The practice of wound care has greatly improved and evolved over the years. The emergency provider (EP) can choose from a wide variety of sutures, adhesives, strips, and surgical staples, and uses proven wound closure techniques to address this common Emergency Department (ED) patient complaint. All EPs should be comfortable and proficient in the management and care of wounds in the ED. Because wound care is responsible for a large number of malpractice claims, EPs need to be aware of practices that can limit bad outcomes and thus decrease their liability risk. EPs should follow a standard examination and ensure that there is no damage to underlying structures (ie, nerves, tendons, and vasculature), and that foreign bodies are meticulously looked for and removed if found. Discharge instructions that alert the patient on warning signs of infection, and having all patients return within 48hours for a wound check are 2 ways to optimize patients' outcomes.
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| http://dx.doi.org/10.1016/j.emc.2010.06.009 | DOI Listing |
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Author Affiliations: Department of Community Medicine, Information and Health Decision Sciences, University of Porto, Porto, Portugal (Dr Mota); Health School, Polytechnic Institute of Viseu, Viseu, Portugal (Drs Mota, Santos, and Cunha); Health Sciences Research Unit: Nursing (UICISA: E), Coimbra, Portugal (Drs Mota and Cunha); CINTESIS@RISE - Center for Health Technology and Services Research, University of Porto, Porto, Portugal (Drs Mota and Santos); Academic Clinical Centre of Beiras, Covilhã, Portugal (Drs Mota and Cunha); Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, Portugal (Drs Melo and Santos); Portugal Centre for Evidence-Based Practice: A Joanna Briggs Institute Centre of Excellence, Coimbra, Portugal (Dr Santos); Hospital São Teotónio, Tondela Viseu Hospital Centre, Viseu, Portugal (Dr Abrantes); Santa Casa da Misericórdia de Seia, Seia, Portugal (Dr Monteiro); and Nursing School of Porto, Porto, Portugal (Dr Santos).
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Section of Acute Care Surgery, Department of General Surgery, Stanford University, Stanford, CA.
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Although nonoperative management is the mainstay for rib fracture treatment, surgical stabilization of rib fractures is becoming more common. Recently, the number of high-quality studies on management of rib fractures has also increased. The primary purpose of this review is to analyze the currently available prospective randomized studies on the management of rib fractures.
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