Classification and management of acute wounds

Acute wounds are aetiologically and pathophysiologically diverse, features that impact on their natural history and guide management. Wound healing is a dynamic process and requires appropriate shifts in perspective in the clinical management of the wound, and is reflected in the terminology and classification systems which address different domains of the wound. Wound management begins with assessment and classification and may continue well after the wound has clinically healed. Before a wound can be closed, it may need to be prepared by toilet and debridement and protected against infection by appropriate prophylactic measures. Judgement and surgical skill are necessary to decide whether a wound is best allowed to heal by first, second or third intention. Wounds may be directly closed by approximation of edges or by transfer of tissues.