81st Saturday Summit: WACEM Weekly Global e-Grand Rounds - The Quaterly Resident Rumble : Evidence Based Wound Care in the ED

WACEM Quarterly Resident Rumble

2^nd October 2021

 

Presenter: Dr. Courtney Kirkland, DO

                    PGY III

                    Florida State University

                    EM Residency Program, Sarasota, Florida.

 

Part I of the Presentation:

Journey of PGY III Resident and Status Today:

• Description of Sarasota Memorial Hospital acuity and volumes

• Responsibilities of an EM resident physician

• A list of skillsets and procedures that we are proficient in.

 

Part II of the Presentation:

Evidence Based Wound Care:

 

• Literature review with various data on controversial wound care management topics

• Consensus on “time since wounding” for primary closure vs. delayed primary closure regarding clean wounds is 6-10 hours for extremity wounds and 10-12 hours or even more for wounds on the face and scalp

• Contaminat4ed, infected or high-risk wounds should be closed by delayed primary closure

• Always obtain an x-ray when concerned about a retained glass foreign body, physical examination alone is not enough to rule it out

• Standard for wound irrigation consists of high-pressure irrigation with saline or water

• Tap water is just as effective for irrigation as saline

• Sterile gloves show no benefit over regular gloves for wound closure

• Certain immunocompromised populations may require prophylactic antibiotics

• Currently bite wounds above the clavicle are recommended to be closed with careful consideration of primary closure of bite wounds to the extremities