Abstract
SUMMARY Primary wound care should proceed in an orderly fashion and is based on the history and complexity of the wound. With rare exception, epinephrine-containing local anesthetic agents are used for regional block anesthesia and local infiltration. Essentially all the commonly used topical antiseptic agents, even when diluted, are toxic to the open wound and should be avoided. Removal of gross debris is followed by copious irrigation with high pressure (>8 psi) sterile saline. Judicious debridement of frankly necrotic tissue precedes careful, tension-free, layered closure of the wound. Sutured and partial-thickness wounds can be covered with topical antibiotic ointment and an occlusive dressing to enhance epithelial healing. Selective systemic antibiotic therapy, gentle wound cleansing, sun protection, and tape strip support of the wound for the first 6 weeks after injury are important wound adjuncts.
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