Professional Documents
Culture Documents
Initial Management
ATLS Procedure
A : airway
B : breathing
C : circulation
D : disabilities
E
: exposure
Compressive dressings
for hemorrhage
Check
Cervical
Chest
Abdoment
X ray
Head
Pelvis
Neurovascular
on
y Hemorrhage
y Location
y Size
y Border
y Wound type
y Exudate
y Infection
y Dressed or undressed
Wound management
Wound irrigation
Irrigate with NaCl 0,9 %
1 2 litre
Brush, evacuate foreign
body
Use :
Povidon iodine
Savlon
Perhidrol
(hidrogen peroxide)
Irrigate with NaCl to
cleanse
Debridement
Excision:
y
y
y
y
Wound Edge
Skin Abrasion
Dead Tissue
Dirty Bone
Evacuate:
y Foreign body
Primary Closure
Dry Dressings
dry wound
Wet-to-Dry Dressings
wet wound
Packing
deep wound
Contamination
2.
NV injury
3.
Tension
skin loss :
y Secondary intention
y Release / counter incision
y STSG, FTSG
y Flap fasciocutaneus,
rotational
Fracture Classification
Close (simple)
Open
y Gustillo Anderson
Grade I
Grade II
Grade III a
Grade IIIb
Grade IIIc
Gustillo Anderson
As soon as possible
Scrub and brush
wound dirt
Superficial
debridement:
Identify and explore
Deep debridement :
When in doubt take it out
Check muscle : 4 c
Color
Capacity to bleed
Contractility
Consistency
Cover by tissue or moist dressing
Remove Foreign body
Debridement Procedure
Irrigation
Use NS, high volume
low pressure lavage
For grade II-III :
y 6 10 l
Use antiseptics,
perhidrol, antibiotic, etc
Skeletal Stabilisation
Evaluate vascular
status, limb salvage,
debridement and
irrigation
Stabilize the bone :
Restore length
Angular alignment
Rotation
Cast :
y splint, circular cast
Traction :
y skin, skeletal
External fixation :
y steinman or K wire
Internal Fixation
IM nails
y Restore alignment
y Callus healing
y Minimize soft tissue damage
Compartment syndrome
Rehabilitation
Early Range of Motion
Isometric, isotonic, isokinetic excercise
Motor Power excercise
Non weight bearing
Partial weight bearing
Full weight bearing
Return to normal activity