Proper handling of soft tissue in the acute phase.

Proper handling of soft tissue in the acute phase demands proper attention to fundamental principles in wound evaluation, preparation, and repair. Foundational to immediate wound care is appropriate hemostasis and anesthesia. Correct soft tissue cleaning techniques are important, and the surgeon should understand special situations in which contamination may be a problem, including bites. The controversial issue of antibiotic prophylaxis is discussed. Certain wounds are not amenable to closure, but, where closure is indicated, orientation and preparation of the repair are important. Regional considerations important to the face are addressed. Numerous methods of wound closure are now available, and the advantages of each are enumerated. Postoperatively, attention to patient counseling, dressings, ointment, cleaning, and scar revision help assure an optimal outcome for the traumatized tissue.