Wound Closure Classification
Classifies types of wound closure.
Use in patients with open wounds, with a focus on wounds resulting from trauma.
Advice
- Management will depend on the diagnosed pathology or injury, and wound closure will differ depending on the clinical scenario.
- Surgeon experience and judgment will generally dictate the type and timing of closure. Multiple studies of varying levels of evidence have compared primary versus delayed primary closure of contaminated or infected abdominal wounds in the context of reducing surgical site infections, with no definite conclusions.
Management
- For the management of open fractures, ACS TQIP guidelines, which are based on expert opinion due to lack of evidence, recommend that skin defects overlying open fractures should be closed at the time of initial debridement.
- For open fractures associated with wounds requiring coverage with skin grafting or soft tissue transfers (in other words, Gustilo type IIIB), it is recommended that coverage be completed within seven days from the time of the injury.