Traumatic Open Wounds: Let’s Define the Types

Learn the difference between the types of open wounds caused by trauma.

Traumatic open wounds involve a disruption in the integrity of the skin and underlying tissues caused by mechanical forces. In other words, these wounds are caused by brief but forceful contact with another object or surface. Types of traumatic wounds include abrasions, lacerations, avulsions, punctures, and excoriations. 

Differentiating the types of traumatic open wounds involves noting the characteristics of the tissue, as well as the nature of the mechanical force that caused it.

Below, we outline six acute, traumatic open wounds that are commonly confused.

Abrasion

Abrasions result from shearing of the skin by a rough surface. They appear as lines of scraped skin with tiny spots of bleeding.

Their size can vary from the common scraped knee to road rash over a large area of the body.

Abrasions are always partial thickness, however. You’ll see skin loss through the epidermis and sometimes into the dermis, but not through the entire dermis.

Excoriation

In a layperson’s terms, excoriation is called a scratch. It is similar to abrasion in that it is a partial thickness shearing of skin.

With excoriation, however, the erosion is even more noticeably linear (line-like) because of the mechanical force that caused it.

Light contact with cat’s claws, for example, leads to excoriation, whereas brushing or dragging the skin across a rough, flat surface such as pavement leads to abrasion.

Many clinicians mistakenly use the term excoriation to refer to denudation, which is the correct term for the loss of the epidermis that’s caused by prolonged exposure to body fluids such as urine, feces and exudate plus friction.

When assessing a case of Moisture Associated Skin Dermatitis (MASD), document the areas of erosion as denuded, not excoriated.

Skin tear

The International Skin Tear Advisory Panel (ISTAP) defines skin tears as follows:

A skin tear is a wound caused by shear, friction and/or blunt force resulting in separation of skin layers. A skin tear can be partial thickness (separation of the epidermis from the dermis) or full thickness (separation of both the epidermis and dermis from underlying structures).

Skin tears occur principally on the extremities of older adults because of changes in the skin’s structure that make it more fragile, such as flattening of the junction between the dermis and epidermis. Infants are more vulnerable to skin tears as well.

The ISTAP has developed a skin tear classification system:

• Type 1: No skin loss. Linear or flap tear that can be repositioned to cover the wound bed.
• Type 2: Partial skin loss. Partial flap loss that cannot be repositioned to cover the wound bed.
• Type 3: Total flap loss. Total flap loss exposing entire wound bed.

Because there are a reported 1.5 million instances of skin tears among patients within hospitals, long-term care facilities and other settings, there are global efforts to promote skin tear prevention within these institutions.

Efforts include recommending environmental modifications and raising awareness of the proper care for aging and immature skin.

Avulsion

A skin avulsion, also called “degloving,” occurs when tissue is not just separated but forcefully torn away from the body. It is marked by heavy, rapid bleeding and a noticeable absence of tissue.

Avulsions go deep into the subcutaneous tissue or further (muscle or bone).

The key difference between skin tears and avulsions is depth, which is directly related to the level of force applied.

WCEI Clinical Instructor Bill Richlen, PT, WCC, DWC, explains, “Skin tears can be both full or partial thickness. However, in the case of a skin tear, the full thickness ones are generally only deep enough to expose the subcutaneous tissue.”

Laceration

Lacerations are torn or jagged wounds with edges that do not readily line up. Tear lacerations tend to be caused by blunt force trauma, such as a blow, fall or collision.

A blunt injury that rips open the skin over a bony prominence, such as the scalp, is one example. There may be little or profuse bleeding and minimal or extensive tissue damage.

Puncture

Puncture wounds are caused by a sharp object that deeply penetrates the skin, such as a nail. Generally, puncture wounds are deeper than they are wide.

Typically, there’s little bleeding around the outside of the wound and more bleeding inside, causing discoloration. Puncture wounds may not seem serious but, due to the introduction of germs into the deeper layers of skin, they may easily become infected. There is also the risk that the puncturing object may break off and remain within the skin layers.  

Open wounds can mix and mingle

Note that multiple open wound types can result from a single source of trauma.

A bite from a large dog can cause a crush injury, which may lead to lacerations, puncture wounds and avulsion.

By using the correct terms for open wounds, you can communicate clearly and efficiently with your team, giving them an accurate understanding of the wound being treated.

As with any open wound, traumatic open wounds are at risk of infection. If a traumatic injury wound develops signs of infection such as drainage, odor, redness, warmth, swelling, or the patient develops fever, nausea, or chills, the patient should be evaluated by a healthcare professional. Traumatic wounds should also be evaluated by a healthcare professional if the patient is elderly, very young, immunocompromised, or at risk such as diabetic.

If you’re interested in expanding your knowledge of wound care, networking with colleagues, or seeing the latest wound care products and technology, register for the Wild on Wounds (WOW) conference September 13–16 in Hollywood, Florida.

Editor’s Note: This post was originally published in December 2019 and has been updated with new content. 

Tara Call Triplett, RN, WCC, CHFN

Tara Call Triplett has over 20 years of experience as a registered nurse and is the founder of Call to Health Communications. She is nationally certified in both wound care and heart failure. Triplett currently leads an amazing team of clinicians at an award winning outpatient wound care clinic. She has a passion for teaching and mentoring the next generation of wound care clinicians.

Lacerations: Definition, Diagnosis & Treatment | Portland Urgent Care

Lacerations are scary when they happen, especially if you do not know what to look for or how to handle a cut. Knowing what to look for and how to handle a laceration will help you to determine the correct form of treatment. Find out everything you need to know about lacerations to make the best decisions for you and your family.

What is a laceration wound?

A laceration wound refers to a skin wound without missing skin. Usually, lacerations are caused by sharp objects. These are one of the easiest medical conditions to diagnose and easy to treat. Lacerations form by tearing the soft body tissue, that is, the top layer or layers of skin. Furthermore, lacerations are irregular tear-like wounds often caused by blunt trauma. 

Puncture wounds break more than soft tissue. Lacerations can be deep, shallow, long, short, wide, and even narrow. Minor lacerations do not usually require medical assistance as they can be treated at home with proper cleaning, ointments, and bandages. Also, minor lacerations will not bleed as much as deep lacerations. 

Deeper lacerations may require stitches if they are deep, bleeding profusely, have jagged edges, or expose muscle or fat. Seek medical attention for deep lacerations, especially cuts that will not stop bleeding. Often lacerations are misused as incisions that are caused on purpose or have clearly defined edges. 

What are the signs and symptoms of a laceration?

Lacerations are easy to spot as they refer to damage to the skin. As the skin has nerves, you will feel a sharp pain from a cut. Also, the cut skin will bleed and have a visible tear in the skin when the blood is out of the way. Often you will know when a laceration happens as it involves a cut or injury. The laceration victim will often scream in pain when the accident occurs, which is the first symptom of a cut. 

How do you describe a laceration?

Describe a laceration as a defined tear in the tissue of the skin caused by either shearing or crushing force. Often, lacerations are a result of blunt trauma. A laceration can also be described as an incomplete separation of strong tissue elements such as blood vessels or nerves. Lacerations can be caused by both sharp or dull trauma.

What is the difference between a cut and a laceration?

Cuts and lacerations are often used interchangeably as both indicate damaged skin from a blunt or sharp object. However, a cut often refers to a mild laceration as cuts do not often require more than antibacterial ointment and a bandage. Lacerations may be deeper and require pressure to stop the bleeding and even stitches depending on the depth of the injury or exposure of other parts like bone, tendons, ligaments, or muscle. 

How do you treat a wound laceration?

The first step to treat laceration is to stop the bleeding with pressure and gauze or bandage. Once the wound stops bleeding, clean the area to remove all dirt and debris. Clean by running cool water over the area and then use mild soap and water if possible. Dry with a sterile cloth. 

Next, apply antibiotic ointment and cover the wound with a sterile gauze bandage and medical tape. For smaller lacerations, use a self-sticking bandage for the wound. Clean and replace bandages daily until the wound heals. For smaller cuts, you may be able to use skin closure strips. Avoid using liquid bandages for cuts without consulting a doctor first. 

For deeper lacerations, go to the doctors for stitches. If you can see anything other than the first layer of skin, you also need to go to the doctor for proper treatment. If a cut measures larger than half an inch or has a large gaping wound, it probably requires stitches. 

Moreover, the location of a wound may require stitches to stay shut, such as on a joint, face, near the eye, or in the genital area. Another indication that a laceration requires medical attention is a risk of infection or disease such as a rusty nail, a scratch or bite, or another potentially contaminated item. Finally, prolonged bleeding requires medical assistance. 

After a few days, even if treating a minor laceration, you need to look for signs of infections or complications. Look for fever, chills, redness, swelling, white or yellow pus or drainage from the wound, or worsening pain. Do not wait to see a doctor if any of these symptoms occur; seek medical attention quickly. 

Can a laceration heal without stitches?

Eventually, a laceration will heal on its own without stitches. However, stitches promote faster healing, keep the wound clean from bacteria and infection, and prevent scarring. Furthermore, stitches or staples can help to reduce blood loss and reduce future complications from the wound. Lacerations can sever toes or fingers, and these cannot heal well without stitches. 

How long does it take for a laceration to heal?

Depending on the wound, it can take up to three months for the wound to fully heal. If you require stitches, the wound can heal faster in about six to eight weeks. Minor cuts and lacerations can heal in as little as two weeks, especially if the cut is very small. 

The location of the wound can impact healing as well. If the injury is on your hand, foot, knee, or elbow, it may take longer to heal as the body part moves more often. Immobilizing and injury on these parts, while frustrating, can help the cut to heal faster. 

How can I make my laceration heal faster?

The best way to help a laceration heal faster is to take proper care of the wound. Furthermore, if the cut requires stitches, then get stitches. Most importantly, keep the wound clean to prevent infection and covered to keep out dirt and debris. Avoid an unhealthy diet and drink more water to help provide the nutrients you need to heal properly. Try to eat food rich in vitamin C and antioxidants to help heal quickly. Lastly, avoid smoking and drugs of any sort to give yourself the best chance of healing. 

How deep does a cut heal?

Lacerations heal in four stages. Stage one is stopping the bleeding, also called hemostasis. Adding pressure can help to stop blood flow as the blood clots to prevent blood loss and closes the wound by making a scab, which is stage two. At this stage, you may notice inflammation as well as that helps to heal. 

Stage three involves rebuilding or growth as oxygen-rich red blood cells move to the injury and create new tissue. The last stage is maturation or strengthening, where the wound clots and heals. At this stage, you may notice itching or tightness around pink or stretched skin. From here, the body will continue to heal until the wound is gone or left with a scar. Over time, even deep cuts will heal, but stitches will help to reduce healing time. 

How do you describe a deep laceration?

A deep laceration is a severe laceration. Describe a deep laceration by the size, size, shape, orientation, and margins. You could also describe a deep laceration as a gash as it implies a longer or deeper cut. Make sure to also describe if you can see bones, muscles, or other internal parts that should not be visible. 

What is a severe laceration?

Severe lacerations are those that require stitches, are infected, or will not stop bleeding. Deep lacerations that expose internal parts are also severe. They may extend through more layers of tissue and cause significant pain. Do not hesitate to go to a doctor for a severe laceration. While minor cuts can be cared for at home, deep or severe cuts require medical attention. 

Should I see a doctor for a laceration?

If, after applying pressure, the bleeding does not stop, then you need to see a doctor for a laceration. All severe lacerations require a doctor for treatment. Additionally, if you see signs of infection or if the laceration was caused by something that could cause infection, then seek medical attention. See a doctor also if the laceration is near the eye. Signs of shock warrant a visit to the doctors as well, including a weak pulse, clammy skin, or rapid breathing. 

Signs of the wound reopening require a visit to the doctors as well. Furthermore, look for new or unexpected symptoms such as spasms, rigidity in the muscles, or near the wound. All of these symptoms may indicate complications that require professional care. 

Why choose Portland Urgent Care for laceration treatment?

Portland Urgent Care  works with a multitude of insurance companies to serve more customers. We also use a variety of integrated medical resources by combining both western and eastern medical healthcare which allows us to serve you the way your body needs. 

We offer same-day and walk-in appointments for laceration for immediate care with the best doctors. Get a dedicated treatment plan to prevent infection and help lacerations heal quickly. From bandaging to stitches, we can do everything you need to help deal with the blood and pain to get you on the road to recovery.  

Conclusion

Mild lacerations can be treated at home with antibiotic cream and a bandage. Deeper or severe lacerations that will not stop the bleed run the risk of infection or that are deep require medical attention. When in doubt, stop by Portland Urgent Care and let us look over your wound and help decide the best form of treatment to ensure a quick and safe recovery.

For more information on injuries, see our related blogs:

Common Causes & Effects of Neck Injuries

Neck Injury Treatment

Types of Back Injuries

How Do You Know If Your Back Injury Is Serious?

Types of Ankle Injuries

Common Types & Causes of Knee Injuries

How To Treat & Recover From Knee Injuries

Wrist Ligament Injuries

Wrist Injuries Causes & Treatment

Difference Between Sprains vs Strains

traumatologist appointment in Krivoy Rog

June 13, 2021

Household injuries: treatment in Kryvyi Rih Household injuries are cases of injuries and injuries to limbs or other parts of the body at home, on the street, in the yard. Cuts, bruised limbs, torn ligaments and muscles, as well as dislocations and fractures occur everywhere, and therefore it is necessary to know how to protect yourself from injury and provide first aid if an accident occurs. We recommend that you immediately make an appointment with a traumatologist in Krivoy Rog if you get a burn, cut, bruise!

Unfortunately, one of the leaders in statistics is child injuries. The figures say that about 35% of cases are due to bruises, up to 23-24% for fall injuries, up to 20% for tissue damage with sharp objects, and about 15-18% for burns. Often, the situation is uncontrollable, since young children do not always understand what is possible and what is not, children aged 7-10 years old are extremely inquisitive, and children 11-14 years old are often unsupervised, and while playing on the street they arrange not quite deliberate competitions, they are ready to climb trees on a dare, they like to spend time at construction sites.

Hundreds and thousands of cases of falls and fractures, banal games of war games and traumatization of the eyes and face during “staging battles”. It is impossible to predict where and when grief will happen, but you can always carry out preventive work with the child in time, talk about the need to be careful, and not allow the influence of bad company.

What is domestic injury

We intersect with this concept every day, even within our own family. Getting minimal injuries, we do not pay attention to them, depending on the severity. Hitting your little finger on a table leg, cutting yourself or getting burned in the kitchen is already standard. A cry of surprise, a stingy tear, cold water to relieve pain or a piece of ice from the freezer … and that’s it. Sometimes, this is really enough, but what if the injuries are more serious? Let’s talk about them in more detail!

Ordinary domestic injuries overtake us in an apartment, a private house, in the yard during a walk or while working on our own site. We propose to conditionally divide injuries according to severity, as they are seen by all people, and not purely medical workers!

Shallow cut: treatment, first aid

Cuts on arms and legs: first aid Shallow cut with a knife or glass, damage to the skin from broken dishes when a glass or cup was crushed in the hand, cut with paper. Unpleasant, but not fatal, right? Despite this fact, first aid is needed, which will exclude infection and more complex consequences, and also help the body recover faster.

First aid for minor cuts! It is necessary to wash the wound if it is contaminated, gently blot the blood, dry the wound with a sterile bandage or gauze, and treat the edges of the cut with an antiseptic, brilliant green or iodine, preventing these funds from getting on damaged tissues. After that, you need to apply a clean bandage and stick it with a medical plaster. Contacting a doctor for bandaging and treatment control, additional manipulations, at your own discretion!

What to do if you get a deep cut

This kind of damage can happen at home, while doing repairs or cleaning your own yard. A cut with a sharp knife, a tin can, a cut with glass or a construction cutter, power tools.

Deep cuts on the arms, legs or torso are damage not only to the skin, but also to internal tissues, blood vessels and muscle fibers, ligaments and tendons. It is important to quickly stop the bleeding, for which the wound is clamped with a clean bandage and pressed. If the limb is damaged, you need to raise its top. Do not crush your arm or leg by applying a tourniquet, this often leads to additional injuries and complex consequences. It is better to immediately seek help, call an ambulance or, in case of successful stopping of bleeding, drive to a medical facility where a specialist will examine, treat the wound and perform suturing.

First aid for lacerations

Lacerations: treatment, sutures, dressingThis type of injury occurs when organic tissues come into sharp contact with objects, with the presence of additional efforts. An example would be a hand cut with a hacksaw for wood, a lacerated wound from a grinder disk at high speeds, when a person stumbles and falls on a glass container, a stack of dishes, or when he steps with his bare foot on a stone, glass.

Rupture – damage with jagged edges, of varying depth and with varying degrees of tissue damage. Up to 80% of people think so. For physicians, lacerations represent a slightly different type of damage, which is associated with rupture of the skin and mucous membranes as a result of external influences that are stronger than the ability of the tissue to stretch. Roughly speaking, the skin and subsequent tissues burst on contact with solid objects. The injury can be serious – from a puncture of the skin to damage to muscles, blood vessels and nerves.

Quickly stop the bleeding, apply a sterile dressing and go to surgery or the nearest emergency room for antiseptic treatment, cleaning and washing, excision of non-viable tissues, suturing and draining!

Puncture wounds

The complexity and severity of the injury is difficult to assess. Of course, if you prick your finger with a needle or step on a nail, the problem is understandable. But traumatologists cite numerous other cases as an example. Often, experts talk about piercing a finger with a skewer, about a more difficult puncture of a leg with a skewer when stringing meat, piercing palms. In the practice of doctors, there are cases of deep tissue damage when a person steps on or falls on a pitchfork, sits on a knife or broken glass. Deep injuries are not uncommon for builders who step on nails while roofing or laying floors.

In severe cases, call an ambulance and take the victim to the nearest medical center. Whenever possible, the objects of injury are not removed from the tissues in situ. The extraction is performed by doctors who have the opportunity to immediately stop the bleeding that has arisen, to proceed with the recovery operation, because the vessels and nerves, veins and arteries are often damaged.

Domestic injuries: video interview with a Mediton Clinic traumatologist

Cuts, lacerations and puncture wounds are only a small number of the total number of possible injuries. And in the next article, we give examples of them, based on cases of patients visiting our traumatology department.

Pay attention to the safety rules when working with power tools, be careful when decorating your own home or cleaning your summer cottage, remember to take care of yourself even during banal cooking or washing dishes. This will not protect you 100% from adverse events, but it will seriously limit them and significantly reduce the possible degree of damage in the event of negative situations!

Assistance in case of domestic injuries Book an appointment with a traumatologist in Krivoy Rog by phone (098) 530-60-40: contact center, viber. Book online through your personal account on the clinic website!

Pay attention:

Winter injuries: first aid and prevention

Treatment of burns, first aid

Treatment of sports injuries

Scratches, abrasions, cuts, lacerations – we can “get” all this even in our own apartments. And in the country, the risk grows exponentially. At the height of the season, we talk about how to properly treat wounds and when to see a doctor.

So, let’s start with when exactly you need to seek the help of specialists:

1. When a small child got hurt.

2. When bitten by animals – not only dogs, but also foxes, hedgehogs, rodents. This is very important, since the animal can be a carrier of rabies, and only timely medical care can save the victim.

3. If the wound was caused by a dirty or rusty object and you have not had a tetanus shot in the last 5 years.

4. For cuts and lacerations, if the depth of the wound is deeper or more than 1.5 cm.

5. If there is bleeding of a pulsating nature.

6. If wounds and deep cuts on the hands, face, neck, head.

7. When the blood does not stop for more than 20 minutes.

8. When there are several wounds.

9. If a high temperature has risen and persists after the injury.

10. If the victim has dizziness and nausea.

11. If there is inflammation, the wound does not heal well.

How to treat wounds

Prepare to treat the wound: wash your hands and apply hand sanitizer, alcohol solution, or an alcohol wipe.

Depending on the type of wound, the procedure may vary slightly, but in general it is as follows:

Examine the wound, determine what its nature is and how severe the damage is

· Try to stop the bleeding.

Rinse the wound with hydrogen peroxide (3%), a solution of chlorhexidine or furacilin (0.5%), or a solution of pink potassium permanganate (it must be filtered through gauze). Dry the wound with a tissue.

· Treat the skin around the wound with an antiseptic and apply a sterile bandage. Afterwards, do not forget to do dressings.

Make a decision about the need to see a doctor. Take a pain reliever if necessary.

Almost all “household” wounds are dirty, so it is very important to clean the wound, if possible, without touching it with your hands. A clean wound will heal faster and help avoid complications.

Only the edges of the wound need to be treated. You can not pour alcohol, iodine, brilliant green, etc.