Surgical management of wounds

Surgical management of a wound whether elective or post-traumatic requires strict adherence to certain basic precepts if a successful outcome is to be expected: 1. The patient must be stabilized. 2. Blood supply to the tissues must be adequate in order for the wound to heal. 3. All necrotic tissue must be debrided as it provides an excellent medium for bacterial growth. 4. Wound irrigation is necessary to remove foreign matter, hematoma, and decrease contaminants, e.g., bacteria. 5. Deep structures may be repaired as appropriate to help restore function. 6. Antibiotics and tetanus prophylaxis protocol are administered as appropriate. 7. Wound closure is performed as indicated, i.e., primary closure, delay primary closure, secondary intention (granulation).