Wound Types

Wound Types

1. Puncture

   • Penetrating or perforating wound

2. Avulsion

   • Skin separated from underlying tissue

3. Degloving

   • Tearing/ loss of skin from limb

4. Incised

   • Clean regular, linear wound edges

5. Lacerated

   • Irregular tearing

6. Abrasional

   • Frictional damage

7. Crushing injury

   • Extensive damage to underlying tissue

8. Gunshot

   • Contaminated?

9. Penetrating

   • Wide-spread damage

10. Foreign bodies

11. Burns

    • Hot, cold,chemical

12. Shear

    • Severe frictional damage

13. Decubital ulcers

    • Open wounds on bony prominences

14. Contusion (closed wound)

    • 1st degree: bruise/ rupture of capillaries subcut.
    • 2nd degree: rupture of larger vessels causing blood accumulation (Haematoma)
    • 3rd degree;extensive tissue damage, Infection? internal organs damaged

15. Contamination?

    • Clean
    • Clean-contaminated
    • Contaminated
    • Dirty (active infection/necrosis)

16. Infected?

    • 10^5 bacteria per g tissue=infected
      • Swab deep wound after lavage 1cm2: slide test. Wound not closed if bacteria present (Haemolytic streptococci etc)
    • Viability (necrotic? Blood supply?)
    • Foreign material (debri?)

17. Examination of wound

    • How old?
    • type?
    • Location?
    • degree of damage

18. Emergency treatment

    • Haemostasis
      • Sterile swab apply direct pressure(indirect pressure foreign bodies)
      • 1:1000 adrenaline : contraindicated in extremities
      • Pack with haemostatic agents (calcium alginate?)
    • Profuse arterial bleeding (pressure point haemostasis)
      • Femoral/ brachial artery
    • Pressure cuffs & tourniquets
      • Proximal to appendicular wounds
        • inflated higher than measured blood pressure
          • Not in place more than 6 hours
      • Tourniquets not recommended unless amputation.
        • Narrow no more than 3-5 minutes
        • 5-10 cm width:10 minutes (30 minutes?)