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Wound
A wound is any disruption of or damage to living tissue, such as skin, mucous membranes, or organs. Wounds can either be the sudden result of direct trauma (mechanical, thermal, chemical), or can develop slowly over time due to underlying disease processes such as diabetes mellitus, venous/arterial insufficiency, or immunologic disease. Wounds can vary greatly in their appearance depending on wound location, injury mechanism, depth of injury, timing of onset ( acute vs chronic), and wound sterility, among other factors. Treatment strategies for wounds will vary based on the classification of the wound, therefore it is essential that wounds be thoroughly evaluated by a healthcare professional for proper management. In normal physiology, all wounds will undergo a series of steps collectively known as the wound healing process, which include hemostasis, inflammation, proliferation, and tissue remodeling. Age, tissue oxygenation, stress, underlying medical conditions, and certain m ...
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Wound Healing
Wound healing refers to a living organism's replacement of destroyed or damaged tissue by newly produced tissue. In undamaged skin, the epidermis (surface, epithelial layer) and dermis (deeper, connective layer) form a protective barrier against the external environment. When the barrier is broken, a regulated sequence of biochemical events is set into motion to repair the damage. This process is divided into predictable phases: blood clotting (hemostasis), inflammation, tissue growth ( cell proliferation), and tissue remodeling (maturation and cell differentiation). Blood clotting may be considered to be part of the inflammation stage instead of a separate stage. The wound-healing process is not only complex but fragile, and it is susceptible to interruption or failure leading to the formation of non-healing chronic wounds. Factors that contribute to non-healing chronic wounds are diabetes, venous or arterial disease, infection, and metabolic deficiencies of old age.Enoch, ...
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Ballistic Trauma
A gunshot wound (GSW) is a penetrating trauma, penetrating injury caused by a projectile (e.g. a bullet) Shooting, shot from a gun (typically a firearm). Damage may include bleeding, bone fractures, organ (anatomy), organ damage, wound infection, and Plegia, loss of the ability to move part of the body. Damage depends on the part of the body hit, the path the bullet follows through (or into) the body, and the type and speed of the bullet. In severe cases, although not uncommon, the injury is Death, fatal. Long-term complications can include bowel obstruction, failure to thrive, neurogenic bladder and paralysis, recurrent cardiorespiratory distress and pneumothorax, hypoxic brain injury leading to early dementia, amputations, chronic pain and pain with light touch (hyperalgesia), deep venous thrombosis with pulmonary embolus, limb swelling and Debility (medical), debility, and lead poisoning. Factors that determine rates of gun violence vary by country. These factors may include ...
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Scar
A scar (or scar tissue) is an area of fibrosis, fibrous tissue that replaces normal skin after an injury. Scars result from the biological process of wound repair in the skin, as well as in other Organ (anatomy), organs, and biological tissue, tissues of the body. Thus, scarring is a natural part of the healing process. With the exception of very minor lesions, every wound (e.g., after accident, disease, or surgery) results in some degree of scarring. An exception to this are animals with complete Regeneration (biology), regeneration, which regrow tissue without scar formation. Scar tissue is composed of the same protein (collagen) as the tissue that it replaces, but the fiber composition of the protein is different; instead of a random basketweave formation of the collagen fibers found in normal tissue, in fibrosis the collagen cross-links and forms a pronounced alignment in a single direction. This collagen scar tissue alignment is usually of inferior functional quality to the ...
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Penetrating Trauma
Penetrating trauma is an open wound injury that occurs when an object pierces the Human skin, skin and enters a tissue (biology), tissue of the body, creating a deep but relatively narrow entry wound. In contrast, a blunt trauma, blunt or ''non-penetrating'' trauma may have some deep damage, but the overlying skin is not necessarily broken and the wound is still closed to the outside environment. The penetrating object may foreign body, remain in the tissues, come back out the path it entered, or pass through the full thickness of the tissues and exit from another area. A penetrating injury in which an object enters the body or a structure and passes all the way through an exit wound is called a perforating trauma, while the term ''penetrating trauma'' implies that the object does not perforate wholly through. In gunshot wounds, perforating trauma is associated with an entrance wound and an often larger exit wound. Penetrating trauma can be caused by a foreign object or by fragm ...
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Puncture Wound
Penetrating trauma is an open wound injury that occurs when an object pierces the skin and enters a tissue of the body, creating a deep but relatively narrow entry wound. In contrast, a blunt or ''non-penetrating'' trauma may have some deep damage, but the overlying skin is not necessarily broken and the wound is still closed to the outside environment. The penetrating object may remain in the tissues, come back out the path it entered, or pass through the full thickness of the tissues and exit from another area. A penetrating injury in which an object enters the body or a structure and passes all the way through an exit wound is called a perforating trauma, while the term ''penetrating trauma'' implies that the object does not perforate wholly through. In gunshot wounds, perforating trauma is associated with an entrance wound and an often larger exit wound. Penetrating trauma can be caused by a foreign object or by fragments of a broken bone. Usually occurring in violent ...
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Splinter
A splinter (also known as a sliver) is a fragment of a larger object, or a foreign body that penetrates or is purposely injected into a body. The foreign body must be lodged inside tissue to be considered a splinter. Splinters may cause initial pain through ripping of flesh and muscle, or infection through bacteria on the foreign object. Splinters are primarily made of wood, but there are many other types, for example, other common types of splinters are, hair, glass, plastic, metal, and spines of animals. As with any wound that breaks the skin, splinters can lead to infection, which if left untreated could develop into more serious complications. If a splinter is in the body for more than 2–3 days, or if the wound shows signs of inflammation or tenderness (whether the splinter was removed or not), advice should be sought from a doctor. Getting a splinter Generally, a splinter causes an initial feeling of pain as the sharp object makes its initial penetration through th ...
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International Red Cross Wound Classification System
The International Red Cross wound classification system is a system whereby certain features of a wound are scored: the size of the skin wound(s); whether there is a cavity, fracture or vital structure injured; the presence or absence of metallic foreign bodies. A numerical value is given to each feature (E, X, C, F, V, and M). The scores can later be graded according to severity and typed according to the structures injured. This scoring system is intended for quick and easy use in the field. Wounds are scored after surgery or initial assessment. *E = (Entry) centimetres. Estimate the maximum diameter of the entry. *X = (eXit) centimetres. Estimate the maximum diameter of the exit (X = 0 if no exit). *C = (Cavity) Can the "cavity" of the wound take 2 fingers before surgery? No: C=0, Yes: C=1. :This may be obvious before operation or only established after skin incision. For chest and abdominal wounds it refers to the wound of the chest or abdominal wall. *F = (Fracture) No ...
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Gustilo Open Fracture Classification
The Gustilo open fracture classification system is the most commonly used classification system for open fractures. It was created by Ramón Gustilo and Anderson, and then further expanded by Gustilo, Mendoza, and Williams. This system uses the amount of energy, the extent of soft-tissue injury and the extent of contamination for determination of fracture severity. Progression from grade 1 to 3C implies a higher degree of energy involved in the injury, higher soft tissue and bone damage and higher potential for complications. It is important to recognize that a Gustilo score of grade 3C implies vascular injury as well as bone and connective-tissue damage. Classification Reliability There are many discussions regarding the inter-observer reliability of this classification system. Different studies have shown inter-observer reliability of approximately 60% (ranging from 42% to 92%), representing poor-to-moderate agreement of scale grading between health-care professionals. T ...
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Hemostasis
In biology, hemostasis or haemostasis is a process to prevent and stop bleeding, meaning to keep blood within a damaged blood vessel (the opposite of hemostasis is hemorrhage). It is the first stage of wound healing. Hemostasis involves three major steps: * vasoconstriction * temporary blockage of a hole in a damaged blood vessel by a platelet plug * blood coagulation (formation of fibrin clots) Coagulation, the changing of blood from a liquid to a gel which forms the fibrin clots, is essential to hemostasis. Intact blood vessels moderate blood's tendency to form clots. The endothelial cells of intact vessels prevent blood clotting with a heparin-like molecule and thrombomodulin, and prevent platelet aggregation with nitric oxide and prostacyclin. When endothelium of a blood vessel is damaged, the endothelial cells stop secretion of coagulation and aggregation inhibitors and instead secrete von Willebrand factor, which initiates the maintenance of hemostasis after in ...
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Abrasion (medical)
An abrasion is a partial thickness wound caused by damage to the skin. It can be superficial, which involves only the epidermis, or deep, which involves the deep dermis. Abrasions usually involve minimal bleeding.McCurnin, D.M. & Bassert, J. M. (2010) Clinical Textbook for Veterinary Technicians. 7th Edition. St. Louis, MO: Saunders Elsevier. pg 1243-1244 Mild abrasions, also known as ''grazes'' or ''scrapes'', do not scar or bleed because the dermis is left intact, but deep abrasions that disrupt the normal dermal structures may lead to the formation of scar tissue. A more traumatic abrasion that removes all layers of skin is called an avulsion. Abrasion injuries most commonly occur when exposed skin comes into moving contact with a rough surface, causing a grinding or rubbing away of the upper layers of the epidermis. By degree * A first-degree abrasion involves only epidermal injury. * A second-degree abrasion involves the epidermis as well as the dermis and may bleed ...
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Amputation
Amputation is the removal of a Limb (anatomy), limb or other body part by Physical trauma, trauma, medical illness, or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as cancer, malignancy or gangrene. In some cases, it is carried out on individuals as a Preventive healthcare, preventive surgery for such problems. A special case is that of congenital amputation, a congenital disorder, where fetus, fetal limbs have been cut off by constrictive bands. In some countries, judicial amputation is currently used punishment, to punish people who commit crimes. Amputation has also been used as a tactic in war and acts of terrorism; it may also occur as a war injury. In some cultures and religions, minor amputations or mutilations are considered a ritual accomplishment. When done by a person, the person executing the amputation is an amputator. The oldest evidence of this practice comes from a skeleton found buried in Liang Tebo c ...
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Skin
Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other animal coverings, such as the arthropod exoskeleton, have different developmental origin, structure and chemical composition. The adjective cutaneous means "of the skin" (from Latin ''cutis'' 'skin'). In mammals, the skin is an organ of the integumentary system made up of multiple layers of ectodermal tissue and guards the underlying muscles, bones, ligaments, and internal organs. Skin of a different nature exists in amphibians, reptiles, and birds. Skin (including cutaneous and subcutaneous tissues) plays crucial roles in formation, structure, and function of extraskeletal apparatus such as horns of bovids (e.g., cattle) and rhinos, cervids' antlers, giraffids' ossicones, armadillos' osteoderm, and os penis/ os clitoris. All mammals have some hair on their skin, even marine mammals like whales, ...
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