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Wound Assessment and Management: Key Concepts in Laceration Repair
Pedro A Colio1, Michael D Gooch, Karen Sue Hoyt
1Author Affiliations: San Diego State University, School of Nursing, San Diego, CA (Dr Colio); Cardiology Department, Imperial Cardiac Center, Imperial, CA (Dr Colio); American Academy of Nurse Practitioners Certification Board, Austin, TX (Dr Colio); American Academy of Nurse Practitioners, Austin, TX (Dr Colio); Vanderbilt University, School of Nursing, Nashville, TN (Dr Gooch); Emergency, Vanderbilt University Medical Center, Nashville, TN (Dr Gooch); EmergeED Consultation, Editor-in-Chief, Advanced Emergency Nursing Journal, Wolters Kluwer/Lippincott, Williams & Wilkins (Dr Hoyt); and Naval Medical Center San Diego/Naval Medical and Training Command, San Diego, CA (Dr Gerhart).
Abstract:
The purpose of this article is to discuss wound assessment and management for advanced practice registered nurses (APRNs). Skin anatomy is reviewed, and the stages and methods of wound healing are also addressed. Common types of wound/skin disruption are listed. The importance of a thorough and meticulous history and physical exam outlining the appropriate initial evaluation of wounds and including the identification of potential complications such as infection, retained foreign bodies, and neurovascular injuries are also considered. Clinical decision-making and the formulation of differential diagnoses for patients presenting with wounds will be discussed along with a management plan for patients requiring laceration repair. Information regarding the procedural phase of care [e.g., anesthesia use, common wound closure techniques (e.g., suture, tissue adhesives, staples)], offering guidance on technique selection based on wound characteristics and location will also be given. A comprehensive plan of care including patient disposition, and referral and documentation exemplars with practical pearls to avoid litigation will also be provided. APRNs will also be offered evidence-based strategies to deliver safe and effective wound care and management.
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