Open wounds and lacerations are frequently encountered problems in emergency medicine and constitute 8% of the 95 million emergency department cases in the United States. The goal of treatment is to provide good functional and cosmetic results; to minimize potential factors leading to wound infection, and to support wound healing.
Wound infections are common after injuries, and many factors contribute to the development of wound site infection, such as mechanism of injury, degree of contamination, delay in seeking medical care, and co-morbid diseases. Although the upper time limit to wound closure, ideal suture materia, cleaning solution, and wound dressings remain controversial topics, repairing a clean wound in as short a time as possible remains the goal for the emergency medicine practitioner.
Routine use of antibiotics is not necessary for the management of traumatic wounds. Removal of foreign bodies from tissue spaces and debridment is essential however.
When indicated, antibiotics should be given in sufficient concentrations at the time of wound closure and given as soon as possible to insure adequate absorption and tissue distribution. Intravenous administration leads to effective tissue concentrations in a short time. Topical antibiotics also play an important role in wound care. They are widely used for wounds having a high risk of dermal infections