Since infection is the most common complication of wound care, the critical step in managing any wound is thorough cleansing. Low energy shearing lacerations are much less likely to become infected than wounds created by high energy mechanisms. Highly contaminated wounds are much more likely to become infected than the routine contaminated wound. The goal when cleaning any wound is to reduce residual bacteria counts so that the patient's immune system can prevent infection. All wounds should be thoroughly cleaned and when indicated, thoroughly irrigated.
Irrigation is important when cleaning heavily contaminated wounds.
There is no definite length of this golden period. Each wound must be evaluated for all variables affecting the potential for infection. A 22 hour old facial laceration in a healthy young patient may be closed primarily while a foot wound in a diabetic may do better with delayed closure. Every patient should have tetanus status determined and documented. Tetanus and rabies prophylaxis should be initiated as appropriate following recommendations of the Center for Disease Control.