Prise en charge des plaies en structure d'urgence

These formalized expert guidelines were written by the French Society of Emergency Medicine (SFMU), in partnership with the French Society of Plastic Reconstructive and Aesthetic Surgery (SOFCPRE) and the French and Francophone Wound Healing Society (SFFPC), and the support of the French Infectious Diseases Society (SPILF) and the French Speaking Group in Pediatric Intensive Care and Emergency (GFRUP). Their aim is to deliver key messages on one of the most common reasons for admission at emergency departments. There is little consensus on the management and pre-hospital regulation of wounds. The previous national guidelines dates from 2005 and required updating. The first issue is to assess the life-threatening condition of a wound and then assess its functional and aesthetic status. The care is positioned in support of the natural healing. Abundant washing with controlled water is the first essential step to teach. A wet protection between the various steps of management and the application of an anticipated local anesthesia protocol favors mechanical evaluation and mechanical debridement of good quality. There is no justification for the use of antiseptics outside wounds that are difficult to wash. Controlling the risk of exogenous contamination of a wound is a constant and major aim. The notion of an emergency wound closure time disappears as any indication to local antibiotic therapy. Appropriate initial assessment, as well as surveillance of regional or general infectious risk, may involve general antibiotic therapy, specialist advice, or follow-up. This document deals with the management of acute wounds in SU, including chronic wounds. Care, complications, chronic wounds, burns and injuries in a nuclear, radiological, biological or chemical context will be excluded.