Cuts and puncture wounds: MedlinePlus Medical Encyclopedia

A cut is a break or opening in the skin. It is also called a laceration. A cut may be deep, smooth, or jagged. It may be near the surface of the skin, or deeper. A deep cut can affect tendons, muscles, ligaments, nerves, blood vessels, or bone.

A puncture is a wound made by a pointed object such as a nail, knife, or sharp tooth. Puncture wounds often appear to be on the surface, but may extend into the deeper tissue layers.

Symptoms include:

• 
  Bleeding
• Problems with function (movement) or feeling (numbness, tingling) below the wound site
• Pain

Infection may occur with some cuts and puncture wounds. The following are more likely to become infected:

• Bites
• Punctures
• Crush injuries
• Dirty wounds
• Wounds on the feet
• Wounds that are not promptly treated

If the wound is bleeding severely, call your local emergency number, such as 911.

Minor cuts and puncture wounds can be treated at home. Prompt first aid can help prevent infection and thereby speed healing and reduce the amount of scarring.

Take the following steps:

FOR MINOR CUTS

• Wash your hands with soap or antibacterial cleanser to prevent infection.
• Then, wash the cut thoroughly with mild soap and water.
• Use direct pressure to stop the bleeding.
• Apply antibacterial ointment and a clean bandage that will not stick to the wound.

FOR MINOR PUNCTURES

• Wash your hands with soap or antibacterial cleanser to prevent infection.
• Rinse the puncture for 5 minutes under running water. Then wash with soap.
• Look (but do not poke around) for objects inside the wound. If found, don’t remove them. Go to your emergency or urgent care center.
• If you can’t see anything inside the wound, but a piece of the object that caused the injury is missing, also seek medical attention.
• Apply antibacterial ointment and a clean bandage that will not stick to the wound.

• DO NOT assume that a minor wound is clean because you can’t see dirt or debris inside. Always wash it.
• DO NOT breathe on an open wound.
• DO NOT try to clean a major wound, especially after the bleeding is under control.
• DO NOT remove a long or deeply stuck object. Seek medical attention.
• DO NOT push or pick debris from a wound. Seek medical attention.
• DO NOT push body parts back in. Cover them with clean material until medical help arrives.

Call 911 or your local emergency number if:

• The bleeding is severe or cannot be stopped (for example, after 10 minutes of pressure).
• The person cannot feel the injured area, or it doesn’t work right.
• The person is otherwise seriously injured.

Call your health care provider right away if:

• The wound is large or deep, even if the bleeding is not severe.
• The wound is more than a quarter inch (.64 centimeter) deep, on the face, or reaching the bone. Stitches may be needed.
• The person has been bitten by a human or animal.
• A cut or puncture is caused by a fishhook or rusty object.
• You step on a nail or other similar object.
• An object or debris is stuck. Do not remove it yourself.
• The wound shows signs of infection such as warmth and redness in the area, a painful or throbbing sensation, fever, swelling, a red streak extending from the wound, or pus-like drainage.
• You have not had a tetanus shot within the last 10 years.

Keep knives, scissors, sharp objects, firearms, and fragile items out of the reach of children. When children are old enough, teach them to how to use knives, scissors, and other tools safely.

Make sure you and your child are up to date on vaccinations. A tetanus vaccine is generally recommended every 10 years.

Wound – cut or puncture; Open wound; Laceration; Puncture wound

• First aid kit
• Laceration versus puncture wound
• Stitches
• Snake bite
• Minor cut – first aid

Ball JW, Dains JE, Flynn JA, Solomom BS, Stewart RW. Skin, hair, and nails. In: Ball JW, Dains JE, Flynn JA, Solomom BS, Stewart RW, eds. Seidel’s Guide to Physical Examination. 9th ed. . St Louis, MO: Elsevier; 2019:chap 9.

Lammers RL, Aldy KN. Principles of wound management. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges’ Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 34.

Simon BC, Hern HG. Wound management principles. In: Walls RM, Hockberger RS, Gausche-Hill M, eds, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 52.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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

Gastric and duodenal ulcer — diagnosis and treatment at SM-Clinic

This disease is treated by Gastroenterologist
, Surgeon

• What is a stomach ulcer?
• Classification
• Symptoms and manifestations of gastric ulcer
• Causes of stomach ulcers
• Diagnosis of gastric and duodenal ulcer
• Treatment of gastric and duodenal ulcers
• Surgical treatment
• Rehabilitation for gastric ulcer
• Prevention of stomach ulcers
• Doctors

Classification

There is no generally accepted classification of peptic ulcer. Depending on the presence or absence of H. pylori infection, ulcers are distinguished, associated and not associated with H. pylori infection. The latter form is sometimes also called idiopathic.

PUD is also distinguished as an independent disease (essential peptic ulcer) and symptomatic ulcers of the stomach and duodenum (medicated, “stress”, with endocrine pathology, with other chronic diseases of internal organs), which occur against the background of other diseases and according to the mechanisms of their development associated with specific etiological and pathogenetic factors.

Depending on the location, gastric ulcers (cardiac and subcardiac, gastric body, antrum, pyloric canal), duodenal ulcers (bulb, postbulbar region, as well as combined gastric and duodenal ulcers) are distinguished. In this case, ulcers can be located on the small or greater curvature, anterior and posterior walls of the stomach and duodenum.

According to the number of ulcerative lesions, single and multiple ulcers are distinguished, and depending on the size of the ulcer defect, ulcers of small (up to 0. 5 cm in diameter) and medium (0.6-1.9 cm in diameter) sizes, large (2 .0 – 3.0 cm in diameter) and giant (over 3.0 cm in diameter) ulcers.

Symptoms and manifestations of gastric ulcer

The disease proceeds differently during periods of remission and exacerbation. Basically, the signs of a stomach and duodenal ulcer are as follows:

• Pain sensations of aching or cramping nature, can also be of low intensity. Mostly they make themselves felt on an empty stomach or immediately after a meal.
• Persistent heartburn, which is especially pronounced at night and in the morning.
• Sensation of nausea.
• Belching that tastes bitter or sour.
• Feeling of heaviness in the stomach and rapid filling.
• Coffee grounds vomiting and black stools – observed when bleeding from ulcers.
• Decreased appetite.
• Very sharp, severe pain in the abdomen or behind the sternum, nausea with vomiting, pain when the abdominal muscles are tense – such symptoms are characteristic of perforated ulcers.

Causes of stomach ulcers

The main causes of the disease are stomach damage by infection with Helicobacter pylori bacteria, as well as long-term use of medications that have an ulcerogenic (provoking the appearance of ulcers) effect. The secondary causes of the onset of the disease include:

• disturbed diet;
• stressful situations and severe emotional strain;
• drinking alcohol and smoking tobacco;
• hypovitaminosis;
• genetic predisposition to develop the disease;
• metabolic disorders in the body.

Get advice

If you experience these symptoms, we recommend that you make an appointment with your doctor. Timely consultation will prevent negative consequences for your health.

You can find out more about the disease, prices for treatment and sign up for a consultation with a specialist by phone:

+7 (495) 292-39-72

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Why SM-Clinic?

1

Treatment is carried out in accordance with clinical recommendations

2

Comprehensive assessment of the nature of the disease and treatment prognosis

3

Modern diagnostic equipment and own laboratory

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High level of service and balanced pricing policy

Diagnosis of gastric and duodenal ulcer

The earlier the disease is diagnosed, the higher the likelihood of its successful treatment with conservative methods.

If symptoms of the disease are detected, it is recommended to perform:

• Esophagogastroduodenoscopy (gastroscopy). This diagnostic method will allow you to determine the ulcerative defect, also draw a conclusion about its depth and location, and take tissue for research (biopsy).
• Radiography or CT. Another method for determining the expressed expression.
• Urease breath test with urea. Blood study. Study of feces. Needed to determine the presence of H.Pylori infection.
• General and biochemical blood test. Helps identify signs of anemia.

Treatment of gastric ulcer in “SM-Clinic”

The specific method of treatment is prescribed only by the doctor after the diagnosis. In the case of diagnosing the disease at an early stage, there is a possibility of successful medical treatment of stomach ulcers. It is aimed at healing ulcers by taking special drugs that reduce the acidity of gastric juice and destroy Helicobacter pylori bacteria. Also, the doctor will recommend a diet, which generally boils down to: the rejection of products that contribute to the production of gastric juice and irritation of the walls of the stomach. You will also have to give up fatty foods, spicy and salty foods and replace them with steamed or boiled foods.

With the development of complications, such as a malignant tumor, pyloric stenosis, bleeding, perforation of the ulcer, surgical treatment of a stomach ulcer is prescribed. In this case, the stomach ulcer is removed or sutured, bleeding stops, and measures are taken to expand the digestive tube.

Also, surgery is mandatory when a malignant tumor is detected. Treatment can be successful if the tumor has not affected all layers of the stomach, has not spread to neighboring organs. The success of treatment directly depends on the early diagnosis of the disease.

Surgical treatment

Despite the success of conservative therapy of peptic ulcer, in 10-15% of patients it is not possible to achieve stable remission. It is believed that if 3-4 times drug treatment in a hospital does not lead to a stable remission, then the question of surgical treatment should be raised.

Surgery is also indicated for advanced forms or complicated course of peptic ulcer (ulcer perforation, profuse gastrointestinal bleeding, stenosis, etc.).

SM-Clinic performs all types of operations, both radical and organ-containing. The main method of surgical treatment of gastric ulcer and duodenal ulcer is gastric resection – surgical removal of the affected area of ​​the stomach.

Gastric ulcer: diagnosis and treatment

Rehabilitation for gastric ulcer

A specific method of treatment is prescribed only by a doctor after diagnosis. In the case of diagnosing the disease at an early stage, there is a possibility that rehabilitation is carried out according to the following program:

• adherence to a specially designed diet as directed by a doctor;
• medical treatment;
• annual dispensary observation for 5 years since the last exacerbation.

Prevention of stomach ulcers

The main preventive measure is the prevention of infection with Helicobacter pylori infection. It is also recommended:

• Periodic full body examinations to detect the disease at an early stage;
• in the presence of peptic ulcer in relatives or with a diagnosis of peptic ulcer of a past illness, it is necessary to take a test for H. pylori bacteria;
• refuse or minimize alcohol intake, smoking;
• lead a healthy lifestyle – adhere to the daily routine, give the body physical activity, get enough sleep;
• adhere to proper nutrition – avoid fatty, fried foods, minimize the intake of salty and spicy foods;
• exclude stressful situations;
• improving the standard of living and choosing better and healthier foods;
• control the intake of medications, use them only as prescribed by a doctor.

If the stomach ulcer is without complications, then with proper therapy there is every chance for successful treatment.

Gastroenterology: Ref. practical doctor / A.V. Kalinin, I.V. Maev, S.I. Rapoport; under total ed. S.I. Rapoport. – M.: Medpress-inform, 2009.

Drobchenko SN, Noskov PS, Calvo A. Rapid simple methods for diagnosing helicobacteriosis. Gastroenterology of St. Petersburg: scientific and practical journal. – St. Petersburg, 2005. – No 1-2.

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Heartburn
intestinal candidiasis
liver cyst
pancreatic cyst
intestinal colic
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Blood in stool
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Mechanical jaundice
food poisoning
Pancreatitis
Intestinal pneumatosis
Polyps of the stomach
Gallbladder polyps
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Reflux esophagitis (GERD)
Gilbert’s syndrome
Spasm of the esophagus
Toxic hepatitis
Helicobacteriosis
Cholangitis
cholestasis
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celiac disease
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Peptic ulcer of the stomach and / or duodenum – City Hospital No.

Sestroretsk, st. Borisova, 9

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What is an ulcer?

Gastric and/or duodenal ulcer is a defect or erosion of its mucous membrane, surrounded by an area of ​​inflammation. Occurs as a result of an imbalance between the “protective” factors of the gastric mucosa such as the muco-epithelial barrier, microcirculation, gastric mucus, bicarbonates, hormones (gastrin, secretin, somatostatin), active regeneration, prostaglandins and “aggression” factors – pepsin, hydrochloric acid, Helicobacter pylori.

Incidence rate.

Despite the rapid development of modern medicine and pharmacology, the emergence of the latest medical equipment, a wide range of methods for examining and treating patients, gastric ulcer remains a fairly common disease.

Trusting the statistics, it can be argued that from 6 to 14% of the population in different parts of the world suffer from stomach ulcers.

In Russia, stomach ulcers can be found in approximately 10% of the population. Children account for 1% of the incidence.

Men aged 40-60 are most often affected. Rarely seen in teenagers.

Risk factors

1. Hereditary predisposition
2. Helicobacter pylori
3. Smoking
4. Blood type I antigens
5. Medicinal products
6. Alcohol abuse
7. Irrational diet (spicy, salty, rough food)
8. Violation of the evacuation of food from the stomach
9. Reduced immunity
10. Nervous and physical strain, frequent stress
11. Meteorological influences (seasonal)
12. Insufficient amount of vitamins in the body

Depending on the location of the lesion, four types of ulcers are distinguished:

• Type I – erosion occurs in the body of the stomach and at the site of its transition to the antrum.
• Type II – association of gastric ulcer with duodenal ulcer.
• III type – lesion of the pyloric part of the stomach.
• IV type – ulcers that occur on the lesser curvature in the upper part of the stomach, in the area of ​​​​the transition of the esophagus to the stomach. These ulcers are highly prone to malignancy.

What symptoms characterize a stomach ulcer?

Pain in the abdomen (in the epigastric region). By nature, these pains are burning, aching, pressing, squeezing. The pain radiates to the region of the left hypochondrium, lower back on the sides of the spine. Duration from 90 minutes to 3 hours. Characterized by seasonal exacerbation of pain (spring, autumn).

• Nausea
• Heartburn
• Belching (air or food)
• Vomiting (very rare)
• Constipation
• Weight loss
• Disorder of appetite (more often it increases)

Due to unbearable pain in the epigastric region, patients have to take a forced position: squatting, they grab their stomach with both hands or press against the edge of the table, lying in bed, turn on their stomach, etc.

What can be visually detected in a patient with a stomach ulcer?

• White coated tongue
• Excessive sweating, wet palms
• Anterior abdominal wall very sensitive
• Sharp pains on pressure in the epigastric region
• Appearance of tender points on the back in the region of the spine

How to diagnose peptic ulcer?:

• Complete blood count (remains unchanged when the disease is not complicated by other diseases)0006
• Fecal occult blood test – Gregersen test
• Examination of the acid-forming function of the stomach (intragastric pH-metry)
• Detection of Helicobacter pylori
• X-ray method: using a contrast agent, this method allows you to detect defects in the gastric mucosa.

FEGDS (fibroesophagogastroduodenoscopy) with a biopsy from the bottom of the ulcer from 4-6 points and a mandatory cytological examination of the biopsy.

Ultrasonography (based on the use of ultrasound at approximately 30,000 Hz to image deep body structures) identifies a defect in the stomach wall.

Electrogastroenterography (a method designed to study the motor-evacuation function of the gastrointestinal tract, based on the simultaneous registration of biopotentials from different parts of the gastrointestinal tract).

Possible complications

In most cases, a stomach ulcer diagnosed in time can be cured without any complications. But in those cases when the patient begins to neglect his health (the unwillingness of the patient to see a doctor, relying on the fact that the pain will pass by itself; fear of the upcoming diagnosis and procedures; material problems, etc.), he makes his body suffer more and more , which leads to the development of terrible complications:

• Bleeding
• Penetration (penetration of an ulcer into surrounding tissues and organs)
• Perforation (perforation of the ulcer)
• Peritonitis (spread of infection in the abdominal cavity, inflammation of the peritoneum)
• Perivisceritis (formation of adhesions to neighboring organs)
• Ulcer malignancy (malignancy)

Conservative treatment

• Substances that neutralize hydrochloric acid.