Wound Care Case Studies

Course overview

Medical errors and adverse outcomes related to wound care remain a high-frequency problem. Practitioners must evaluate and manage wounds that may contain foreign bodies, penetrating injuries that my have injured underlying neurovascular or tendon structures, puncture wounds, fingertip injuries, and dirty wounds at high risk for infection. Although litigation related to wound care generally results in small verdicts or settlements, wound complications caused by medical errors resulting in adverse outcomes are high-frequency occurrences. Attention to the details of high-quality wound care and an examination of lessons learned the hard way (i.e., adverse outcomes) can assist the healthcare team in improving patient care while reducing errors and risk in this important area. In this activity, we provide an overview of the common themes in wound care litigation and present and discuss a number of cases in order to illustrate these common themes (e.g., failure to diagnose a retained foreign body, failure to diagnose tendon injury, failure to diagnose or warn about compartment syndrome for injuries near a neurovascular bundle, etc.). After completing this activity, practitioners should be able to: plan an approach to the evaluation of patients with extremity wounds that includes the four key elements of the physical exam (wound exploration, neurological exam, vascular exam, and tendon exam); evaluate patients with extremity wounds, keeping in mind the common related medical errors and causes of malpractice litigation; and identify the risks and complications associated with extremity wounds caused by glass.