Basic Principles of Wound Management

Consistently successful results in wound management require practice, attention to small details, and adherence to the basic principles of wound care. This chapter discusses specific details on wound care. The intraoperative assessment of the wound after exploration, debridement, and lavage is the best time to determine if wound closure should be attempted now or at a later time. Establishment of a healthy vascular wound bed, free of necrotic tissue and infection, allows the surgeon to consider all options for final wound closure. In preparation for definitive wound cleansing and surgical management, the exposed wound is covered with sterile gauze pads impregnated with sterile K-Y Jelly, sterile saline, or an antimicrobial solution prior to liberally clipping the skin and preparing the defect for surgery. Whether the wound can be handled by delayed primary closure, secondary closure, or healing by second intention is determined as wound management progresses.