{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T14:47:21Z","timestamp":1746456441255,"version":"3.38.0"},"reference-count":18,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2014,6,1]],"date-time":"2014-06-01T00:00:00Z","timestamp":1401580800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Wilderness &amp; Environmental Medicine"],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:p> We present a case of failed conservative management of a traumatic wound sustained in a wilderness setting. The patient was initially treated with a povidone-iodine scrub, suture closure, and expectant management by 2 physicians who were paying clients on a multiday river rafting expedition. Empiric antibiotic coverage and irrigation of the dehisced wound were initiated several days after initial treatment. The patient arranged his own evacuation 8 days after injury. Hospitalization, intravenous (IV) antibiotics, and surgical debridement with wound vacuum placement led to a full recovery. This case presents several common wound care pitfalls. The sequelae to these pitfalls are more dramatic in a wilderness setting and underscore the importance of early aggressive management and considering prompt evacuation when treating wounds sustained in the wilderness. <\/jats:p>","DOI":"10.1016\/j.wem.2013.10.007","type":"journal-article","created":{"date-parts":[[2014,1,11]],"date-time":"2014-01-11T08:18:16Z","timestamp":1389428296000},"page":"182-189","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["They Had Me in Stitches: A Grand Canyon River Guide\u2019s Case Report and a Review of Wilderness Wound Management Literature"],"prefix":"10.1177","volume":"25","author":[{"given":"Susanne J.","family":"Spano","sequence":"first","affiliation":[{"name":"UCSF-Fresno Medical Education Program, Fresno, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brad","family":"Dimock","sequence":"additional","affiliation":[{"name":"Arizona Raft Adventures (AzRA), Flagstaff, AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2014,6,1]]},"reference":[{"key":"bibr1-jwem201310007","unstructured":"Repanshek K. National Park visitation in 2012 rose to nearly 283 million. National Parks Traveler. Online 15 February 2013http:\/\/www.nationalparkstraveler.com\/2013\/02\/national-park-visitation-2012-rose-nearly-283-million22827. Accessed November 22, 2013."},{"key":"bibr2-jwem201310007","unstructured":"The National Ambulatory Medical Care Survey: 2008 Emergency Department summary tables. 2011http:\/\/www.cdc.gov\/nchs\/data\/ahcd\/nhamcs_emergency\/2008_ed_web_tables.pdf. Accessed November 22, 2013."},{"key":"bibr3-jwem201310007","doi-asserted-by":"publisher","DOI":"10.1580\/1080-6032(2004)015[0011:EOWSAR]2.0.CO;2"},{"key":"bibr4-jwem201310007","unstructured":"National Water Information System, US Geological Survey. Peak streamflow for the nation: USGS09380000 Colorado River at Lee\u2019s Ferry, AZhttp:\/\/nwis.waterdata.usgs.gov\/nwis\/peak?site_no=09380000&agency_cd=USGS&format=html. Accessed November 22, 2013."},{"issue":"22","key":"bibr5-jwem201310007","first-page":"10","volume":"15","author":"Wolf T.J.","year":"1983","journal-title":"High Country News"},{"key":"bibr6-jwem201310007","doi-asserted-by":"publisher","DOI":"10.3133\/ds780"},{"key":"bibr7-jwem201310007","unstructured":"Joslin J, Auerbach P. Laceration repair in the wilderness. 2008http:\/\/www.healthline.com\/health-blogs\/outdoor-medicine\/laceration-repair-wilderness. Accessed November 22, 2013."},{"key":"bibr8-jwem201310007","doi-asserted-by":"publisher","DOI":"10.1007\/s12245-010-0217-5"},{"key":"bibr9-jwem201310007","volume-title":"Chronic Wound Care","author":"Rodeheaver G.T.","year":"2008","edition":"4"},{"key":"bibr10-jwem201310007","doi-asserted-by":"publisher","DOI":"10.1016\/0195-6701(91)90172-5"},{"key":"bibr11-jwem201310007","doi-asserted-by":"publisher","DOI":"10.1016\/j.emc.2007.01.012"},{"key":"bibr12-jwem201310007","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(87)80751-5"},{"key":"bibr13-jwem201310007","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200507000-00004"},{"key":"bibr14-jwem201310007","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199003000-00011"},{"key":"bibr15-jwem201310007","first-page":"219","volume":"101","author":"Beckert B.W.","year":"2004","journal-title":"Mo Med"},{"key":"bibr16-jwem201310007","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2007.046813"},{"key":"bibr17-jwem201310007","doi-asserted-by":"publisher","DOI":"10.1016\/j.wem.2012.08.004"},{"key":"bibr18-jwem201310007","doi-asserted-by":"publisher","DOI":"10.1177\/1553350611418989"}],"container-title":["Wilderness &amp; Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1080603213003359?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1080603213003359?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1016\/j.wem.2013.10.007","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1016\/j.wem.2013.10.007","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1016\/j.wem.2013.10.007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T17:03:52Z","timestamp":1741626232000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1016\/j.wem.2013.10.007"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,6]]},"references-count":18,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2014,6]]}},"alternative-id":["10.1016\/j.wem.2013.10.007"],"URL":"https:\/\/doi.org\/10.1016\/j.wem.2013.10.007","relation":{},"ISSN":["1080-6032","1545-1534"],"issn-type":[{"type":"print","value":"1080-6032"},{"type":"electronic","value":"1545-1534"}],"subject":[],"published":{"date-parts":[[2014,6]]}}}