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Wounding
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 me ...
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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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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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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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Emergency Medicine
Emergency medicine is the medical specialty concerned with the care of illnesses or injuries requiring immediate medical attention. Emergency physicians (or "ER doctors") specialize in providing care for unscheduled and undifferentiated patients of all ages. As frontline providers, in coordination with emergency medical services, they are responsible for initiating resuscitation, stabilization, and early interventions during the acute phase of a medical condition. Emergency physicians generally practice in hospital emergency departments, pre-hospital settings via emergency medical services, and intensive care units. Still, they may also work in primary care settings such as urgent care clinics. Sub-specialties of emergency medicine include disaster medicine, medical toxicology, point-of-care ultrasonography, critical care medicine, emergency medical services, hyperbaric medicine, sports medicine, palliative care, or aerospace medicine. Various models for emerg ...
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Asphalt Concrete
Asphalt concrete (commonly called asphalt, blacktop, or pavement in North America, and Tarmacadam, tarmac or bitumen macadam in the United Kingdom and the Republic of Ireland) is a composite material commonly used to surface road surface, roads, parking lots, airports, and the core of embankment dams. Asphalt mixtures have been used in pavement construction since the nineteenth century. It consists of Construction aggregate, mineral aggregate Binder (material), bound together with bitumen (a substance also independently known as asphalt, Pitch (resin), pitch, or tar), laid in layers, and compacted. The American English terms ''asphalt'' (or ''asphaltic'') ''concrete'', ''bituminous asphalt concrete'', and ''bituminous mixture'' are typically used only in engineering and construction documents, which define concrete as any composite material composed of mineral aggregate adhered with a binder. The abbreviation, ''AC'', is sometimes used for ''asphalt concrete'' but can also denot ...
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Blood Vessel
Blood vessels are the tubular structures of a circulatory system that transport blood throughout many Animal, animals’ bodies. Blood vessels transport blood cells, nutrients, and oxygen to most of the Tissue (biology), tissues of a Body (biology), body. They also take waste and carbon dioxide away from the tissues. Some tissues such as cartilage, epithelium, and the lens (anatomy), lens and cornea of the eye are not supplied with blood vessels and are termed ''avascular''. There are five types of blood vessels: the arteries, which carry the blood away from the heart; the arterioles; the capillaries, where the exchange of water and chemicals between the blood and the tissues occurs; the venules; and the veins, which carry blood from the capillaries back towards the heart. The word ''vascular'', is derived from the Latin ''vas'', meaning ''vessel'', and is mostly used in relation to blood vessels. Etymology * artery – late Middle English; from Latin ''arteria'', from Gree ...
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Hematoma
A hematoma, also spelled haematoma, or blood suffusion is a localized bleeding outside of blood vessels, due to either disease or trauma including injury or surgery and may involve blood continuing to seep from broken capillaries. A hematoma is benign and is initially in liquid form spread among the tissues including in sacs between tissues where it may coagulate and solidify before blood is reabsorbed into blood vessels. An ecchymosis is a hematoma of the skin larger than 10 mm. They may occur among and or within many areas such as skin and other organs, connective tissues, bone, joints and muscle. A collection of blood (or even a hemorrhage) may be aggravated by anticoagulant medication (blood thinner). Blood seepage and collection of blood may occur if heparin is given via an intramuscular route; to avoid this, heparin must be given intravenously or subcutaneously. Signs and symptoms Some hematomas are visible under the surface of the skin (commonly called bruise ...
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Bullet
A bullet is a kinetic projectile, a component of firearm ammunition that is shot from a gun barrel. They are made of a variety of materials, such as copper, lead, steel, polymer, rubber and even wax; and are made in various shapes and constructions (depending on the intended applications), including specialized functions such as hunting, target shooting, training, and combat. Bullets are often tapered, making them more aerodynamic. Bullet size is expressed by weight and diameter (referred to as "caliber") in both imperial and metric measurement systems. Bullets do not normally contain explosives but strike or damage the intended target by transferring kinetic energy upon impact and penetration. Description The term ''bullet'' is from Early French, originating as the diminutive of the word ''boulle'' (''boullet''), which means "small ball". Bullets are available singly (as in muzzle-loading and cap and ball firearms) but are more often packaged with propellant as a cartri ...
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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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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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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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Degloving
Degloving occurs when skin and the fat below it, the subcutaneous tissue, are torn away from the underlying anatomical structures they are normally attached to. Normally the subcutaneous tissue layer is attached to the fibrous layer that covers muscles known as deep fascia. A degloving injury is a type of soft-tissue avulsion injury that can occur anywhere in the body. Commonly affected areas include the face, scalp, trunk, limbs, and genitalia. Degloving injuries are caused by shearing forces that cause the soft tissue layers to get pulled apart. They were first reported in the twentieth century from machinery such as a wringers used to dry clothes. The invention and widespread use of automobiles also lead to degloving and other traumatic injuries. Degloving injuries can be categorized as either open or closed. Closed injuries are not open to the external world and the underlying structures are not visible. In open injuries, the skin is torn back so that the underlying struc ...
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