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Tue November 12, 2013
Dr. Joel Beam, University of North Florida – Wound Care
In today’s Academic Minute, Dr. Joel Beam of the University of North Florida examines what the body of research says about the best method for treating wounds.
Joel Beam is an associate professor of clinical and applied movement sciences and Director of the Athletic Training Education Program at the University of North Florida. His research is primarily focused on the management of acute skin trauma with a particular focus on dressing techniques. He has published a number of book chapters and peer-reviewed articles.
Dr. Joel Beam – Wound Care
Abrasions, blisters, and lacerations are common in recreational and athletic activities and inappropriate care of these wounds can result in delayed healing and infection, including MRSA.
We formed a panel of medical professionals to search the current research and literature to create best practice recommendations for the care of acute wounds. We categorized over 250 studies and articles using the Strength of Recommendation Taxonomy developed by the American Academy of Family Physicians. The taxonomy grades the quality and consistency of the data and provides strength ratings for the recommendations. The strength ratings define the overall body of evidence as high or low quality and whether the evidence is consistent or inconsistent. The recommendations generated allow for the implementation of patient-oriented, evidence based medicine into patient health care.
Based on our review, wounds should be cleansed through irrigation with normal saline or tap water. This method was found to be effective in removing debris and bacteria while preserving the healing tissues. Scrubbing of the wound bed with gauze may damage the tissues, but can be safely used on the non-injured skin around the wound. Although antiseptics can be effective in killing bacteria, they have been shown to impede healing and should be used with caution.
Wounds should be covered with a dressing vs. left uncovered to promote healing. However, non-occlusive dressings such as gauze, non-adherent pads, and adhesive strips promote drying of the wound and increase the risk of infection, delaying the healing process. Occlusive dressings such as films, foams, and hydrocolloids seal the wound from the external environment, trapping moisture over the wound bed to create a moist environment. These dressings produce faster rates of healing and lower rates of infection compared to non-occlusive dressings or no dressing.
These recommendations provide guidelines for the appropriate treatment of acute skin trauma to promote healing and lessen the risk of infection.