> I used saline to clean the wound, inspected for underlying
> tissue damage and
> solid debris and then applied the strips. A dressing was
> placed over the top
> and then the patient was taken to A&E. The benefit of the
> adhesive strips is
> to start the healing process at an early stage.
> Just so you know where I am coming from. I never considered treat and
> release when I posted this.
Can you clarify what patients you are dealing with- are you really talking
about patients with minor lacerations who call 999 ambulances, or are you
talking about patients from RTAs with several injuries of which one is a
minor laceration? If the latter, don't delay transfer to apply dressings; if
the former, empower your paramedics not to transport. (Although treat and
release has its own problems- if we persuade the public that the best
response to a 'minor injury' is to call for an ambulance rather than making
their way to the ED...)
If it is simple 'minors' and failing a see and release policy, I'd say you
shouldn't use steris. It is impossible to examine a wound fully without
removal of the steristrips. If the wound does not require full examination,
the patient should not be brought to A and E; if it does then application of
the strips involves increased wound handling (and thus tissue damage and
risk of infection) as well as taking up your time (assuming they are not
applied in the back of a moving ambulance) and being costly. As a general
rule, if your examination of the patient is not going to influence
management, then don't examine the patient. I appreciate your comments about
the wound drying out- maybe we should consider saline soaks to cover all
wounds.
Matt Dunn
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