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Adv Wound Care (New Rochelle). 2015 May 1;4(5):286-294.

Evidence-Based Care of Acute Wounds: A Perspective.

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Department of Surgery, Academic Medical Center , Amsterdam, The Netherlands .
Department of Surgery, Lucas Andreas Hospital , Amsterdam, The Netherlands .
Department of Surgery, St. Antonius Hospital , Nieuwegein, The Netherlands .
Department of Surgery, Academic Medical Center , Amsterdam, The Netherlands . ; School for Health Professions , Amsterdam, The Netherlands .


Significance: Large variation and many controversies exist regarding the treatment of, and care for, acute wounds, especially regarding wound cleansing, pain relief, dressing choice, patient instructions, and organizational aspects. Recent Advances: A multidisciplinary team developed evidence-based guidelines for the Netherlands using the AGREE-II and GRADE instruments. A working group, consisting of 17 representatives from all professional societies involved in wound care, tackled five controversial issues in acute-wound care, as provided by any caregiver throughout the whole chain of care. Critical Issues: The guidelines contain 38 recommendations, based on best available evidence, additional expert considerations, and patient experiences. In summary, primarily closed wounds need no cleansing; acute open wounds are best cleansed with lukewarm (drinkable) water; apply the WHO pain ladder to choose analgesics against continuous wound pain; use lidocaine or prilocaine infiltration anesthesia for wound manipulations or closure; primarily closed wounds may not require coverage with a dressing; use simple dressings for open wounds; and give your patient clear instructions about how to handle the wound. Future Directions: These evidence-based guidelines on acute wound care may help achieve a more uniform policy to treat acute wounds in all settings and an improved effectiveness and quality of wound care.

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