Military Dermatology, Chapter 7, Cutaneous Trauma and Its Treatment
Cutaneous Trauma and Its Treatment Chapter 7 CUTANEOUS TRAUMA AND ITS TREATMENT MICHAEL MULVANEY, M.D.* AND ALLAN HARRINGTON, M.D.† INTRODUCTION FRICTION BLISTERS Pathogenesis Risk Factors Prevention and Treatment CUTANEOUS TRAUMA Anatomy Evaluation and First Aid Microbiology SURGICAL INTERVENTION Anesthesia Surgical Technique Wound Healing Wound Dressings Complications SUMMARY *2 Corporate Plaza, Albany, New York 12203; formerly, Major, Medical Corps, U.S. Army, Dermatology Service, Walter Reed Army Medical Center, Washington, D.C. 20307-5001 †Major, Medical Corps, U.S. Army; Dermatology Service, Walter Reed Army Medical Center, Washington, D.C. 20307-5001 143 Military Dermatology INTRODUCTION The skin presents itself on the front lines of de- datory for scar revision, skin grafts, and local cuta- fense against the outside world, affected by the neous flaps. It is a natural extension of this exper- harsh effects of the environment: high and low tise for the dermatologist to be involved in caring humidity and temperature, solar radiation, wind, for traumatic injury to the skin. Most of the derma- dirt, arthropods, and infectious agents. The soldier’s tologists deployed during Operations Desert Shield skin may also be assaulted by nuclear, biological, and Desert Storm were in general medical officer and chemical agents. Finally, skin on the feet is positions. Those stationed at battalion aid stations frequently subjected to frictional forces, which were likely to receive and treat soldiers with trau- causes blisters. Dermatologists have had a tradi- matic skin injuries. tional role in caring for skin disease resulting from Treatment of cutaneous traumatic injuries draws many of these insults. on knowledge that is well established in dermato- With the advent of dermatologic surgery, knowl- logic surgery: anatomy, anesthesia, microbiology, edge and experience in caring for wounded skin has wound healing, surgical technique, dressings, and been established.
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