Suturing as the Module Suggests, \"Each Wound

Suturing

As the module suggests, "Each wound that is encountered and considered for repair must be addressed independently," ("Wound considerations"). This is true whether the injury is an acute one, or whether there is a procedure involved. Generally, however, suturing can take place in an outpatient care clinic regardless of whether there was an acute injury or not. It depends a lot on the nature of the injury, and the nature of the procedure, though. Generalizing about situations like injuries and procedures is unnecessary, unproductive, and potentially dangerous. Each would certainly requires an evaluation of the situational and patient variables. The age and overall health condition of the patient, and the age of the wound are all taken into consideration when there has been an acute injury; the type of the wound also needs to be taken into consideration when there was an injury. Acute injury patients might not be regular patients at the care center facility, and would not need any specialized attention other than appropriate suturing as the wound requires.

With suturing necessary after minor surgical or medical procedures, the primary care physician or health care team is more likely to be aware of the variables that would impact the decision. When the procedure is straightforward and without complications, then outpatient servicing of the wound is completely appropriate and in fact, preferable given that it takes place in conjunction with the initial procedure. This allows for greater continuity of care. A greater risk occurs when there is a lack of continuity of care, versus where the patient received suturing. Therefore, the decision of which situation to assign to an outpatient facility cannot be answered in simple terms. The decision of outpatient for injury vs. outpatient for procedure is made not according to whether it was an injury wound or a surgical procedure wound; it is made according to other variables are listed in the answer to the following question.

b. It depends largely on the location of the wound, and its intensity. The decision would also depend on what type of procedure is being done. Generally, if the procedure takes place in outpatient care, then the preparation for suturing can also be made in conjunction with that procedure. If the procedure required a more extensive array of equipment, then it could be necessary to suture in hospital.

Concerns related to potential contamination must also be taken into consideration. Deep puncture wounds warranting deep and regular cleaning due to the high potential for contamination might be better served in an in-patient setting. Likewise, the nurse needs to consider how much time has elapsed since the initial injury. The more time that has elapsed, the greater the chance for infection. "Any wound that has been exposed for greater than 8 hours is at significant risk for infection, regardless of the mechanism of injury," ("Wound considerations"). Seriously contaminated wounds are often better served without suturing at all, but instead with thorough cleaning, monitoring, and breathing. A specialist might be necessary to determine the extent of any gross infection that could cause serious problems.