Emergency Management of Difficult Wounds: Part I

Younggren, Bradley N.; Denny, Mark A.

doi:10.1016/j.emc.2007.01.003

Cited by 26 publications

(14 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Management involves irrigation, debridement, antibiotic prophylaxis, with tetanus and rabies immunization as appropriate, and primary wound closure or surgical reconstruction. 10,11 THERMAL AND CHEMICAL BURNS Bath scalds are a significant problem in children below 5 years. The best way to prevent this unintended injury is by reducing the temperature in domestic hot water tanks, and testing the water temperature before placing an infant or child in the bath.…”

Section: Animal and Human Bitesmentioning

confidence: 99%

Genital Trauma in Children and Adolescents

Merritt¹

2008

Clinical Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

Traumatic wounds of the female genitalia include accidental straddle injuries or impalement, chemical or thermal burns, insufflation injuries, blunt trauma, or crush injuries. Children and adolescents may be victims of rape, sexual abuse, and female genital mutilation. Information is provided on epidemiology, pathophysiology, and management. Treatment guidelines are offered using the best evidence available, and recommendations are provided when data are limited.

show abstract

Section: Animal and Human Bitesmentioning

confidence: 99%

Genital Trauma in Children and Adolescents

Merritt¹

2008

Clinical Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

show abstract

“…Tetanus toxoid is administered in a variety of forms: the diphtheria–pertussis–tetanus and diphtheria–tetanus vaccines are currently used in children; tetanus toxoid alone and the tetanus-diphtheria vaccine, containing a reduced amount of diphtheria toxoid, are used in adults; and the alternative tetanus-diphtheria-pertussis formulation can be used in adolescents and adults 1 8 10. In addition, if a patient presents with a dirty wound that could be infected with C tetani , treatment can be given in the form of antibiotics and human tetanus immunoglobulin (HTIG), to ensure instant protection, and/or a toxoid booster dose 1 10 11. However, it is difficult to identify tetanus-prone wounds 12…”

Section: Tetanus Vaccinationmentioning

confidence: 99%

“…Data from the USA have estimated that approximately 5.8% of emergency hospital visits involve the treatment of open wounds and management of potential infection complications 11. In the UK, it has been estimated that about 11% of emergency department visits are for the treatment of lacerations 19.…”

Section: Determining Tetanus Protection Statusmentioning

confidence: 99%

Are current UK tetanus prophylaxis procedures for wound management optimal?

Cooke

2009

Emergency Medicine Journal

View full text Add to dashboard Cite

Tetanus is a potentially fatal disease that occurs after contamination of a wound with Clostridium tetani spores. The introduction of comprehensive infant vaccination programmes in the 1960s dramatically reduced the incidence of tetanus in the UK. To achieve comprehensive protection against tetanus, the World Health Organization guidelines recommend the administration of the five-dose childhood immunisation regimen and an additional sixth dose, after approximately 10 years, to ensure long-lasting immunity. To supplement these measures, tetanus prophylaxis with human tetanus immunoglobulin is considered essential for incompletely immunised individuals presenting with dirty wounds. However, identifying those individuals who are not fully immunised has, until recently, been problematical. The use of a new rapid, point-of-care immunoassay to assess tetanus immune status may facilitate the optimal management of patients with wounds.

show abstract

“…Copious irrigation with tissue debridement, tetanus toxoid, and radiographs to rule out foreign body and fracture are essential. Infection prophylaxis with a 5-day course of amoxicillin/clavulanate or clindamycin with either ciprofloxin or trimethoprim/sulfamethoxazole (in penicillinallergic patients) is recommended (2). Delays in presentation, especially in the settings of drug and alcohol intoxication, is the norm and manifests with cellulitis involving the dorsum of the hand.…”

mentioning

confidence: 98%