Wound treatment has been an important aspect of physician care throughout the ages. From the Smith Papyrus in 1700 BC to the latest medical journals, various methods are described to manipulate wounds to speed healing.

Wound care is particularly important to primary care physicians such as emergency-room physicians, dermatologists, internists, and family doctors all of whom experience a high frequency of wound-care problems in their practice.

A statewide survey of 118 general-practice physicians in Virginia showed that during a two-year interval, 88,000 patients sought physician advice for 526,196 individual health complaints. Lacerations, contusions, abrasions, and other common soft-tissue injuries accounted for 21,137 visits, ranking third behind routine physical exams and hypertension as the most frequent problems encountered by a family practitioner.

A survey of emergency rooms would have likely shown a greater frequency of these injuries. If we could survey the time and importance assigned the teaching of soft-tissue injury management to nurses, medical students, and family or emergency practice residents, the results would not likely reflect the importance of these problems.

This book is designed to review the principles of wound healing that are important in the care of common every day wounds.

Priorities for effective wound management are listed chronologically. Reassurance, sedation and anesthesia are assigned their deserved roles. Instruments are selected for their simplicity, durability and effectiveness. Aseptic technique is then discussed with emphasis on the fact the sterility is not an option - despite all the traditional warnings that shaving, prepping, masking, etc, are useful.

Bleeding control is explained as well. Special attention is given to the selection and placement of sutures, as well as the application of dressings. A well planned, skillfully applied dressing can be as important as the actual wound closure. Detailed follow-up instructions are deemed essential.

Specific types of wounds are discussed in detail: burns, bites, fingertip injuries, avulsions, and hand infections. Advice is offered for avoidance and management of thick scars, keloids, and other unwanted sequelae of minor injuries.

Finally, the book concludes with a few words about referral. There are times when it is appropriate to repair a wound yourself and there are also times to refer patients to more experienced hands. A list of valid reasons to refer is offered.

Ambrose Pare once said: "I cared for the wound, but God healed it." The physician can certainly help prepare a wound for healing, but the natural mechanisms of repair will heal it.