The skin serves as the body’s interactive surface with the environment. As such, it is vulnerable to a variety of wounds, which differ by the type and severity of skin injury. Treatment options vary according to the nature of the lesion. Promotion of wound healing with minimal disfigurement and prevention of infection remain the goals of treatment.
Lacerations consist of cuts to the skin caused by sharp objects. Broken glass, shop tools, knives and other cutting implements commonly cause skin lacerations. In “Common Simple Emergencies,” Drs. Philip Buttaravoli and Thomas Stair explain that thorough cleansing of a laceration is of utmost importance in prevention of wound infection. Closure of lacerations may be accomplished with adhesive strips, tissue adhesive, skin staples or stitches. Choice of closure technique depends on the location, shape, size and severity of the laceration.
Puncture wounds result from forceful, deep skin penetration by slender objects. Accidentally stepping on a nail or other sharp object is a common cause of puncture wounds. MayoClinic.com points out that the penetrating object may introduce bacteria into the deep layers of the skin where they can flourish. The risk for tetanus, an infection caused by the bacterium Clostridium tentani, provokes concern because of the prevalence of the bacteria in the environment. Management of puncture wounds typically includes thorough cleansing and ensuring current tetanus vaccination. Puncture wounds associated with animal or human bites may require antibiotic treatment due to the high risk for wound and underlying bone infection. Animal bites may require rabies vaccination if the rabies status of the involved animal is unknown.
Abrasions are wounds caused by traumatic scraping and loss of skin. Falls occurring while in motion frequently lead to skin abrasions. Extensive skin loss may occur with high-speed motorcycle or similar accidents. The University of Virginia Health System advises thorough cleansing and bandaging of abrasions involving limited, superficial skin loss. Extensive or deep abrasions require more intensive treatment, which may include skin grafting for the most severe cases.
Burn injuries vary according to the depth of the burn and the amount of skin surface involved. Superficial burns are the least serious, typically healing quickly and without scarring. Deeper burns include superficial and deep partial-thickness burns. In a review article on the treatment of burns published in “American Family Physician,” Dr. Eric Morgan and colleagues report that superficial partial-thickness burns infrequently cause scarring. Deep partial-thickness burns, however, often lead to skin disfigurement. The most severe burn injuries are full-thickness burns, with complete skin destruction in the affected region. Extensive deep partial-thickness and full-thickness burns require intensive in-hospital treatment.
Ulcers are open, cavitary skin wounds caused by local skin breakdown. The Cleveland Clinic explains that poor circulation, inflammatory disorders, prolonged pressure and excessive fluid accumulation frequently precipitate skin ulcers. Chronic ulcers present a challenge due to impaired skin healing. Improvement in the underlying condition may promote skin ulcer resolution.
- American Family Physician; Essentials of Skin Laceration Repair; Randall T. Forsch, M.D., M.P.H; October 2008
- Emergency Medicine on the Web, Common Simple Emergencies: Simple Laceration
- MayoClinic.com: Puncture Wounds, First Aid
- Emergency Medicine on the Web, Common Simple Emergencies: Puncture Wounds