Finally, the Red Cross wound classification (RCWC) (Additional file 2) can be applied to acute wounds with or without an underlying fracture. Their corresponding interobserver variability was studied in wounds with fractures to ensure uniform application of these classifications and was shown to vary from moderate to good 11, 12, 13, 14. Classifications originally designed for assessing acute soft tissue injuries with underlying fractures are the Gustilo Anderson wound classification (GAWC) (Additional file 1) 7, AO soft tissue classification 8, OTA Open Fracture classification 9, and Tscherne classification 10. Additionally, the TIME model is advocated to aid a uniform and systematic approach to wound care 4, 6, as its four parameters, including the type of Tissue affected, presence of Infection, Moistness of the wound, and aspect of wound Edges are systematically assessed. The Red Yellow Black (RYB) system, applied by nurses to the care of (chronic) wounds 5, can be combined with wound moistness to evaluate acute wounds 4. This requires information on the type of injury and time since the injury occurred. The Dutch guideline on wound care advocates classifying wounds according to the degree of contamination 4. This was also observed with skin tears, for which a need was observed for simplified documentation and assessment methods among healthcare providers 3. As there is no standard classification in practice for acute wound assessment, wound description is currently not performed uniformly. Wound assessment should be adequately performed to determine wound severity and guide wound management 2. Awareness should be raised of existing wound classifications, specifically among less experienced healthcare professionals.Īpproximately 176,000 patients visited the Dutch emergency departments (EDs) with acute open wounds in 2016 1. It is recommended to apply the GAWC to acute wounds with underlying fractures and the RCWC to major traumatic injuries. However, their user-friendliness is moderate. The interobserver variability of the GAWC and RCWC in acute wounds is promising, and both classifications are easy to apply. Emergency physicians are reserved to use a classification for acute wound assessment. The GAWC was only of additional value in wounds with fractures, whereas the RCWC’s additional value in acute wound assessment was independent of the presence of a fracture. Participants considered both classifications helpful for acute wound assessment when the emergency physician was less experienced, despite a moderate user-friendliness. Fifty percent of the participants reported using a classification for acute wounds, mostly the GAWC. The study included twenty emergency physicians from eight hospitals. We examined the interobserver variability of both classifications using a Fleiss’ kappa analysis, with a subdivision in RCWC grades and types representing wound severity and injured tissue structures. Afterwards, they rated the user-friendliness of these classifications. Participants classified ten fictitious wounds by applying the GAWC and RCWC. We contacted emergency physicians from eleven hospitals in the south-eastern part of the Netherlands and identified the currently applied classifications. This multicentre cross-sectional survey study employed an online oral questionnaire. This study aimed to assess the most frequently used classifications for acute wounds in the Netherlands and the interobserver variability of the Gustilo Anderson wound classification (GAWC) and Red Cross wound classification (RCWC) in acute wounds. Many wound classification systems exist, but often these were not originally designed for acute wounds. Annually, a vast number of patients visits the emergency department for acute wounds.
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