Acute wound management: revisiting the approach to assessment, irrigation, and closure considerations

BACKGROUND: As millions of emergency department (ED) visits each year include wound care, emergency care providers must remain experts in acute wound management. The variety of acute wounds presenting to the ED challenge the physician to select the most appropriate management to facilitate healing. A complete wound history along with anatomic and specific medical considerations for each patient provides the basis of decision making for wound management. It is essential to apply an evidence-based approach and consider each wound individually in order to create the optimal conditions for wound healing. AIMS: A comprehensive evidence-based approach to acute wound management is an essential skill set for any emergency physician or acute care practitioner. This review provides an overview of current evidence and addresses frequent pitfalls. METHODS: A systematic review of the literature for acute wound management was performed. RESULTS: A structured MEDLINE search was performed regarding acute wound management including established wound care guidelines. The data obtained provided the framework for evidence-based recommendations and current best practices for wound care. CONCLUSION: Acute wound management varies based on the wound location and characteristics. No single approach can be applied to all wounds; however, a systematic approach to acute wound care integrated with current best practices provides the framework for exceptional wound management.