| Wound Type |
Additional Guidance |
Penetrating or
Puncture Wound |
- Consider pre-emptive antibiotics
- Assess tetanus immunization status and administer prophylaxis if indicated
- Avoid tissue adhesive and occlusive dressing
- Avoid tight suture repairs
|
| Animal Bite |
- Consider pre-emptive antibiotics for high-risk groups
- Consider rabies prophylaxis
- Assess tetanus immunization status and administer prophylaxis if indicated
- Follow-up in ~48 hrs to evaluate for signs of infection
- Avoid tissue adhesive
- Consider avoiding suture or loose repair for these bites:
- Of particular concern are bites on hands/feet, immunocompromised hosts, bites older than 12 hrs, cat bites
- Consider risk of infection vs. cosmesis
|
| Human Bite |
- Consider pre-emptive antibiotics
- Assess tetanus immunization status and administer prophylaxis if indicated
- Follow up in ~48 hrs to evaluate for signs of infection
- If sutured, avoid deep sutures, keep sutures loose
- Avoid tissue adhesive
- Consider avoiding suture or loose repair for these bites:
- Of particular concern are bites on hands/feet, immunocompromised hosts, bites older than 12 hrs
- Consider risk of infection vs. cosmesis
|
| Retained Foreign Body |
Consider need for imaging (plain radiograph or ultrasound), removal and prophylactic antibiotics |
| Previously Repaired Wound Presenting with Complications |
- Dehiscence more than 24 hrs after repair
- Healing by secondary intention may be appropriate
- Referral to plastic surgery
- Infection
- Washout vs. debridement
-
Antibiotics
- Consider possibility of retained foreign body
|