Wound
In medicine, a wound is a type of physical trauma wherein the 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.
Before any medical or paramedical evaluation, a wound is considered as minor when:
- it is superficial (a "flesh wound");
- it is away from natural orifices;
- there is only minor bleeding;
- it was not caused by a tool or an animal.
Any other wound should be considered as severe. If there is any doubt, a wound should be considered as severe. "Severe" does not necessarily means that it endangers life, but it must at least be seen by a physician. In the case of severe open wounds, there is a risk of blood loss (which could lead to shock), and an increased chance of infection due to bacteria entering a wound that is exposed to air. Due to the risk of infection, wounds should be kept clean, and closed if possible until professional help is available.
Depending on their severity, closed wounds can be just as dangerous as open wounds. An injury to the brain such as a contusion is an extremely dire closed wound, and requires emergency medical attention.
Types of wound
Open
Open wounds can be classified into a number of different types, 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. Incisions which involve only the epidermis are legally classified as cuts, rather than wounds.
- Lacerations - Irregular wounds caused by a blunt impact to soft tissue which lies over hard tissue (e.g. laceration of the skin covering the skull) or tearing of skin and other tissues such as caused by childbirth. Lacerations may show bridging, as connective tissue or blood vessels are flattened against the underlying hard surface. Commonly misused in reference to injury with sharp objects, which would not display bridging (connective tissue and blood vessels are severed).
- Abrasions (grazes) - a superficial wound in which the topmost layers of the skin (the epidermis) are scraped off, 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.
In a medical context, all stab wounds and gunshot wounds should be considered major wounds.
Types of wound (continued)
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 a bruise) - caused by blunt force trauma that damages tissue under the skin
- Hematoma - (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.
Blisters
A blister or bulla is a defense mechanism of the human body. It consists of a pool of lymph and other bodily fluids beneath the upper layers of the skin. It may be formed in response to burns or friction, and helps to repair damage to the skin. If a blister is punctured, it forms an open wound. However, it is a good idea to bandage it when one is working around unsanitary conditions. After the blister has 'popped,' the excess skin should not be removed, unless it is dirty or torn. Removing the excess skin often makes the wound more prone to further infection (Kaiser Permanente, 2001). As with all wounds, it is a good idea to keep blisters clean. Applying polysporin to the area will speed up the healing process.
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