Acute Wounds

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Basic concepts of normal wound healing

In the past several decades, we have learned a great deal about the biochemistry, molecular biology, and cell physiology of the events that lead to a healed wound (Fig. 1). The physiologic mechanisms of wound healing are similar in different tissues with slight variations. This article covers the healing of acute wounds.

Wound healing is classically divided into three phases: the early, intermediate, and terminal phases (Fig. 2). The initial response to injury, whether mechanical, immunologic,

Acute wound care

The management of all acute wounds starts with a thorough history and physical examination. This procedure is often difficult in an emergency room setting, especially when the patient is intoxicated and combative and the treating physician is in a rush. The initial evaluation should identify all injuries and rule out associated occult injuries. The occult injuries may be life-threatening—for instance, intra-abdominal trauma, injury to the brain and cervical spine, thoracic injuries, or airway

Summary

The most important factors in the management of acute wounds are the history and physical examination. The goals of wound care are fivefold: avoid further tissue damage, achieve wound closure as rapidly as possible, restore function to the injured tissue, facilitate the patient's expedient return to normal daily activities, and restore the patient's quality of life. The treating physician must have a good understanding of the wound healing mechanism. One must rule out all associated occult

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