Wounds and Lacerations: Emergency Care and Closure (Expert Consult - Online and Print)

With Wounds and Lacerations: Emergency Care and Closure, you'll get clear, concise guidance on the latest techniques and strategies for treating lacerations, wounds, and burns. This medical reference book will help you optimize every aspect of patient care based on current literature and guidelines. Expedite review and reference with a bulleted "Key Practice Points" section at the beginning of each chapter. Quickly reference the latest recommendations for tetanus and rabies prophylaxis. Implement the latest approaches for the use of ultrasound in foreign-body detection and removal; use of absorbable sutures on the face and hand; approaching complicated infections such as MRSA; managing chronic wounds seen in elderly and diabetic patients; applying new suture techniques and materials for pediatric patients; and updated recommendations for tetanus and rabies prophylaxis. Get step-by-step visual guidance on all aspects of wound care through more than 300 detailed line drawings and photographs showing techniques for wound assessment, irrigation, closure, wound dressing, foreign body removal, administration of local anesthesia, and follow-up care. Quickly find all the relevant information necessary to treat patients with material that focuses only on injuries that are handled by emergency physicians. On the scene or at the hospital, search the complete contents online at expertconsult.com. Master the art of healing wounds and lacerations with clear, concise guidance on everything from the patient's arrival in the ED to discharge and follow-up care. Wounds and Lacerations 4th 2012......Page 1 Copyright ......Page 2 Wounds and Lacerations : Emergency Care and Closure ......Page 3 Dedication ......Page 4 Contributors......Page 5 Editorial Coordinator......Page 6 Preface......Page 7 Goals of Wound Closure......Page 8 Risks of Wound Care......Page 9 References......Page 10 Initial Hemostasis......Page 11 Severe Soft Tissue Injuries......Page 12 Basic History......Page 14 Screening Examination......Page 15 References......Page 16 Epidermis and Dermis (Skin or Cutaneous Layer)......Page 17 Superficial Fascia (Subcutaneous Layer)......Page 18 Skin Tension Lines......Page 19 References......Page 21 4 - Wound Healing and ­Cosmetic Outcome......Page 22 Inflammatory Phase......Page 23 Wound Contraction and Remodeling......Page 24 Shearing......Page 25 Compression......Page 27 Wound Infection......Page 28 Technical Factors......Page 29 Drugs......Page 30 Scar Management and Revision......Page 31 References......Page 33 5 - Wound Care and the ­Pediatric Patient......Page 34 Assessing the Child......Page 35 Immunization Status......Page 36 Pediatric Patient Sedation......Page 37 Medications for Sedation......Page 39 Choice of Closure Materials......Page 41 Face......Page 42 Hand......Page 43 Perineum/Straddle Injuries......Page 44 References......Page 45 Local Anesthetics: Practical Points......Page 48 Lidocaine with Epinephrine......Page 50 Toxicity of Local Anesthetics......Page 51 Alternatives for Allergic Patients......Page 52 Adult Patient Sedation......Page 53 Anesthesia Techniques......Page 55 Technique......Page 56 Indications......Page 57 Indications......Page 58 Technique......Page 59 Technique......Page 60 Technique......Page 62 Indications......Page 64 Anatomy......Page 65 Alternative Technique for Digital Block......Page 66 Anatomy......Page 71 Anatomy......Page 73 Anatomy......Page 74 Technique for Posterior Tibial Nerve Block......Page 75 References......Page 78 Povidone-Iodine......Page 80 Chlorhexidine......Page 81 Blood and Body Fluid Precautions......Page 82 Wound Area Hair Removal......Page 83 Wound Periphery Cleansing......Page 84 Cleansing Setup and Procedures......Page 85 References......Page 87 Basic Instruments and Handling......Page 89 Technique for Handling Needle Holder......Page 90 Technique for Handling Forceps......Page 91 Technique for Scissor Tip Control......Page 92 Hemostats......Page 93 Knife Handles and Blades......Page 94 Suture Materials......Page 95 Polyglycolic Acid (PGA) (Dexon, Dexon II)......Page 96 Nylon (Ethilon, Dermalon)......Page 98 Needle Types......Page 99 References......Page 100 Timing of Closure......Page 102 Technique for Delayed Primary Closure......Page 103 Techniques for Wound Exploration......Page 104 Hemostasis......Page 105 Tissue Débridement and Excision......Page 106 Technique for Full Wound Excision......Page 108 Immediate Antibiotic Therapy......Page 109 References......Page 112 Definition of Terms......Page 114 Techniques for Wound Edge Eversion......Page 115 Vertical Mattress Suture......Page 118 Horizontal Mattress Suture......Page 119 Wound Tension......Page 120 Deep Closures......Page 122 Wound Undermining......Page 124 Dead Space......Page 125 Closure Sequence and Style......Page 126 References......Page 127 Description......Page 128 Technique for Pull-Out Subcuticular Closure......Page 129 Description......Page 131 Description......Page 132 Technique for Closing Flaps with Nonviable Edges: V-Y Closure......Page 135 Technique for Closure of Geographic Wounds......Page 136 Technique for Closing a Dog Ear......Page 138 Technique for Closure of Parallel Lacerations......Page 140 Description......Page 141 Technique for Closing a Laceration in an Abrasion......Page 142 12 - Special Anatomic Sites......Page 144 Scalp......Page 145 Preparation for Closure......Page 146 Uncomplicated Lacerations......Page 147 Aftercare......Page 148 Multiple Small Flaps, Lacerations, and Abrasions (Windshield Injury)......Page 149 Aftercare......Page 150 Eyebrow and Eyelid......Page 151 Closure of Intramarginal Lid Lacerations......Page 152 Cheek or Zygomatic Area......Page 153 Closure of Uncomplicated Cheek Lacerations......Page 154 Nasal Structures......Page 155 Aftercare......Page 156 Preparation for Repair......Page 157 Lacerations Involving Cartilage......Page 158 Uncomplicated Lacerations......Page 160 Aftercare......Page 161 Buccal Mucosal and Gingival Lacerations......Page 162 Dental Trauma......Page 163 Aftercare......Page 164 Foot......Page 165 References......Page 166 Initial Treatment......Page 168 Patient History......Page 170 Examination of The Hand......Page 171 Motor Function......Page 172 Sensory Function......Page 174 Extensor Function......Page 176 Flexor Function......Page 177 Circulation......Page 180 Wound Exploration......Page 181 Fingertip Injuries......Page 182 Blunt Injuries (Subungual Hematoma)......Page 184 Nail Bed Lacerations......Page 185 Nail Removal Technique......Page 187 Avulsion Injuries......Page 189 Tendon Lacerations......Page 190 Nerve Injuries......Page 191 Amputated Parts......Page 192 Paronychia......Page 193 Pressure Injection Injuries......Page 195 Antibiotics for Hand Wounds......Page 196 References......Page 197 Tissue Adhesives......Page 199 Adhesive Wound Closure Technique......Page 201 Adhesive Closure Aftercare......Page 202 Taping Technique......Page 203 Wound Stapling......Page 204 Staple Aftercare......Page 207 References......Page 212 15 - Bite Wounds......Page 213 General Bite Wound Management......Page 214 Specific Injuries......Page 215 Suturing......Page 216 Cat Bite Wound Management......Page 217 Microbiology......Page 218 Rat Bites......Page 219 Rabies Exposure and Prophylaxis......Page 220 Type of Exposure......Page 221 Wild Carnivores and Bats......Page 222 Livestock......Page 223 Immunosuppression, HIV, and Pregnancy......Page 224 References......Page 225 Foreign Bodies......Page 227 Clinical Evaluation......Page 228 Radiodense Objects......Page 229 Nonradiodense Objects......Page 230 Techniques for Removal......Page 231 Protruding Objects......Page 232 Thorns and Cactus Spines......Page 233 Puncture with Suspected Retained Material......Page 234 Complicated Punctures......Page 235 Fishhooks......Page 236 String Traction......Page 237 Hook Push-Through......Page 238 Abrasions and Tattooing......Page 239 References......Page 241 17 - Minor Thermal Burns......Page 243 Initial Management and Patient Assessment......Page 244 Depth of the Burn......Page 245 Extent of the Burn......Page 247 Treatment of Minor Burns......Page 249 Burn Dressing......Page 250 References......Page 253 18 - Cutaneous and ­Superficial Abscesses......Page 255 Hidradenitis Suppurativa......Page 256 Buttock and Perianal Abscesses......Page 257 Management of Abscesses......Page 258 Technique for Incision and Drainage......Page 259 Follow-Up Care......Page 262 Antibiotic Use in Abscess Care......Page 263 References......Page 264 19 - Complicated, Chronic, and Aging Skin Wounds......Page 265 Evaluation and Treatment......Page 266 Chronic Skin Ulcerations......Page 267 Evaluation of Chronic Ulcerations......Page 268 Management of Skin Ulcerations......Page 269 Repair of Type 1 Skin Tears: Flaps Without Tissue Loss......Page 270 References......Page 272 Wound Dressing Principles......Page 273 Bandaged Wounds......Page 275 Dressing Application......Page 276 Scalp......Page 278 Trunk......Page 279 Groin, Hip, and Thigh......Page 281 Ankle, Heel, and Foot......Page 284 References......Page 288 Tetanus Prophylaxis......Page 289 Complications of Tetanus Toxoid and Tdap......Page 290 Prophylactic Antibiotics for Emergency Wounds......Page 292 References......Page 293 Timing of Removal......Page 295 Analgesia......Page 296 Wound Protection......Page 297 Written Instructions......Page 298 Understanding Wound Healing......Page 299 References......Page 300 A......Page 301 B......Page 303 C......Page 304 D......Page 306 E......Page 307 F......Page 308 G......Page 309 H......Page 310 I......Page 311 M......Page 312 N......Page 313 P......Page 314 S......Page 316 T......Page 318 W......Page 320 Z......Page 321 Emergency wound care : an overview / Alexander T. Trott Patient evaluation and wound assessment / Alexander T. Trott Anatomy of wound repair / Alexander T. Trott Wound healing and cosmetic outcome / Alexander T. Trott Wound care and the pediatric patient / Carolyn K. Holland, Gregg A. Digiulio, and Javier A. Gonzalez del Rey Infiltration and nerve block anesthesia / Alexander T. Trott Wound cleansing and irrigation / Alexander T. Trott Instruments, suture materials, and closure choices / Alexander T. Trott Decisions before closure : timing, debridement, and consultation / Alexander T. Trott Basic laceration repair : principles and techniques / Alexander T. Trott Complex and ageing skin wounds : advanced repair techniques / Alexander T. Trott Special anatomic sites / Alexander T. Trott The hand / Alexander T. Trott Tissue adhesives and alternative wound closure / Alexander T. Trott Bite wounds / Alexander T. Trott Common wound care problems / Alexander T. Trott Minor thermal burns / Alexander T. Trott Cutaneous and superficial abscesses / Alexander T. Trott Complicated, chronic, and ageing skin wounds / Alexander T. Trott Wound dressing and bandaging techniques / Alexander T. Trott Tetanus immunity and antibiotic wound prophylaxis / Alexander T. Trott Suture removal and wound aftercare / Alexander T. Trott. Provides guidance on the advanced techniques and strategies for treating lacerations, wounds, and burns. This book helps you to optimize various aspects of patient care.