J Public Health 84:657, 1994.

5. Lillis KA, Jaffe DM: Playground injuries in children. Pediatr Emerg Care 13:149, 1997.

6. Hollander JE, Singer AJ, Valentine S: Comparison of wound care practices in pediatric and adult lacerations repaired in the emergency department. Pediatr Emerg Care 14:15, 1998.

7. Edlich RF, Rodeheaver GT, Morgan RF, et al: Principles of emergency wound management. Ann Emerg Med 17:1284, 1988.

8. Hollander JE, Blasko B, Singer AJ, et al: Poor correlation of short- and long-term cosmetic appearance of repaired lacerations. Acad Emerg Med 2:983, 1995.

9. American College of Emergency Physicians: Clinical policy for the initial approach to patients presenting with penetrating extremity trauma. Ann Emerg Med 23:1147, 1994.

10. Warshaw EM: Latex allergy. J Am Acad Dermatol 39:1, 1998.

11. Howell JM, Chisholm CD: Wound care. Emerg Med Clin North Am 15:417, 1997.

36 WOUND PREPARATION

Susan Stone Wallace A. Carter

Anesthesia Hemostasis Foreign-Bpdy..Remova| Hair Removal

Irrigation Debridement Antibiotics Tetanus Prophylaxis Wound Coverage Chapter. References

Wound preparation is a vital step in emergency department wound care for restoring the integrity and function of the injured tissue while minimizing the risk of infection and maximizing the cosmetic result. While the vast majority of wounds treated in emergency departments heal with a good outcome, careful preparation is particularly important when underlying medical conditions or wound factors may alter wound healing and increase the chance of infection ( Iable 36:l). Many traditional methods of wound preparation have surprisingly little scientific validation. 12 Ihis chapter reviews the basic principles of wound preparation, using available experimental models and prospective clinical studies, where available, to justify these techniques.

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