Wound Registry: Development and Validation☆,☆☆,★
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INTRODUCTION
Traumatic wounds are one of the most common problems encountered in the emergency department. Emergency physicians treat an estimated 11.5 million wounds annually.1Development of successful strategies to reduce wound occurrence would provide the optimal method of preventing injury-related complications. Unfortunately, emergency physicians mainly treat patients in whom wounds have already been inflicted. Wound infection rates range from 1% to 31% 2, 3, 4, 5, 6, 7, 8, 9depending on the wound
MATERIALS AND METHODS
The development of the wound registry comprised seven steps: survey of practitioners' wound care and suture techniques, revisions of initial registry to adjust to the needs of all practitioners, development of registry definitions for categories of data entry, pilot phase of data collection to ensure ease of use, development of a system for patient follow-up, validation of the data collection instrument, and implementation of the wound registry data collection instrument.
Initial Survey of
RESULTS
Pilot Phase of Data Collection From October 27, 1992, through September 6, 1993, 1,000 patients were entered in the wound registry.
The mean±SD age of patients was 23±18 years. There were 738 men (74%) and 262 women (26%). Injuries were evaluated shortly after occurrence (median time, 1 hour; interquartile range (IQ25-75, 0 to 2 hours).
The causes and locations of wounds are shown in Tables 1 and 2, respectively. The median laceration length was 2 cm (IQ25-75, 1 to 3 cm). Wounds were linear in
DISCUSSION
Wound management should focus on the prevention of infection, enhancement of cosmetic appearance, and restoration of function. Most studies of wound care have focused on the infection rate after primary wound closure.2, 3, 4, 5, 6, 7, 8, 9Many factors that influence the rate of wound infection cannot be affected at the time of medical intervention. These factors, along with the time elapsed before the initiation of medical treatment, can be influenced only by patient education directed at
Acknowledgements
The authors acknowledge Henry C Thode, Jr, PhD, for his assistance and statistical support.
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Cited by (0)
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From the Department of Emergency Medicine, University Medical Center, State University of New York Health Sciences Center, Stony Brook, New York.
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Address for reprints: Judd E Hollander, MD, Department of Emergency Medicine, University Hospital, Room L4-515, State University of New York, Stony Brook, New York 11794-7400, 516-444-2499, Fax 516-444-3919
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Reprint no. 47/1/64107