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    Attention COACH STUDY participants:

    The principal investigators of the study request that you use the official version of the modified score here.

    Wound Closure Classification

    Classifies types of wound closure.

    INSTRUCTIONS

    Use in patients with open wounds, with a focus on wounds resulting from trauma.

    When to Use
    Pearls/Pitfalls
    Why Use

    Patients with open wounds after traumatic injuries. The types of wound closure will differ depending on the wound’s etiology and pattern of injury, morphology, contamination classification, and complexity.

    • The types of wound closure are clearly described; however, patient-specific characteristics, such as risk factors and nutritional status, in addition to the quality of the wound itself, will make every clinical scenario different.
    • Surgeon experience and judgment often dictate type and timing of closure.
    • Has limited application in abdominal and orthopedic wounds. Multiple studies (of varying levels of evidence) have compared primary versus delayed primary closure of contaminated or infected abdominal wounds, and of traumatic open orthopedic wounds, in the context of reducing surgical site infections— currently no definitive evidence-based consensus exists on the optimal time of primary skin closure for either abdominal or orthopedic wounds.

    The type and timing of wound closure in traumatic or contaminated wounds play a role in the incidence of surgical site infections. Surgical site infections are a source of significant morbidity to the patient and increased health care costs.

    Clean wounds with minimal tissue loss, e.g. surgical wounds, clean lacerations
    Significant tissue loss precluding tension-free approximation of edges, devitalized edges, ulcerations, or abscess cavities
    Grossly contaminated wounds with or without significant tissue loss

    Result:

    Please fill out required fields.

    Next Steps
    Evidence
    Creator Insights
    Dr. David Leaper

    About the Creator

    David Leaper, MD, ChM, DSc, FRCS, FACS, FLS, is an emeritus professor of clinical sciences at the Institute of Skin Integrity and Infection Prevention at the University of Huddersfield and emeritus professor of surgery at the University of Newcastle upon Tyne. He has served as president of the Surgical Infection Society of Europe and the European Wound Management Association. Dr. Leaper’s primary research interests include surgical site infection, sepsis and critical care, and wound healing.

    To view Dr. David Leaper's publications, visit PubMed

    Are you Dr. David Leaper? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    Content Contributors
    • Jennie Kim, MD
    About the Creator
    Dr. David Leaper
    Are you Dr. David Leaper?
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