Search for content here...
    

WOUND MANAGEMENT

Surgical wound classification:

  • Clean
  • Clean Contaminated: normal but colonized tissue
  • Contaminated: contains foreign or infected material
  • Infected: obvious pus present
  • Clean wounds: close immediately to allow healing by primary intention
  • Contaminated or infected wounds: never close, leave open to heal by secondary intention
  • Clean Contaminated: surgical toilet, leave open, then close 48 hours later - delayed primary closure
  • Careless closure of a contaminated wound will promote infection and delay healing

Primary repair:

  • Primary closure requires clean tissue to be approximated without tension
  • Leave skin sutures in place for an average 7 days; longer if healing expected to be slow due to blood supply of particular location (back or legs) or patient’s condition
  • Close deep wounds in layers; absorbable sutures for deep layers

Delayed Primary Closure:

  • Irrigate clean contaminated wounds, then pack open with damp saline gauze
  • Close wounds with sutures at 2 days

Secondary healing:

  • Perform wound toilet, surgical debridement without closure; may need skin graft
© Copyright 2020 WHO