A number of patients seen in the Emergency Department will have some form of acute or chronic wound resulting from an injury or infection.

Wounds can range from the simple to complex requiring the use of evidence-based practices to manage and promote healing. You will need to be familiar with a structured approach to wound assessment and the guiding principles of wound care.

This skill includes identifying the type of wound, wound aetiology, associated factors affecting wound healing and appropriate treatment plan. During your clinical placement in the ED you will likely encounter many different types of wounds.

Within this module are a number of resources to enhance your knowledge of complex wound care and guide decision-making.

Wound care in the Emergency Department

Building a healthy Australia
Australian Guidelines for the Prevention and Control of Infection in Healthcare (2010)
https://nhmrc.gov.au/about-us/publications/australian-guidelines-prevention-and-control-infection-healthcare-2010


NSQHS Standards
Links to download PDFs of the NSQHS Standards resources
https://nationalstandards.safetyandquality.gov.au/resources


Treatment of chronic wounds
Wound management with appropriate dressings for each phase of wound healing
https://www.bbraun.co.uk/en/products-and-therapies/wound-management.html


Bioengineered skin
The development of bioengineered skin was motivated by the critical need to cover extensive burn injuries in patients with insufficient skin for grafting. Bioengineered skin substitutes have also been widely used for a variety of chronic wounds with the aim of faster healing, reduced infection and better cosmetic appearance.
https://www.dermnetnz.org/topics/bioengineered-skin/


Maggot Debridement Therapy (MDT)
While maggots will always have an image problem, they have a lot to offer the field of medicine in the 21st century.
http://medent.usyd.edu.au/projects/maggott.htm


Ultrasonic Debridement For Wounds: Where Are We Now?
Whether it is the eradication of biofilm or treating wounds in locations not conducive to sharp debridement, ultrasonic debridement can be a key tool for promoting improved wound healing. These authors discuss their experience with this modality and the evolution of the technology.
https://www.podiatrytoday.com/ultrasonic-debridement-wounds-where-are-we-now


Treatment Options for Leg Ulcers
Around 1% of the Australian population suffer from leg ulcers – they are more common in older people (over 65) and three times more likely to affect women than men.
http://www.smith-nephew.com/australia/healthcare/treatment-options/treatment-options-for-leg-ulcers/


Application and techniques
From solutions for small pressure sores to large, highly exuding open abdomens, Smith & Nephew’s easy-to-apply, flexible NPWT system offers a range of products to perfectly suit your patients’ wound care needs.
http://www.smith-nephew.com/canada/microsite/negative-pressure-wound-therapy/education/

Bonham, J. (2016). Assessment and management of patients with minor traumatic wounds. Nursing Standard, 31(8), 60-71. doi:10.7748/ns.2016.e10573

Jones, A. P., Barnard, A. R., Allison, K., & Wright, H. (2012). Review of Emergency Department wound management in soft tissue trauma — is there a plan? Journal of Wound Care, 21(9), 431-438.

Mankowitz, S. L. (2017). Laceration management. The Journal of Emergency Medicine, 53(3), 369-382. doi:10.1016/j.jemermed.2017.05.026

Miles, G., Olmos, M., Trotter, E., & Newcomb, P. (2018). Teaching nurses how to infiltrate lacerations in the Emergency Department. JEN: Journal of Emergency Nursing, 44(5), 453-458. doi:10.1016/j.jen.2018.03.020

Van Donk, P., Tanti, E. R., & Porter, J. E. (2017). Triage and treat model of care: Effective management of minor injuries in the Emergency Department. Collegian, 24(4), 325-330. doi:10.1016/j.colegn.2016.05.003

Zacher, M. T., Högele, A. M., Hanschen, M., von Matthey, F., Beer, A., Gebhardt, F., Kanz, K. (2016). General principles of wound management in Emergency Departments. Der Anaesthesist, 65(4), 303.