Wounds

A wound is any damage or injury to the body. Sarah's Story

Sarah's Story

What Are Wounds?

A wound, also called an injury, is any damage to the body. It is a general term that refers to harm caused by accidents, falls, hits, and weapons. In general, wounds are injuries that break the skin and include cuts (e.g., lacerations), abrasions (e.g., scrapes), punctures, and bruises. Wounds can be described as open or closed. In an open wound, the skin is broken and open to the air and possible contaminants. In a closed wound, the skin has not been broken, and the injury is under the skin. Some common wounds include:

How Common Are Wounds?




Examples of open wounds.





Examples of open wounds.
Illustration by Electronic Illustrators Group. © 2016 Cengage Learning®.

Wounds can be intentional (i.e., caused by someone wanting to inflict injury) or unintentional (i.e., happen by accident).

* from motor vehicle accidents (a motor vehicle is any vehicle that has a motor including cars, trucks, motorcycles, motorized bicycles, and scooters). The Centers for Disease Control and Prevention reports that there were 31 million visits to hospital emergency departments for unintentional injuries in 2011.

Did You Know?

Unintentional injuries are the fourth-leading cause of death in the United States, accounting for 93,200 deaths in the home and community in 2013, including 29,500 deaths from falls and 33,804 deaths in motor vehicle accidents.

What Causes Wounds?

Causes of wounds include falls, motor vehicle accidents, and accidents that can occur in the home, at work, at play, indoors, outdoors, and in any activity a person participates in such as sports, walking, dancing, bicycling, and running.

Who Is at Risk for Wounds?

Children are at risk for wounds because of their daily activities in play and sports. People who participate in high-risk activities are also at risk for wounds or injuries. The elderly are at increased risk for falls and therefore are at risk for fall-related wounds.

What Are the Signs of Wounds?

The most common signs of a laceration, abrasion, or puncture wound are broken skin and bleeding. There may be pain associated with the wound, and it may be uncomfortable to move the affected area.

Signs of a bruise are the bluish discoloration of the skin overlying the bruised area and pain and swelling in the bruised area. A deep bruise may affect mobility of the area. For example, if the elbow has been bruised, it may be difficult to bend the elbow.

How Are Wounds Diagnosed and Treated?

Diagnosis

The healthcare provider obtains a health history from the person asking specific questions about how the injury occurred, how long ago the injury occurred, any associated signs or symptoms (e.g., pain, difficulty moving the area), and what has already been done for the wound. The healthcare provider also confirms the person's immunization * history to ensure that the person is protected against tetanus * . An examination is done to determine if the wound is clean, contaminated, or dirty:

If the wound is superficial, that is, it does not penetrate deeply to involve any body organs, x-rays and other diagnostic studies are not necessary. If the person shows any signs of difficulty breathing, hemorrhagic shock, or other serious injury, appropriate diagnostic studies are done to determine the source of the problem in order to plan treatment.

In the case of a bruise, the healthcare provider ensures that the pressure of blood collecting under the skin is not interfering with normal function.

Treatment

Many minor wounds can be treated without contacting a healthcare professional. Proper cleaning, application of an antibacterial * ointment, and application of a bandage usually result in healing. If infection * appears to be present in the wound (e.g., redness surrounding the wound, pus draining from the wound), the person should seek professional medical attention immediately.

The healthcare provider puts on a mask prior to treating the wound to prevent breathing into the wound; breathing into the wound could cause contamination.

For minor cuts or abrasions, the injury is washed thoroughly with a mild soap and water. Direct pressure is applied to stop any bleeding. Antibacterial ointment is applied, and the wound is bandaged with material that will not stick to the wound. When the laceration is long or jagged and the edges of the wound do not come together naturally, the healthcare provider has several options to close the wound. First, the wound is cleaned thoroughly. Then one of the following wound closure techniques is performed:

Whichever of these methods is used, the wound is then bandaged with material that will not stick to the wound.

For puncture wounds, the puncture and surrounding area are rinsed under running water for five minutes and then washed with soap and antibacterial solution. Any objects still in the wound are removed because they could be a source of infection. Antibacterial ointment is applied, and the wound bandaged with a nonstick dressing.




Wound healing takes place in four distinct phases from stopping the bleeding (Bleeding) to the immune system attack on any contaminating debris or germs (Inflammatory) to producing new skin and tissue cells





Wound healing takes place in four distinct phases from stopping the bleeding (Bleeding) to the immune system attack on any contaminating debris or germs (Inflammatory) to producing new skin and tissue cells (Proliferative) and finally to building toward the original strength and flexibility of the skin (Remodeling).

If the person has not had a tetanus immunization booster within the last 10 years, a tetanus shot is given. The person is instructed to keep the wound clean and dry and to monitor for any signs of infection. Signs of infection include redness and swelling around the wound site, pus coming from the wound, pain, and sometimes fever. If infection occurs, the healthcare provider may prescribe antibiotic medication.

Bruises usually heal on their own in a week to 10 days. During the healing process, the bruise will change through many colors starting with blue and purple and ending with greenish yellow.

Can Wounds Be Prevented?

Wounds can be prevented by taking safety precautions and wearing protective gear (e.g., pads, helmets) when participating in sports, play, or occupations where injury can occur. The following are some prevention strategies:

See also Abscesses • Bites and Stings • Bruises • Burns • Child Abuse • Skin and Soft Tissue Infections • Trauma

Resources

Books and Articles

Piazza, Gina M., ed. American College of Emergency Physicians First Aid Manual. 5th ed. New York: DK, 2014.

Websites

American College of Emergency Physicians. “Emergencies A to Z: Cuts and Abrasions.” http://www.emergencycareforyou.org/Content.aspx?id=228 (accessed April 15, 2016).

American College of Foot and Ankle Surgeons. “Puncture Wounds.” http://www.foothealthfacts.org/footankleinfo/puncture-wounds.htm (accessed April 15, 2016).

Centers for Disease Control and Prevention. “FastStats: Accidents or Unintentional Injuries.” http://www.cdc.gov/nchs/fastats/accidental-injury.htm (accessed April 15, 2016).

MedlinePlus. “Cuts and Puncture Wounds.” U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000043.htm (accessed April 15, 2016).

MedlinePlus. “Wounds and Injuries.” U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/woundsandinjuries.html (accessed April 15, 2016).

Organizations

Centers for Disease Control and Prevention. 1600 Clifton Rd., Atlanta, GA 30329-4027. Toll-free: 800-232-4636. Website: http://www.cdc.gov/ (accessed April 15, 2016).

National Safety Council. 1121 Spring Lake Dr., Itasca, IL 60143-3201. Toll-free: 800-621-7615, 800-621-7619. Website: http://www.nsc.org (accessed April 15, 2016).

* trauma is a wound or injury, whether psychological or physical. Psychological trauma refers to an emotional shock that leads to lasting psychological damage.

* immunization (ih-MYOON-uhzay-shun) is giving, usually by an injection, a preparation of killed or weakened germs, or a part of a germ or product it produces, to prevent or lessen the severity of the disease caused by that germ. Also called vaccination.

* tetanus (TET-nus) is a serious bacterial infection that affects the body's central nervous system.

* antibacterial (an-tie-bak-TEERee-al) refers to any substance that kills or prevents the growth of bacteria, such as an ointment, drug, or other medication.

* infection (in-FEK-shun) is the invasion and proliferation of microorganisms in the body, including bacteria, viruses, or parasites.

  This information is not a tool for self-diagnosis or a substitute for professional care.