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Wound
Classification and external resources

Wounded man
ICD-10 T14.0-T14.1
ICD-9 872-893
MeSH D014947

In medicine, a wound is a type of injury in which skin is torn, cut or punctured (an open wound), or where blunt force trauma causes a contusion (a closed wound). In pathology, it specifically refers to a sharp injury which damages the dermis of the skin.

Contents

[edit] Types of wounds

An open wound
Wound, sewn with four stitches
A laceration to the leg

[edit] Open

Open wounds can be classified according to the object that caused the wound. The types of open wound are:

  • Incisions or incised wounds, caused by a clean, sharp-edged object such as a knife, a razor or a glass splinter.
  • Lacerations, irregular tear-like wounds caused by some blunt trauma. The term laceration is commonly misused in reference to incisions.[citation needed]
  • Abrasions (grazes), superficial wounds in which the topmost layer of the skin (the epidermis) is scraped off. Abrasions are often caused by a sliding fall onto a rough surface.
  • Puncture wounds, caused by an object puncturing the skin, such as a nail or needle.
  • Penetration wounds, caused by an object such as a knife entering the body.
  • Gunshot wounds, caused by a bullet or similar projectile driving into or through the body. There may be two wounds, one at the site of entry and one at the site of exit, such is generally known as a through-and-through.

[edit] Closed

Closed wounds have fewer categories, but are just as dangerous as open wounds. The types of closed wounds are:

  • Contusions, more commonly known as bruises, caused by a blunt force trauma that damages tissue under the skin.
  • Hematomas, also called a blood tumor, caused by damage to a blood vessel that in turn causes blood to collect under the skin.
  • Crushing injuries, caused by a great or extreme amount of force applied over a long period of time.
  • Chronic and Acute Acute or traumatic wounds are the result of injuries that disrupt the tissue. Chronic wounds are those that are caused by a relatively slow process that leads to tissue damage. Chronic wounds include pressure, venous, and diabetic ulcers. Typically, an insufficiency in the circulation or other systemic support of the tissue causes it to fail and disintegrate. Infection then takes hold of the site and becomes a chronic abscess. Once the infection hits a critical point, it can spread locally or become systemic (sepsis).

[edit] Healing

To heal a wound, the body undertakes a series of actions collectively known as the wound healing process.

[edit] Treatment

Treatment of recent lacerations involves examination, cleaning, and closing the wound. If the laceration occurred some time ago it may be allowed to heal by secondary intention due to the high rate of infection with primary closure.

[edit] Cleaning

For simple lacerations cleaning can be accomplished using a number of different solutions including tap water, sterile water, saline solution, or antiseptic solution. Tap water infection rates do not differ for wounds cleansed with water or saline.

[edit] Closure

If closure of a wound is decided upon a number of techniques can be used. These include Bandaids, a Cyanoacrylate glue, staples, and sutures.

Absorbable sutures have the benefit over non absorbable sutures of not requiring removal. They are often preferred in children.[1]

[edit] Complications

[edit] Infection

Bacterial infection of wound can impede the healing process and lead to life threatening complications. Scientists at Sheffield University have identified a way of using light to rapidly detect the presence of bacteria. They are developing a portable kit in which specially designed molecules emit a light signal when bound to bacteria. Current laboratory-based detection of bacteria can take hours or even days.[2]

[edit] Cultural history

Medieval treatment of wound with lance grittings

From the Classical Period to the Medieval Period, the body and the soul were believed to be intimately connected, based on several theories put forth by the philosopher Plato. Wounds on the body were believed to correlate with wounds to the soul and vice versa; wounds were seen as an outward sign of an inward illness. Thus, a man who was wounded physically in a serious way was said to be hindered not only physically but spiritually as well. If the soul was wounded, that wound may also eventually become physically manifest, revealing the true state of the soul.[3] Wounds were also seen as writing on the "tablet" of the body. Wounds gotten in war, for example, told the story of a soldier in a form which all could see and understand, and the wounds of a martyr told the story of their faith.by Dr.Sajjad Ahmad (Hebei North Med Univ Zhangjiakou China)[3]

[edit] Laceration

Tearing of skin and sub-cutaneous tissues, caused by blunt weapon are called Lacerations.

[edit] Types of laceration

  • Split laceration
  • Over stretching
  • Grinding compression
  • Cut laceration
  • Tearing

[edit] Split laceration

Sudden compression of tissues between two hard objects. they are commonly seen on scalp,face,hands and lower legs. they are caused by a blunt and almost perpendicular impact. the injury is due to crushing of the skin between two hard objects.

[edit] Over stretching

Angular impact with localized pressure in the form of pull or push.

[edit] Grinding compression

Localized pressure causing tearing and separation of skin from the under lying tissues which are crushed.

[edit] Cut laceration

Caused by heavy edged weapons e.g. hatchet, chopper, axes, even paper.

[edit] See also

[edit] References

  1. ^ "BestBets: Absorbable sutures in pediatric lacerations.". http://www.bestbets.org/bets/bet.php?id=874. 
  2. ^ "Light to detect wound infection" (web). UK scientists have identified a way of using light to rapidly detect the presence of bacteria. bodat. BBC News. 11 March 2007. http://news.bbc.co.uk/1/hi/health/6427787.stm. Retrieved 2008-03-17. 
  3. ^ a b Reichardt, Paul F. (1984). "Gawain and the image of the wound". PMLA 99 (2): 154-161. doi:10.2307/462158. 

[edit] External links




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