A wound is an injury that typically causes a break in the integrity of the skin. The skin is the body's first protection against infection. When there is a break in the skin, there is an increased risk of infection. Certain wounds have a higher potential for infections. The goal in wound management is to restore function, repair skin integrity and minimize infection.
Laceration
Lacerations are open wounds usually caused from sharp or blunt trauma to the skin. Depending on the depth of the laceration, the wound may be managed with pressure and a bandage dressing, or it may require stitches or skin glue. The first thing to do for a laceration is to control the bleeding by applying direct pressure. If the laceration is on an extremity, elevating the extremity will help to control the bleeding.
Abrasions
The text "Emergency Nursing Core Curriculum" describes an abrasion as an injury similar to a burn. The skin is scraped or worn away. Abrasions are most commonly caused from falls, scrapes or cycling accidents. Abrasions are painful and require meticulous care to remove any imbedded debris. If debris is not removed from the wound, during the healing process the wound will have a tattooing effect from the imbedded debris.
Avulsions
Avulsions are wounds where there is full-thickness loss of skin to a specific area. This means there are no skin edges to pull back together for closing the wound. Small avulsions may heal by themselves, but larger avulsed areas may require skin grafting.
Puncture Wounds
Puncture wounds occur when the skin is penetrated by a sharp or blunt object. Common causes of puncture wounds result from stepping on nails, needles or broken glass. Puncture wounds have a higher incidence of infection because they tend to have less bleeding and they seal themselves off. A puncture wound that occurs near a joint can lead to serious bacterial infection within the joint, states "Emergency Nursing Core Curriculum."
Penetrating Wounds
Wounds that are called penetrating may occur from stab wounds, gunshot wounds or other high pressure devices such as a nail gun. Penetrating wounds can cause injuries to other underlying structures. If bone is shattered from a bullet, the pieces of bone can scatter and injure surrounding tissue and organs.
Bite Wounds
Bite wounds may consist of both puncture and laceration type injury to the skin. "Clinical Practice of Emergency Medicine" indicates that the most frequent complication from bite wounds is infection. It is also noted that closure of human bites and cat bites is not recommended because of the high risk of infection. The primary closure of dog bites is controversial at this time, according to "Clinical Practice of Emergency Medicine."
Amputation
An amputation is a wound where there is loss of a body part. Fingers are frequently amputated when working with a table saw. When an amputation occurs, direct pressure should be applied to control the bleeding for the patient. If the amputated body part can be found, it should be placed in a plastic bag, and the bag can be placed on ice to be brought to the hospital with the patient.
References
- "Emergency Nursing Core Curriculum"; Kathleen Sanders Jordan RN, MS (Editor); 2007
- "Clinical Practice of Emergency Medicine"; Allan B. Wolfson (Editor); 2010
