Chisholm C D
Emergency Medicine and Trauma Center, Methodist Hospital of Indiana, Indianapolis.
Emerg Med Clin North Am. 1992 Nov;10(4):665-72.
The approach to wound management in the Emergency Department does not differ from that used in evaluating other complaints. This consists of a problem-directed history and physical examination. The history should probe for host and wound factors that increase the risk of a poor outcome. The examination should emphasize a search for the involvement of underlying structures. Appropriate cleansing remains the foundation for good wound management. Until a rapid inexpensive test is available to identify wounds with low bacterial counts, the clinician should assume that all wounds have bacterial loads capable of causing infection. Therefore, most wounds should be cleansed by irrigation with at least 200 mL of normal saline. Larger quantities or 1% povidone-iodine solution may be used in wounds that have high wound or host risk factors. Wound exploration should occur in a well-lit environment and combine good hemostasis with appropriate analgesia and anesthesia.
急诊科伤口处理的方法与评估其他病症的方法并无不同。这包括以问题为导向的病史采集和体格检查。病史应探究增加不良结局风险的宿主和伤口因素。检查应着重寻找潜在结构是否受累。适当的清洁仍是良好伤口处理的基础。在有快速廉价的检测方法可识别细菌数量少的伤口之前，临床医生应假定所有伤口的细菌载量都有导致感染的可能。因此，大多数伤口应用至少200毫升生理盐水冲洗进行清洁。对于有高伤口或宿主风险因素的伤口，可使用更大剂量或1%聚维酮碘溶液。伤口探查应在光线充足的环境中进行，并将良好的止血与适当的镇痛和麻醉相结合。
