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Wound Care
This lecture and the post-test is worth 1.5 credit hours. The author discusses how to recognize and treat lacerations caused by sharp objects, blunt lacerations, and puncture wounds, or bites – especially from rabid animals. A proper history of the wound's cause, duration, and the patient's overall health status in the healing process is important, as is avoiding such complications as dehiscence and infection. Timing of treatment and wound location are also significant. A complete assessment requires a proper setting, and includes determining motor, sensory and vascular status as well as the patient's tetanus status. The lecture provides a review of the indications, benefits, methods, complications and limitations of healing by primary versus secondary intention. For example, wounds of more than six hours' duration, or that are contaminated or have lost significant amounts of tissue are usually not amenable to suturing; rather, the wound is left open to heal from the inside. Barriers to effective healing include diabetes, peripheral vascular disease, and alcoholism. A discussion of pain control includes the types of anesthetic agents that are most appropriate for various types of wounds. The lecture also compares the effectiveness of sutures, staples, tissue adhesives, and tape skin closures. The lecture concludes with detailed explicit discharge care instructions, especially about the importance of keeping the wound clean, and the time for a return visit. The lecture offers more than 40 excellent illustrations of the various types of wounds and their treatment. |
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