By Joseph E. Grey, Keith G. Harding
This fresh name within the ABC sequence appears on the therapy and administration of wounds and therapeutic technique - it is the ideal relief for college students, nursing employees, health center medical professionals and GPs.
Covers the review, prognosis and administration of all wounds - from disturbing to power. Giving sensible recommendation on dressings and units utilized in the administration of wounds.
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Extra info for ABC of Wound Healing
Greater lengths of flap can be used by including the underlying deep fascia and also by including a perforating blood vessel in the base of the flap. In some circumstances better cosmesis may be obtained by raising the flap as fascia only, leaving the overlying skin behind. “Islanding” a flap on its vascular pedicle allows even greater pedicle length and thus greater mobility and versatility. Occasionally no options are available for local wound cover, and tissue has to be harvested from elsewhere around the body by using microvascular techniques.
Methicillin resistant Staphylococcus aureus The incidence of MRSA wound infection and osteomyelitis is increasing. Isolation of MRSA from a wound, however, does not require treatment in the absence of clinical signs of infection. Topical antimicrobial agents, such as iodine and silver compounds, have activity against MRSA and may be used in localised wound infection when there is no evidence of invasion, cellulitis, or systemic upset. In a systemically unwell individual, a glycopeptide (vancomycin or teicoplanin) should be administered.
In general, topical antibiotics are not recommended. Reasons for this include inadequate penetration for deep skin infections, development of antibiotic resistance, hypersensitivity reactions, systemic absorption when applied to large wounds, and local irritant effects leading to further delay in wound healing. Short courses of silver sulfadiazine or topical metronidazole can be useful, however, in certain circumstances—for example, with burns and chronic ulcers. Osteomyelitis associated with wound infection Necrotising fasciitis Topical antimicrobial preparations x Iodine releasing agents (povidone-iodine preparations, cadexomer-iodine preparations) x Potassium permanganate solution x Silver releasing agents (composite silver dressings, silver sulfadiazine) x Topical antibiotic (metronidazole) Osteomyelitis may develop after direct inoculation of bone from a contiguous focus of infection.