wound care
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Laboratory
- wound culture if suspected infection
- bone biopsy with culture for suspected osteomyelitis
Radiology
- radionuclide bone scan, CT or MRI if osteomyelitis suspected
- see osteomyelitis
Management
- also see management of cutaneous ulcer
- see wound dressing
- thorough cleansing is often sufficient for most cuts & scrapes[3]
- non-stick dressing over white petrolatum is a more expensive option[3]
- wounds heal faster with less scarring with kept moist & occluded[3]
- use white petrolatum rather than antibiotics on clean wounds[3]
- wound debridement
- remove debris
- remove necrotic tissue (unless arterial insufficiency)
- gauze for exudative wounds
- ribbon gauze packs for deep tunnels
- control pain associated with wound care procedures
- control infection
- use Silvadene for wounds with > 1 million CFU/g tissue or any infection with beta-hemolytic Streptococci
- consider topical antibiotic for clean wounds that are not healing after 2-4 weeks of optimal care
- systemic antibiotics for signs of spreading infection, cellulitis, or osteomyelitis
- see treatment of cellulitis
- see treatment of osteomyelitis
- adjunctive therapy for wound healing
- prevent further injury (see pressure ulcer)
- nutritional support for repair processes
- protein: 1.25-1.5 g/kg/day unless contraindicated, i.e. ESRD
- calories: 30-35 kcal/kg/day
- correct vitamin C deficiency
- correct zinc deficiency
- avoid exposure to cold
- vasoconstriction reduces blood flow to the wound
- ensure adequate hydration
- re-evaluate if wound does not show healing within 2 weeks
More general terms
More specific terms
- complex wound repair, eyelid/nose/ear/lip
- complex wound repair, forehead/cheeks/chin//mouth/neck/axillae/genitalia/hand/foot
- complex wound repair, scalp/arm/leg
- intermediate wound repair, face/ear/eyelid/nose/lip/mucous membrane
- intermediate wound repair, neck/hand/foot/genitalia
- intermediate wound repair, scalp/neck/axilla/genitalia/trunk/extremity
- laser ablation burn/scar
- laser ablation open wound
- negative pressure wound therapy
- no-touch technique
- simple wound repair, face/ear/eyelid/nose/lip/mucous membrane
- simple wound repair, scalp/neck/axilla/genitalia/trunk/extremity
- ultrasound wound therapy
- wound care, burn
- wound care, dehiscence
- wound care, eyelid/nose/ear/lip
- wound care, face/ear/eyelid/nose/lip/mucous membrane
- wound care, forehead/cheek/chin/mouth/neck/axilla/genitalia/hand/foot
- wound care, neck/genitalia/hand/foot
- wound care, scalp/arm/leg
- wound care, scalp/axilla/trunk/extremity
- wound care, scalp/neck/axilla/genitalia/trunk/extremity
- wound care, trunk
- wound irrigation
Additional terms
References
- ↑ Prescriber's Letter 15(5): 2008 Comparison of Chronic Wound Care Products Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=240511&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society
- ↑ 3.0 3.1 3.2 3.3 3.4 Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18. American College of Physicians, Philadelphia 2012, 2015, 2018
- ↑ Gist S, Tio-Matos I, Falzgraf S, Cameron S, Beebe M. Wound care in the geriatric client. Clin Interv Aging. 2009;4:269-87. Epub 2009 Jun 9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19554098
- ↑ Fonder MA, Lazarus GS, Cowan DA et al Treating the chronic wound: A practical approach to the care of nonhealing wounds and wound care dressings. J Am Acad Dermatol. 2008 Feb;58(2):185-206 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18222318
- ↑ Alam W, Hasson J, Reed M Clinical approach to chronic wound management in older adults. J Am Geriatr Soc 2021. May 17 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34002364 Review https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/jgs.17177