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Wound Characteristics (wound + characteristic)

Distribution by Scientific Domains

Medical Sciences	62%

Selected Abstracts

Effects of Decomposition on Gunshot Wound Characteristics: Under Moderate Temperatures with Insect Activity

JOURNAL OF FORENSIC SCIENCES, Issue 2 2009
Lauren E. MacAulay B.Sc. (Hons)
Abstract:, Previous studies document characteristics of gunshot wounds shortly after they were inflicted. This study was conducted to determine if the early stages of decomposition obscure or alter the physical surface characteristics of gunshot wounds, thereby affecting the quantity and quality of information retrievable from such evidence. The study was conducted in August and September, 2005 in Nova Scotia, Canada in forested and exposed environments. Recently killed pigs were used as research models and were shot six times each at three different ranges (contact, 2.5 cm, and 1.5 m). Under these test conditions, the gunshot wounds maintained the characteristics unique to each gunshot range and changes that occurred during decomposition were not critical to the interpretation of the evidence. It was concluded that changes due to decomposition under the conditions tested would not affect the collection and interpretation of gunshot wound evidence until the skin was degraded in the late active or advanced decay stage of decomposition. [source]

Effects of Decomposition on Gunshot Wound Characteristics: Under Cold Temperatures with No Insect Activity

JOURNAL OF FORENSIC SCIENCES, Issue 2 2009
Lauren E. MacAulay B.Sc. (Hons)
Abstract:, Information on gunshot wound characteristics has been well documented; however, there is little documented information on the effects of decomposition or environmental conditions on gunshot wound characteristics. This study was conducted in order to determine if decomposition would obscure or alter the physical surface characteristics of gunshot wounds when exposed to a low temperature environment. The study was conducted from November 2005 to January 2006 in Nova Scotia, Canada in forested and exposed environments, with air temperatures between ,10°C and +10°C. Pigs were used as human models and were shot six times each at three different ranges (contact, 2.5 cm, and 1.5 m). Gunshot wound characteristics persisted until the wounds were covered with ice and snow, after which changes were observed. The changes were recognized as being unique to the different ranges of gunshots and it was concluded that changes due to decomposition under the conditions tested would not affect the collection and interpretation of gunshot wound evidence. [source]

Digital versus Local Anesthesia for Finger Lacerations: A Randomized Controlled Trial

ACADEMIC EMERGENCY MEDICINE, Issue 10 2006
Stuart Chale MD
Abstract Objectives To compare the pain of needle insertion, anesthesia, and suturing in finger lacerations after local anesthesia with prior topical anesthesia with that experienced after digital anesthesia. Methods This was a randomized controlled trial in a university-based emergency department (ED), with an annual census of 75,000 patient visits. ED patients aged ,8 years with finger lacerations were enrolled. After standard wound preparation and 15-minute topical application of lidocaine-epinephrine-tetracaine (LET) in all wounds, lacerations were randomized to anesthesia with either local or digital infiltration of 1% lidocaine. Pain of needle insertion, anesthetic infiltration, and suturing were recorded on a validated 100-mm visual analog scale (VAS) from 0 (none) to 100 (worst); also recorded were percentage of wounds requiring rescue anesthesia; time until anesthesia; percentage of wounds with infection or numbness at day 7. Outcomes were compared by using Mann-Whitney U and chi-square tests. A sample of 52 patients had 80% power to detect a 15-mm difference in pain scores. Results Fifty-five patients were randomized to digital (n= 28) or local (n= 27) anesthesia. Mean age (±SD) was 38.1 (±16.8) years, 29% were female. Mean (±SD) laceration length and width were 1.7 (±0.7) cm and 2.0 (±1.0) mm, respectively. Groups were similar in baseline patient and wound characteristics. There were no between-group differences in pain of needle insertion (mean difference, 1.3 mm; 95% confidence interval [CI] =,17.0 to 14.3 mm); anesthetic infiltration (mean difference, 2.3 mm; 95% CI =,19.7 to 4.4 mm), or suturing (mean difference, 7.6 mm; 95% CI =,3.3 to 21.1 mm). Only one patient in the digital anesthesia group required rescue anesthesia. There were no wound infections or persistent numbness in either group. Conclusions Digital and local anesthesia of finger lacerations with prior application of LET to all wounds results in similar pain of needle insertion, anesthetic infiltration, and pain of suturing. [source]

Sutured wounds: Factors associated with patient-rated cosmetic scores

EMERGENCY MEDICINE AUSTRALASIA, Issue 3 2006
Tatiana Lowe
Abstract Objective: To determine the association between wound characteristics, wound management in the ED and patient-rated cosmetic appearance of sutured wounds. Our hypothesis was that practitioner seniority would most strongly predict outcome. Methods: Prospective recruitment of patients with lacerations sutured at the primary ED visit was performed. Data collected included patient demographics, wound characteristics and wound management. A standardized telephone questionnaire was administered 14 days and 3 months later. Scar appearance was scored using a verbal rating scale from zero to 10. Data were obtained about suture removal, antibiotic compliance, infection and dehiscence rates at 2 weeks. Associations of variables with cosmetic scores were analysed using multivariate linear regression. Results: One hundred and thirty-two patients were evaluated. Mean cosmetic scores were not significantly associated with seniority (P = 0.07). Lacerations repaired by senior practitioners were more likely to result from glass or general trauma (P = 0.007), be shorter (P = 0.03), be cleaned with antiseptic (P = 0.03), not to re-open (P = 0.01) or require re-suturing (P = 0.03). Following multivariate regression factors significantly associated with cosmetic scores at 14 days and 3 months were site of injury (P < 0.003) and time from injury to repair (P < 0.009). Wounds of the torso, leg or foot had lower cosmetic scores at both time-points. An association with age (P = 0.04) was present at 3 months. Conclusions: Previous research found improvement between short-term doctor-rated cosmesis and training beyond internship. Our study demonstrated a non-significant trend relationship between seniority and patient-rated outcome, both short and long-term. However, staff seniority was overshadowed by the site of laceration and time from injury to repair. [source]

Six-month mortality risks in long-term care residents with chronic ulcers

INTERNATIONAL WOUND JOURNAL, Issue 5 2008
Paul Y Takahashi
Abstract Chronic ulcers are a common problem in long-term care. Residents with ongoing ulcers are often frail and at risk for mortality. This study evaluated the relationship between wound characteristics and other health predictors with 6-month mortality in nursing home residents. The subjects included were nursing home residents seen by the wound consult service from 1998 to 2007 with an ongoing chronic ulcer. This was a retrospective cohort study. Data were manually and electronically abstracted for each resident. Six-month mortality was collected as the primary outcome. Statistical comparisons were made using logistic regression with a final multivariant model. Four hundred and forty residents were seen with 411 records reviewed. Ulcer area was not associated with mortality; however, chronic ulcer number was associated with 6-month mortality with an odds ratio of 1·32 (95% CI 1·07,1·63). Other significant risk factors included heart failure, dementia, cancer, depression and blindness with all factors having an odds ratio greater than 1·75. Higher haemoglobin and venous insufficiency were protective of 6-month mortality. Ulcer number is an important predictor for 6-month mortality. The presence of multiple ulcers and comorbid health concerns may influence discussion of prognosis for healing and for potential end of life discussions. [source]

Stage 2 Pressure Ulcer Healing in Nursing Homes

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2008
Nancy Bergstrom PhD
OBJECTIVES: To identify resident and wound characteristics associated with Stage 2 pressure ulcer (PrU) healing time in nursing home residents. DESIGN: Retrospective cohort study with convenience sampling. SETTING: One hundred two nursing homes participating in the National Pressure Ulcer Long-Term Care Study (NPULS) in the United States. PARTICIPANTS: Seven hundred seventy-four residents aged 21 and older with length of stay of 14 days or longer who had at least one initial Stage 2 (hereafter Stage 2) PrU. MEASUREMENTS: Data collected for each resident over a 12-week period included resident characteristics and PrU characteristics, including area when first reached Stage 2. Data were obtained from medical records and logbooks. RESULTS: There were 1,241 initial Stage 2 PrUs on 774 residents; 563 (45.4%) healed. Median time to heal was 46 days. Initial area was significantly associated with days to heal. Using Kaplan-Meier survival analyses, median days to heal was 33 for small (,1 cm2), 53 days for medium (>1 to ,4 cm2), and 73 days for large (>4 cm2) ulcers. Using Cox proportional hazard regression models to examine effects of multiple variables simultaneously, small and medium ulcers and ulcers on residents with agitation and those who had oral eating problem healed more quickly, whereas ulcers on residents who required extensive assistance with seven to eight activities of daily living (ADLs), who temporarily left the facility for the emergency department (ED) or hospital, or whose PrU was on an extremity healed more slowly. CONCLUSION: PrUs on residents with agitation or with oral eating problems were associated with faster healing time. PrUs located on extremities, on residents who went temporarily to the ED or hospital, and on residents with high ADL disabilities were associated with slower healing time. Interaction between PrU size and place of onset was also associated with healing time. For PrU onset before or after admission to the facility, smaller size was associated with faster healing time. [source]

Effects of Decomposition on Gunshot Wound Characteristics: Under Cold Temperatures with No Insect Activity

Patterns of Use of Topical Skin Adhesives in the Emergency Department

ACADEMIC EMERGENCY MEDICINE, Issue 6 2010
Adam J. Singer MD
Abstract Objectives:, The objective was to determine patterns of use of topical skin adhesives (TSA) for laceration repair. The authors hypothesized that TSA use would be more common in children and facial lacerations. Methods:, This was a structured retrospective chart review. The setting was a suburban, university-based emergency department (ED) with an emergency medicine (EM) residency; the annual census is 85,000 visits. Charts from consecutive patients presenting with lacerations in the summer of 2008 (June 2008 through August 2008) were reviewed. Demographic, clinical, and wound characteristics were extracted from electronic medical records by trained investigators using structured data collection forms. Characteristics of lacerations repaired with TSA or other closure devices were compared with bivariate and multivariate analyses using odds ratios (ORs) and 95% confidence intervals (CIs). Results:, A total of 755 patients presented to the ED with lacerations over the study period, of whom primary closure was used in 667; nine were excluded because the method of closure was unknown. The most common methods of laceration closure were sutures (485), adhesives (88), and staples (86). Adhesives were used to close 27% of facial lacerations, compared to 4% of all other body locations (difference = 23%, 95% CI = 18% to 29%), and in 20% of pediatric versus 8% of adult lacerations (difference = 13%, 95% CI = 7% to 18%). Adjustment for other potential patient and wound characteristics showed that adhesives were more likely to be used to close facial lacerations (OR = 10.0 CI, 95% CI = 5.5 to 18.0) and lacerations in children (OR = 1.8, 95% CI = 1.1 to 3.0) and less likely to be used as laceration length increased (OR = 0.6, 95% CI = 0.4 to 0.8). Adhesive use was not statistically associated with patient sex or race, laceration edges or shape, or the need for deep sutures. Forty-three percent of adhesive wounds were closed with no anesthetic, and a topical agent was used in another 48%. In contrast, a local anesthetic agent was injected in 87% of sutured wounds (p < 0.001) and 73% of stapled wounds (p < 0.001). Conclusions:, Topical skin adhesives are used more often for children, facial lacerations, and short lacerations. Use of adhesives may improve patient comfort as need for injecting a local anesthetic is reduced. ACADEMIC EMERGENCY MEDICINE 2010; 17:670,672 © 2010 by the Society for Academic Emergency Medicine [source]