Background

Wounds commonly result from ballistic injuries, bites, motor vehicle trauma, or other trauma. In most cases, traumatic wounds can be classified as contaminated or dirty/infected wounds. It is no longer considered appropriate to attribute a set time frame to differentiate between these two categories of wounds but instead consider factors such as location of the wound (e.g., head wounds that are very vascular tend to heal well even after longer periods of time from initial injury), size of the wound, and overall health of the patient to determine if primary closure is appropriate.

Wounds are often noted in conjunction with potentially life-threatening injuries; thus, in all MWDs presenting with wounds, a detailed systematic triage examination and a careful search for – and management of – more severe concurrent injuries must take precedent over management of wounds. In all instances, wound care follows resuscitation and stabilization of the patient.