Tests
1st tests to order
wound cultures
Test
If signs of infection are present, cultures should be obtained from the deepest portion of the wound, before significant wound manipulation but after topical decontamination. Culture data may be incomplete and should be interpreted in the context of the clinical presentation.
Isolated organisms may represent surface colonization, and other organisms may have poor in-vitro growth. This may result in potentially incomplete culture data that should be interpreted in the context of the clinical presentation.
Result
growth of pathogenic organisms
x-ray
Test
If injuries are located near a joint or bone, radiographs may be necessary. X-rays are also useful for evaluation for retained foreign bodies (i.e., embedded teeth).[10] Bites to the head and face of children may be associated with cervical spine injuries.
Result
bony injury (fracture, bony damage), air in soft tissues or joints, foreign bodies, retained teeth or dental fragments
Tests to consider
CBC
Test
Performed if systemic infection or significant blood loss is suspected.
Result
may show elevated white blood cell count, low hemoglobin
blood cultures
Test
Performed if systemic infection is suspected. May detect bacteremia.
Result
growth of pathogenic organisms
angiography
Test
In certain circumstances, such as penetrating injuries to the chest, neck, and thoracic outlet, vascular injury should be evaluated. This is usually done with the assistance of a surgeon.
Result
vascular injury
photography
Test
Given the circumstances of the injury, forensic documentation may be necessary. Diagnostic dental patterns may help in cases of suspected child abuse, where photography may demonstrate an adult-type dentition pattern in bites.
Result
location and extent of wound, dental pattern
DNA swab
Test
May be required as part of a forensic evaluation (e.g., in suspected child abuse).
Result
variable
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