Acute Wound and Management

Acute wounds are a common presenting complaint of patients in the primary care setting. These can result from a variety of mechanisms ranging from lacerations and abrasions to stings, bites or burns. The management of acute wounds involves a proper evaluation with history, physical examination, and adequate management with local wound care, and consideration for the need for specialist review or systemic treatment. The general principles of wound management and special wounds like bite wounds and stings will be discussed.

A New Approach to the Surgical Treatment of Olecranon Bursitis.

Aims: To describe a new approach to the surgical treatment of the nonseptic olecranon bursitis. Methods: The study included 14 patients (13 men, 1 woman; age range 51-77 years) treated in a 10-year period. Patients with a systemic inflammatory disease were excluded. All patients had already been treated with bursal aspiration associated with multiple punctures of the cyst wall and compressive dressing. Clinical features, ultrasonography and analysis of the aspirated bursal fluid were indicative of a nonseptic olecranon bursitis. The new approach included surgical incision to drain the bursa and the use of a Penrose drain tube for post-operative drainage for an average of 5 days. The wound was treated by secondary closure. No antibiotics were used. Results: Eleven patients showed rapid secondary healing of the wound which reached 7 to 14 days following the Penrose drain removal. Wound healing was delayed in 3 patients and required approximately a month. The long-term follow-up ranged from 2 to 10 years. No recurrences or complications were encountered. Conclusion: This novel approach proves that excision of the bursa is not a mandatory step in the surgical treatment of olecranon bursitis. It is worthwhile to consider this new approach as the first step in the surgical management of the, non-responsive to conservative treatment, nonseptic olecranon bursitis.