Classification and management of acute wounds

Kumar, Senthil; Leaper, David John

doi:10.1016/j.mpsur.2007.11.003

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Volume 26, Issue 2 , Pages 43-47, February 2008

Classification and management of acute wounds

Senthil Kumar FRCSC(Ed) is a Clinical Research Fellow in Surgery at University Hospital of North Tees, Stockton-on-Tees, UK. Conflicts of interest: none declared

David John Leaper FRCS FRCS(Ed) is Emeritus Professor of Surgery at Newcastle upon Tyne University, Newcastle, UK, and Visiting Professor of Surgery, Wound Healing Research Unit, Department of Surgery, Cardiff University, Cardiff, UK. Conflicts of interest: none declared

Abstract

Acute wounds are aetiologically and pathophysiologically diverse, features that impact on their natural history and guide management. Wound healing is a dynamic process and requires appropriate shifts in perspective in the clinical management of the wound, and is reflected in the terminology and classification systems which address different domains of the wound. Wound management begins with assessment and classification and may continue well after the wound has clinically healed. Before a wound can be closed, it may need to be prepared by toilet and debridement and protected against infection by appropriate prophylactic measures. Judgement and surgical skill are necessary to decide whether a wound is best allowed to heal by first, second or third intention. Wounds may be directly closed by approximation of edges or by transfer of tissues.

Keywords: acute wounds, general surgery, wound classification, wound closure, wound management