From the Guidelines
Adequate initial wound care involves thorough cleaning of the wound, wrapping it in a sterile wet dressing, and fracture immobilization, as recommended by the most recent guidelines 1. The steps towards adequate initial wound care include:
- Thorough cleaning of the wound with sterile saline solution or clean water, as supported by the 2023 guidelines from the American Academy of Orthopaedic Surgeons 1
- Wrapping the wound in a sterile wet dressing to maintain a warm, moist environment and promote healing, as suggested by the 2021 guidelines for the acute care of severe limb trauma patients 1
- Fracture immobilization to prevent further injury and promote healing, as recommended by the 2021 guidelines for the acute care of severe limb trauma patients 1
- Monitoring the wound for signs of infection, including increased pain, redness, swelling, warmth, pus, or red streaks extending from the wound, and seeking medical attention if signs of infection develop, as advised by the 2016 guidelines for the diagnosis and management of foot infections in persons with diabetes 1 It is essential to note that the use of antimicrobial dressings or agents reported to improve wound healing by altering the biology of the wound is not recommended, as stated in the 2016 guidelines for the use of interventions to enhance the healing of chronic ulcers of the foot in diabetes 1. In cases of allergy to beta-lactam antibiotics, clindamycin and gentamicin may be considered, as suggested by the 2021 guidelines for the acute care of severe limb trauma patients 1. Overall, proper wound care reduces the risk of infection by removing bacteria and creating a clean environment that supports the body's natural healing process, as emphasized by the 2023 guidelines from the American Academy of Orthopaedic Surgeons 1.
From the FDA Drug Label
Prompt institution of appropriate regimens for care of the burned patient is of prime importance and includes the control of shock and pain. The burn wounds are then cleansed and debrided; The steps towards adequate initial wound care are:
- Control of shock
- Control of pain
- Cleansing of the burn wounds
- Debriding of the burn wounds 2
From the Research
Initial Wound Care Steps
The following steps are essential for adequate initial wound care:
- Assessing the wound using reliable and valid methods, including measuring wound area/size and depth, assessing the wound edges, aspect of the wound bed and surrounding skin, as well as the amount and type of exudate and odor 3
- Conducting a holistic assessment of the wound to confirm whether healing is progressing as anticipated, using frameworks such as the TIMERS framework 4
- Understanding the cause, chronicity, location, and level of microbial contamination of the wound, as well as patient factors that affect wound healing 5
- Selecting appropriate wound care products, including antimicrobial dressings, based on parameters such as cost, wound type, local microbial burden, and the location and condition of the wound 6
Wound Assessment and Documentation
- Regularly assessing the wound using the same methods to track progress and identify potential issues 3
- Consistently documenting all findings to provide a foundation for the plan of care and determine its effectiveness 3
- Reassessing the wound and underlying pathology if it fails to achieve sufficient healing after 4 weeks of standard care 7
Wound Management
- Managing the wound and bandage material as the wound heals, taking into account the individual needs of the patient and the wound 5
- Overcoming factors that contribute to delayed healing, such as underlying pathologies, to achieve successful healing 7
- Using advanced therapeutic agents and antimicrobial dressings as needed to promote wound healing and prevent infection 7, 6