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Outlines current management of upper limb conditions in primary care settings

This information is for primary care physicians and a general summary of current practice 

Please consult a physician directly for management of specific injuries  

Wound Dressings

Overview of injury

Mechanism of Injury:  Laceration, Puncture, Compound Fracture, De-Tipping Injuries, Skin Tears

Associated injuries:    Fractures, Soft-Tissue Defects, Neurovascular Trauma


  • pply non-stick layer - suitable options include:

    • Jelonet

    • Bactigras

    • Mepitel

    • Xeroform

  •  Apply absorbent layer - suitable options:

    • Square guaze

    • Melonin

    • Combine

  • Apply light non-stick circumferential dressing

    • Bandage distal to proximal (i.e handygauze)

    • Ensure tension is even, light and does not occlude blood flow

    • DO NOT APPLY TAPE - this is difficult to remove and the adhesive can further affect damaged tissue

  •  Apply immobilisation as required for associated injuries/pain management

    • Zimmer splint

    • Buddy strapping

    • POSI - refer to our previous newsletter on this topic!

  • If not going to theatre same day - discharge on oral antibiotics (this will be confirmed in our reply to referrer)



  • Very important to ensure that blood flow is not occluded when applying dressing - Case may not get to theatre for up to 24hrs

  • Ensure 1-2 layers of non-stick surface placed over the WHOLE wound to facilitate easy removal in theatre with minimal wound contamination or additional trauma

  • Consider amount of layers required to absorb blood or fluid

    • Ensure appropriate to wound size/requirements

  • Educate patient on appropriate home management e.g. elevation of affected limb, keeping dressings clean and dry and seeking medical attention if signs of increased bleeding or infection prior to surgery,


Please refer patient to a ULQ fellowship trained hand surgeon for management 
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