Acute vinger- en handtrauma's: wondzorg

Acute finger and hand injuries : wound care The nature and the mechanism of the injury will influence the process of wound healing after a hand trauma. Sharp instruments will cause wounds with well-defined edges. They are associated with little tissue destruction. Thus, primary healing with minimal scarring can be expected. Wounds resulting from tearing or bursting of the skin have irregular edges. The viability of the tissues is at risk and secondary healing with extensive scarring can be expected. The majority of fingertip injuries canbe treated conservatively. Small skin defects can be covered with non-adherent dressings impregnated with paraffin or silicone. Larger defects can be covered with a skin graft. Fingertip lesions with exposed bone can be treated with a semi-occlusive polyurethane film dressing. More extensive tissue defects require a flap to reconstruct the fingertip. Bandages or dressings for hand wounds should be applied without tension or compression to avoid oedema. The patients should be able to move their fingers when allowed. Wounds in mutilating hand injuries require a thorough surgical debridement. Frequently, a flap is needed to cover skin defects, but usually this is not immediately done. The wound can be closed temporarily with skin substitutes or vacuum sealing. Following the surgical treatment of a severe hand injury or a replantation, the hand can be elevated in a Bradford Sling