Friday, April 7, 2017

Meaning of Open & Closed Wound/Injuries, Types, Signs & Treatment


EXPOSED INJURIES
    These are those injuries in which there's a disruption in the continuity of the skin. These injuries are common in athletics and include open wounds and various skin liaison that may or may not break the skin.

Open Wounds
    Open wounds are normally caused by physical trauma and may range from a simple scratch to a large, deep, freely bleeding laceration. It is important to note that an open wound may only be surface evidence of a more severe and often hidden injury.

    Most open or exposed injuries are minor in severity and do not result in significant hemorrhaging or loss of tissue. However, any bleeding must be controlled before a complete evaluation if the wound itself or of the possible involvement of deeper anatomic structures.

Types of Open Wound
Abrasion
    Abrasion occurs when epidermis and a portion of dermis is scraped or rubbed away. This type of injury is very common in athletic activities and it's usually caused by falling on rough surfaces. Athletes in their own parlance commonly referred to abrasion as turf burns, mat burn or floor burns depending on the surface that caused them.

    A reddish, a regular surface appearance give rise to the descriptive strawberry or "monkey yanch". The bleeding associated with abrasion is usually limited to blood oozing from underline injured capillaries. Although, the injury may be be painful, the primary concern is that of the infection.

    The abraded area will often contain contaminants such as debris or bacteria embedded in the injured tissue.

Treatment of Abrasion
    An Abrasion must be cleaned thoroughly. Soap and water will work well but the surface should be cleaned with antibacterial straw. All foreign materials should be removed. Depending on the circumstance of the injury, we may have to use a soft brush to clean the area injured.

    An abrasion should be referred to a physician if you're finding it difficult to remove all the foreign materials by washing the wound or if the area surrounding the abrasion becomes inflated and infected a few days after the injury.

Laceration
    This is a type of wound that occurs by tearing. This injury is usually a result of some type of direct blow to the skin and is especially common over prominences. The skin may be stretched and actually turn apart.

    Lacerations are often described as a combination of contusion and tear. They generally lack the clean appearance of a typical incision. The edges of a laceration is usually jagged or irregular or at least some surrounding tissue damage occur in most laceration injuries.

   The severity of laceration can range from a very small crack in the skin to a large, deep wound to surrounding and deeper structure. The nature and severity of bleeding associated with laceration is quite variable.

Treatment
    Apply a pressure to stop bleeding, Use cold running water to clean the surface of the wound, followed with the use of antiseptic and methylated spirit on the surrounding and surface of the wound.
 
    You should also use a gauze with iodine to pad the surface of the wound and rap with bondage before referring to physician if the need be.

Incision
    Incision is often caused by cutting with sharp objects such as a sharp knife, razor blade etc. The edges of an incisions are smooth and plainly cut with little or no damage to the surrounding tissues. Occasionally, an incised wound will be deep and there would be damage to the tissues, nerves, muscles as well below the surface of the skin.

Treatment
    The most important thing is to apply pressure to stop the bleeding. If the bleeding is not much, all the treatment under laceration are also applicable to incision. If otherwise, refer the victim to physician.

Puncture Wounds
    Puncture wound occurs as a result of direct penetration of the skin by pointed objects e.g, Nail, Needle, Pin. The opening of the wound may be quite small with little or no bleeding. The penetrating object may however damage underline structures and carry contaminants to the body.

    One of the first consideration in caring for puncture is to determine the depth of the penetration and the possibility of underlined damage. Only if the puncture is very minor and the penetrating object is very small with little depth of penetration. It is the first aider that would justify bynsimply cleaning the wound and observing for signs of infections.

  The majority of puncture wound should be cleaned and promptly referred to a physician and large items that remain embedded should be left in place until a physician can remove them.

Avulsion
    It is the tearing away of a part of a structure when referring to an open wound. An avulsion is tearing loose of a piece of skin which may be turn completely free or remain partially attached hanging as a flay.

    There may or may not be much bleeding. If an avulsed piece of skin or tissue of significant side is turn completely free from the person, it should be saved and transported with the person to the hospital/medical facility.

    The avulsed portion should be rapped in sterilized gauze and kept moist and cool. Occasionally, significant portion of avulsed tissue may be successfully reattached.

   When the avulsed part remain attached, the flap of skin should be placed back in its normal position before bandaging and referring to the appropriate quarters. Small flaps of skin especially in highly vascular body tissues such as the scalp and the face may remain viable and heal if replaced.

UNEXPLOSED/ CLOSED INJURIES
    Unexposed injuries are said to be internal with no associated disruption or break in the continuity of the skin. Unexposed injuries can result in massive injury (bleeding) and significant damage to underlined structure with little or no visible signs on the skin surface.

    Structures commonly involved in injuries of this type include soft tissues such as muscles, tendons, blood vessels and ligaments. Bones are also subject to unexposed injury. Unexposed injury also involve other structures such as nerves and internal organs and their linen, the common unexposed injuries are classified into Contusion, Strains, Sprains, Dislocations and Simple Fractures.

Contusion  
    A Contusion is a Bruce and it's among the most common type of injury that occurs in physical activities. Contusion usually result from a direct blow or impact delivered to some parts of the body which causes damage to underlined blood vessels.

    The resulting bleeding into the skin or subcutaneous tissues may produce symptoms that range from very minor area from discoloration to extremely large debilitating masses. The collection of blood that forms at the side of the contusion is called a hematoma.

    As the blood bleeds into the subcutaneous tissues, it often causes a blue or black discoloration known as ecchymosis. In addition to the swelling, a Bruce usually result in some areas of local tenderness.

Treatment
    The objective of the initial treatment of Contusion is to control the bleeding by means of ice, compression, elevation. Heat and activity during this initial period may encourage and promote bleeding and should be avoided.

Strains
    They are injuries involving the musculo tendonous unit and may involve the muscles, tendons and the juncture between the two and as well as their attachment to bones. Strains or pulls can be caused by various mechanisms such as over stretching, over stressing, a violent contraction against heavy resistance, a stench imbalance between Agonist and antagonist or an abnormal muscle contraction.

    These injuries are generally dynamic. That is, there's no outside intervention and the person enjoy himself/herself. The portion of the musculo tendonous unit that is damaged depends in which component is the weakest at the moment of injury.

    Generally in younger people whose bones have not ossified, the muscles and tendons are stronger. With these set of people, the attachment to the bone may fail and actually avulsed a piece of bone to the tendon or separation at the epiphysis or growth line.

    Strains are graded into three groups based on level of severity. They are mild strain, moderate and severe strains. Strain should be referred to the physician for any of the following reasons.

  • If a visible or palpable gap is noted.
  • If the person demonstrated a significant weakness
  • If there's a doubt about the status of the strain.

Sprain
    It is an injury involving a ligament. Ligaments are basically inelastic and it's designed to prevent abnormal motion at a joint. Whenever the joint is forced to move in abnormal direction, ligaments are stressed. If the ligament is forced beyond its limit, damage will occur at the weakest point of the ligament.

    The damage may be within the ligament itself or at one of its attachment. The severity of the damage depends on the amount and duration of the abnormal force. Hinge joint, those designed to function in only one direction or plane are the most frequently sprained.

    Sprains may occur dramatically. For example, the injury may be self during twisting or turning activities or getting hit on the side of the leg or landing in someone or something in the wrong way.

    Ligament sprains are among the more common injuries in athletics. They are also graded into 3 levels of severity determined by the amount of ligament damaged. As in strain, we also have mild, moderate and severe sprain.

Treatment
    Run cold water on the point of injury. You can apply ointment but do not rub or massage. After that, bind with a bondage to re-stabilize the ligament.

Dislocation
    Dislocation is the displacement of continuous surface of bone composing a joint. This type of injury refer to some forces (usually external) that cause the joint to go beyond its anatomic limit. This may occur as a result of excessive force of or from a movement from abnormal direction.

    When there's an incomplete displacement of the bone's end, the injury is called an incomplete dislocation or sub-luxation. Because ligament function to prevent displacement or abnormal motion at joint, all sprains result into some degree of sub-luxation. A complete dislocation or luxation occurs when there's a complete separation of the bone's end.

    A dislocation will either remain displaced after injury or reduce spontaneously and move back into place. All dislocations and suspected dislocation should be referred to a physician for radiograph and further evaluation.

Treatment
    Dislocation can be managed, depending on the joint involved but essentially, it's the same as that of severe sprains. Surgical intervention is sometimes required and the injured ligament must be supported and protected throughout the healing process.

    Unprotected joint may heal with increased laxity in the ligament, making the joint more vulnerable to subsequent sub-luxation and/or total dislocation.

Fracture
    It is the disruption in the continuity of bone and can range in severity from a simple crack to the severe shattering of the bone into multiple fragments. Fractures are unique injury in that, they heal with the same type of tissue that was injured and therefore regain their injured strength.

    Bones can be fractured in several ways. A direct blow may cause a break at the point of impact such as sudden kick in the lateral resulting in a fractured fibula. An indirect blow may cause a fracture away from the point of impact such as a person landing on his/her hand and breaking parts of its upper extremities like the ulna during physical activities.

    There are different types of fracture such as or ranging from greenstick fracture, simple fracture, complex fracture, greenstick simple fracture, compound fracture, multiple fracture and comminuted fracture.

Signs

  • Tenderness at the point of injury
  • Severe Pain
  • It swell up few minutes after the occurrence

Treatment
   Demobilize the part of the body and immediately make a referral to the medical doctor.






























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