Puncture Wound

Is this your child’s symptom?

• The skin is punctured by a pointed narrow object

Causes of Puncture Wounds

• Metal: nail, sewing needle, pin, tack
• Pencil: pencil lead is actually graphite (harmless). It is not poisonous lead. Even colored leads are not toxic.
• Wood: toothpick

Complications of Puncture Wounds

• Retained Foreign Object. This happens if part of the sharp object breaks off in the skin. The pain will not go away until it is removed.
• Wound Infection. This happens in 4% of foot punctures. The main symptom is spreading redness 2 or 3 days after the injury.
• Bone Infection. If the sharp object also hits a bone, the bone can become infected. Punctures of the ball of the foot are at greatest risk. The main symptoms are increased swelling and pain 2 weeks after the injury.

When to Call for Puncture Wound

Call 911 Now

• Deep puncture on the head, neck, chest, back or stomach
• You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

• Puncture into a joint
• Feels like something is still in the wound
• Won’t stand (bear weight or walk) on punctured foot
• Needlestick from used needle (may have been exposed to another person’s blood)
• Sharp object or setting was very dirty (such as a playground or dirty water)
• No past tetanus shots
• Dirt in the wound is not gone after 15 minutes of scrubbing
• Severe pain and not better 2 hours after taking pain medicine
• Wound looks infected (spreading redness, red streaks)
• Fever occurs
• You think your child has a serious injury
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Last tetanus shot was more than 5 years ago
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• You have other questions or concerns

Self Care at Home

Seattle Children’s Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Care Advice for Puncture Wound

1. What You Should Know About Puncture Wounds:
   • Most puncture wounds do not need to be seen.
   • Here is some care advice that should help.
2. Cleaning the Wound:
   • First wash off the foot, hand or other punctured skin with soap and water.
   • Then soak the puncture wound in warm soapy water for 15 minutes.
   • For any dirt or debris, gently scrub the wound surface back and forth. Use a wash cloth to remove any dirt.
   • If the wound re-bleeds a little, that may help remove germs.
3. Antibiotic Ointment:
   • Use an antibiotic ointment (such as Polysporin). No prescription is needed.
   • Then, cover with a bandage (such as Band-Aid). This helps to reduce the risk of infection.
   • Re-wash the wound and put on antibiotic ointment every 12 hours.
   • Do this for 2 days.
4. Pain Medicine:
   • To help with the pain, give an acetaminophen product (such as Tylenol).
   • Another choice is an ibuprofen product (such as Advil).
   • Use as needed.
5. What to Expect:
   • Puncture wounds seal over in 1 to 2 hours.
   • Pain should go away within 2 days.
6. Call Your Doctor If:
   • Dirt in the wound still there after 15 minutes of scrubbing
   • Pain becomes severe
   • Looks infected (redness, red streaks, pus, fever)
   • You think your child needs to be seen
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 05/30/2021

Last Revised: 03/11/2021

Copyright 2000-2021. Schmitt Pediatric Guidelines LLC.

Puncture Wounds | Michigan Medicine

Do you have a puncture wound?

This is a wound caused by a sharp, pointed object going through the skin. Puncture wounds are deeper and narrower than cuts.

How old are you?

Less than 12 years

Less than 12 years

12 years or older

12 years or older

Are you male or female?

Why do we ask this question?

• If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
• If your symptoms aren’t related to those organs, you can choose the gender you identify with.
• If you have some organs of both sexes, you may need to go through this triage tool twice (once as “male” and once as “female”). This will make sure that the tool asks the right questions for you.

Do you have an eye injury?

Do you have an injury caused by a fishhook?

Do you have a deep wound in your head, neck, chest, or belly?

A deep puncture wound in any of these areas could damage the internal organs.

Yes

Deep puncture wound to head, neck, chest, or belly

No

Deep puncture wound to head, neck, chest, or belly

Are you having trouble breathing (more than a stuffy nose)?

Yes

Difficulty breathing more than a stuffy nose

No

Difficulty breathing more than a stuffy nose

Has the pain lasted for more than 8 hours?

Yes

Pain for more than 8 hours

No

Pain for more than 8 hours

Is the pain getting worse?

Have you been injected with something under high pressure, like oil or paint from a sprayer?

Yes

Injection under high pressure

No

Injection under high pressure

Is there a deep puncture in or over a joint?

A puncture that goes into a joint can be serious.

Yes

Deep puncture in joint area

No

Deep puncture in joint area

Do you have a wound on your arm, leg, hand, or foot that is more than just a scratch?

For an arm or leg wound, is the skin below the wound (farther down the limb) blue, pale, or cold to the touch and different from the other arm or leg?

This may mean that a major blood vessel was damaged and that blood is not reaching the rest of the arm or leg.

Yes

Skin is blue, pale, or cold below an arm or leg injury

No

Skin is blue, pale, or cold below an arm or leg injury

Can you move the area below the injury normally, even though it may hurt?

Yes

Able to move limb normally below injury

No

Unable to move limb normally below injury

For an arm or leg wound, is there any numbness, tingling, or loss of feeling around the wound or below the wound (farther down the arm or leg)?

This may mean that a nerve was damaged.

Yes

Numbness, tingling, or loss of feeling around or below an arm or leg injury

No

Numbness, tingling, or loss of feeling around or below an arm or leg injury

Do you think you may have a fever?

Are there red streaks leading away from the area or pus draining from it?

Do you have diabetes, a weakened immune system, peripheral arterial disease, or any surgical hardware in the area?

“Hardware” includes things like artificial joints, plates or screws, catheters, and medicine pumps.

Yes

Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area

No

Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area

Have you been stuck with a used or dirty needle?

Yes

Stuck with used or dirty needle

No

Stuck with used or dirty needle

Is there an object stuck in the wound, and you can’t get it out?

You may not be able to remove it because of where or how deep the wound is or because it causes severe pain.

Is the object large or small?

Large means things like a nail or piece of wood that is at least 2 in. (5.1 cm) long and anything bigger than that. Small means things like a pencil tip or a small splinter or sliver.

Large

Large embedded object

Small

Small embedded object

Did you have swelling or bruising within 30 minutes of the injury?

Yes

Swelling or bruising within 30 minutes of injury

No

Swelling or bruising within 30 minutes of injury

Has the swelling or bruising raised a lump that’s more than about 1. 5 in. (4 cm) across or deep? This would be bigger than a golf ball or Ping-Pong ball.

Yes

Lump bigger than golf ball or Ping-Pong ball

No

Lump bigger than golf ball or Ping-Pong ball

Do you have a puncture wound in your foot?

Yes

Puncture wound in foot

Did the object go through a shoe or boot?

An object that has enough force behind it to go through a shoe can cause serious injury to the foot. Puncture wounds in the sole of the foot also have a high risk of infection.

Yes

Object went through a shoe or boot

No

Object went through a shoe or boot

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

• Your age. Babies and older adults tend to get sicker quicker.
• Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
• Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
• Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
• Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

• Try home treatment to relieve the symptoms.
• Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Symptoms of infection may include:

• Increased pain, swelling, warmth, or redness in or around the area.
• Red streaks leading from the area.
• Pus draining from the area.
• A fever.

Pain in adults and older children

• Severe pain (8 to 10): The pain is so bad that you can’t stand it for more than a few hours, can’t sleep, and can’t do anything else except focus on the pain.
• Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it’s severe when it’s there.
• Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

• Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
• Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
• Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Certain health conditions and medicines weaken the immune system’s ability to fight off infection and illness. Some examples in adults are:

• Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
• Long-term alcohol and drug problems.
• Steroid medicines, which may be used to treat a variety of conditions.
• Chemotherapy and radiation therapy for cancer.
• Other medicines used to treat autoimmune disease.
• Medicines taken after organ transplant.
• Not having a spleen.

With severe bleeding, any of these may be true:

• Blood is pumping from the wound.
• The bleeding does not stop or slow down with pressure.
• Blood is quickly soaking through bandage after bandage.

With moderate bleeding, any of these may be true:

• The bleeding slows or stops with pressure but starts again if you remove the pressure.
• The blood may soak through a few bandages, but it is not fast or out of control.

With mild bleeding, any of these may be true:

• The bleeding stops on its own or with pressure.
• The bleeding stops or slows to an ooze or trickle after 15 minutes of pressure. It may ooze or trickle for up to 45 minutes.

You may need a tetanus shot depending on how dirty the wound is and how long it has been since your last shot.

• For a dirty wound that has things like dirt, saliva, or feces in it, you may need a shot if:
  • You haven’t had a tetanus shot in the past 5 years.
  • You don’t know when your last shot was.
• For a clean wound, you may need a shot if:
  • You have not had a tetanus shot in the past 10 years.
  • You don’t know when your last shot was.

Symptoms of difficulty breathing can range from mild to severe. For example:

• You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
• It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

• Call your doctor today to discuss the symptoms and arrange for care.
• If you cannot reach your doctor or you don’t have one, seek care today.
• If it is evening, watch the symptoms and seek care in the morning.
• If the symptoms get worse, seek care sooner.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

• Call your doctor now to discuss the symptoms and arrange for care.
• If you cannot reach your doctor or you don’t have one, seek care in the next hour.
• You do not need to call an ambulance unless:
  • You cannot travel safely either by driving yourself or by having someone else drive you.
  • You are in an area where heavy traffic or other problems may slow you down.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Put direct, steady pressure on the wound until help arrives. Keep the area raised if you can.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Eye Injuries

Fishhook Injuries

Puncture wounds: First aid – Mayo Clinic

A puncture wound, such as from stepping on a nail, doesn’t usually cause much bleeding. But these wounds are often deep and can be dangerous because of the risk of infection.

To take care of a puncture wound:

1. Wash your hands. This helps prevent infection.
2. Stop the bleeding. Apply gentle pressure with a clean bandage or cloth.
3. Clean the wound. Rinse the wound with clear water for five to 10 minutes. If dirt or debris remains in the wound, use a washcloth to gently scrub it off. See a doctor if you can’t remove all of the dirt or debris.

4. Apply an antibiotic. Apply a thin layer of an antibiotic cream or ointment (Neosporin, Polysporin). For the first two days, rewash the area and reapply the antibiotic when you change the dressing.

   Certain ingredients in some ointments can cause a mild rash in some people. If a rash appears, stop using the product and seek medical care.

5. Cover the wound. Bandages help keep the wound clean.
6. Change the dressing. Do this daily or whenever the bandage becomes wet or dirty.
7. Watch for signs of infection. See a doctor if the wound isn’t healing or you notice any spreading redness, increasing pain, pus, swelling or fever.

Seek prompt medical care

Get immediate medical help if the wound:

• Keeps bleeding after a few minutes of direct pressure
• Is the result of an animal or human bite
• Is deep and dirty
• Is caused by a metal object
• Is deep and to the head, neck, scrotum, chest or abdomen
• Is over a joint and could be deep

If the injured person hasn’t had a tetanus shot in the past five years and the wound is deep or dirty, your doctor may recommend a booster. The injured person should have the booster shot within 48 hours of the injury.

If the wound was caused by a cat or a dog, try to confirm that its rabies vaccination is up to date. If it was caused by a wild animal, seek advice from your doctor about which animals are most likely to carry rabies.

Aug. 15, 2019

Show references

1. Puncture wounds. American College of Emergency Physicians. http://www.emergencycareforyou.org/emergency-101/puncture-wounds/. Accessed July 10, 2019.
2. Thompson DA. Puncture wound. In: Adult Telephone Protocols. Office Version. 4th ed. Itasca, Ill.: American Academy of Pediatrics; 2018.
3. Briggs JK. Puncture wound. In: Triage Protocols for Aging Adults. Philadelphia, Pa.: Wolters Kluwer; 2019.
4. Rerucha CM, et al. Acute hand infections. American Family Physician. 2019;99:228.
5. Goyal DG (expert opinion). Mayo Clinic, Rochester, Minn. June 22, 2017.
6. Pruthi S (expert opinion). Mayo Clinic, Rochester, Minn. June 22, 2017.
7. Kermott CA, et al. , eds. Emergencies and urgent care. In: Mayo Clinic Guide to Self-Care. 7th ed. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.

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Recognizing and Treating Wound Infection

Wounds can become infected with harmful germs (bacteria). This prevents healing. It also increases your risk of scars. In some cases, the infection may spread to other parts of your body. An infection with the bacteria that causes tetanus can be fatal. Know what to look for and get prompt treatment for infection.

What are the risk factors for infection?

A wound is more likely to become infected if it:

• Results from a hole (puncture), such as from a nail or piece of glass

• Results from a human or animal bite, especially a cat.

• Isn’t cleaned or treated soon after occurring

• Occurs in your hand, foot, leg, armpit, or groin (the area where your belly meets your thighs)

• Contains dirt or saliva

• Heals very slowly

• Occurs and you have diabetes, alcoholism, a weak immune system, or poor blood circulation

What are the symptoms of infection?

Call your healthcare provider at the first sign of infection, such as:

• Redness, warmth around the wound

• Edges look like they are opening

• Yellow, yellow-green, or foul-smelling drainage from a wound

• More pain, swelling, or redness in or near a wound

• A change in the color or size of a wound

• Red streaks in the skin around the wound

• Fever

How are infections treated? 

Treatment depends on the type of infection you have, and how serious it is. Your healthcare provider may prescribe oral antibiotics to help fight bacteria. Your provider may also clean the wound with an antibiotic solution or apply an antibiotic ointment. Sometimes a pocket of pus (abscess) may form. In that case, the abscess will be opened and the fluid drained. You may need hospital care if the infection is very severe.

Preventing wound infection

Follow these steps to help keep wounds from getting infected:

• Wash the wound right away with soap and water.

• Apply a small amount of antibiotic ointment. You can buy this without a prescription.

• Cover wounds with a bandage or gauze dressing. Change it daily or whenever it gets wet or dirty.

• Keep the wound clean and dry for the first 24 hours.

• Wash your hands before and after you care for your wound.

• Change the dressing daily; follow the instructions your healthcare provider gave you.

Puncture Wound | Advocare Society Hill Pediatrics

Is this your child’s symptom?

• The skin is punctured by a pointed narrow object

Causes of Puncture Wounds

• Metal: nail, sewing needle, pin, tack
• Pencil: pencil lead is actually graphite (harmless). It is not poisonous lead. Even colored leads are not toxic.
• Wood: toothpick

Complications of Puncture Wounds

• Retained Foreign Object. This happens if part of the sharp object breaks off in the skin. The pain will not go away until it is removed.
• Wound Infection. This happens in 4% of foot punctures. The main symptom is spreading redness 2 or 3 days after the injury.
• Bone Infection. If the sharp object also hits a bone, the bone can become infected. Punctures of the ball of the foot are at greatest risk. The main symptoms are increased swelling and pain 2 weeks after the injury.

When to Call for Puncture Wound

Call 911 Now

• Deep puncture on the head, neck, chest, back or stomach
• You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

• Puncture into a joint
• Feels like something is still in the wound
• Won’t stand (bear weight or walk) on punctured foot
• Needlestick from used needle (may have been exposed to another person’s blood)
• Sharp object or setting was very dirty (such as a playground or dirty water)
• No past tetanus shots
• Dirt in the wound is not gone after 15 minutes of scrubbing
• Severe pain and not better 2 hours after taking pain medicine
• Wound looks infected (spreading redness, red streaks)
• Fever occurs
• You think your child has a serious injury
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Last tetanus shot was more than 5 years ago
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• You have other questions or concerns

Self Care at Home

Care Advice for Puncture Wound

1. What You Should Know About Puncture Wounds:
   • Most puncture wounds do not need to be seen.
   • Here is some care advice that should help.
2. Cleaning the Wound:
   • First wash off the foot, hand or other punctured skin with soap and water.
   • Then soak the puncture wound in warm soapy water for 15 minutes.
   • For any dirt or debris, gently scrub the wound surface back and forth. Use a wash cloth to remove any dirt.
   • If the wound re-bleeds a little, that may help remove germs.
3. Antibiotic Ointment:
   • Use an antibiotic ointment (such as Polysporin). No prescription is needed.
   • Then, cover with a bandage (such as Band-Aid). This helps to reduce the risk of infection.
   • Re-wash the wound and put on antibiotic ointment every 12 hours.
   • Do this for 2 days.
4. Pain Medicine:
   • To help with the pain, give an acetaminophen product (such as Tylenol).
   • Another choice is an ibuprofen product (such as Advil).
   • Use as needed.
5. What to Expect:
   • Puncture wounds seal over in 1 to 2 hours.
   • Pain should go away within 2 days.
6. Call Your Doctor If:
   • Dirt in the wound still there after 15 minutes of scrubbing
   • Pain becomes severe
   • Looks infected (redness, red streaks, pus, fever)
   • You think your child needs to be seen
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2000-2021. Schmitt Pediatric Guidelines LLC.

Puncture Wound | La Plata Pediatrics & Family Health

Is this your symptom?

• Skin is punctured by a narrow sharp object (a nail, pencil, toothpick)

Some Basics.

..

• Punctures are a type of skin wound made by a narrow sharp object.
• Puncture wounds can become infected, so need proper care.
• A tetanus shot is often needed after a puncture wound.

Types of Puncture Wounds

• Needlestick: if the wound is from a used or discarded needle, call a doctor right away. In some cases, medicines need to be started to stop the spread of infections like HIV/AIDS or hepatitis.
• Foot Punctures: punctures into the bottom of the foot have a 4% risk of infection. This risk is higher in people with puncture wounds that go through a shoe. Pain lasting 4-5 days after the injury may be a sign of infection.
• Pencil Lead Punctures: pencil lead is made of graphite, which is harmless. Pencils are not made of poisonous lead. Colored lead pencils are also nontoxic. However, the graphite will cause a long-lasting skin mark if it is not scrubbed out.

When to Call for Puncture Wound

Care Advice for Minor Puncture Wound

1. What You Should Know:
   • Punctures are a type of skin wound made by a narrow sharp object.
   • Puncture wounds can become infected, so need proper care.
   • You can treat minor puncture wounds at home.
   • Here is some care advice that should help.

2. Cleansing: Wash the wound with soap and warm water for 15 minutes. Scrub the wound with a washcloth to remove any dirt.

3. Antibiotic Ointment: Put on an antibiotic ointment covered with an adhesive bandage (Band-Aid) to reduce the risk of infection. Re-soak the area and put on more antibiotic ointment every 12 hours for 2 days.

4. Pain Medicine:
   • You can take one of the following drugs if you have pain: acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve).
   • They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
   • Use the lowest amount of a drug that makes your pain feel better.
   • Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old.
   • Read the instructions and warnings on the package insert for all medicines you take.

5. Expected Course: Puncture wounds seal over in 1-2 hours. Pain should get better within 2 days.

6. Call Your Doctor If:
   • Dirt in the wound is still there after 15 minutes of scrubbing
   • It begins to look infected (redness, red streaks, pus, or tender to touch)
   • Fever
   • Pain becomes severe or is not gone after 3 days
   • You think you need to be seen
   • You get worse

And remember, contact your doctor if you develop any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

How to Tell If a Cut Is Infected

An infected cut can lead to a serious illness if left untreated. In many cases, skin infections like staph, strep, or methicillin-resistant Staphylococcus aureus (MRSA) get started from the tiniest of cuts. Even a little cut that doesn’t need stitches can cause big problems if it gets infected and goes untreated. So, how can you tell if a cut is infected?

Ellen Lindner / Verywell

Signs of Infection

To tell if a cut is infected, look for these signs:

• Swelling
• Redness
• Local fever (the cut feels hot compared to areas around it)
• Draining pus (the cut is oozing thick, gooey stuff)

If a cut or scrape becomes infected, you need to see a healthcare provider.

In most cases, only doctors, physician assistants, or nurse practitioners can give you antibiotics to fight the infection. Untreated, infected wounds can become serious. The worst-case scenario is that an infected cut develops into a full-body (systemic) infection.

To tell if you are developing a bigger infection, look for:

• Fever over 100 degrees Fahrenheit (taken orally or rectally): It’s one thing if the cut is hot, but when the whole body has a fever it means the infection is spreading.
• Body aches: Especially in joints and areas not adjacent to the injury, these are a sign of a widespread infection. It’s understandable if your cut is sore, but the rest of you shouldn’t be.
• Nausea or diarrhea: These are both indicators that an infection has moved from the local injury to affect other body systems (specifically, the gastrointestinal system).

When to See a Doctor

If you have an infected cut or are developing a systemic infection, see a doctor. Once a cut gets infected, you’re going to need a doctor’s help. Once an infection is identified, antibiotics will be necessary to eliminate it.  There are many antibiotics available, and different antibiotics work on different bacteria.

To figure out which drug is right for your situation, the physician might need to swab your injury and send the swab to be cultured. The material will be examined microscopically and will be placed in culture media to see if any concerning bacteria grow.

As soon as the bacteria grow enough, the exact types will be identified. If nothing concerning grows other than what is expected from healthy skin, the cut is not infected and no antibiotics will be needed. If concerning bacteria are found, they are tested to see which antibiotics are best at killing them and stopping the infection.

Treatment

If the physician, physician’s assistant, or nurse practitioner does prescribe antibiotics, take them all. Often, you’ll start to feel better within a day or two of beginning your antibiotic regimen and you might be tempted to stop taking them. Don’t do it.

Even though you feel better, the antibiotics haven’t killed all the bacteria yet. If you stop, the bacteria that had successfully survived the first few days of antibiotics will reproduce. These are the stronger bacteria, and their offspring will be much more resistant to that antibiotic.

Prevention: Keep It Clean

To avoid an infected cut, it’s important to keep cuts clean as they heal. Most of the time, soap and water are all you need. Whether you use an antibiotic ointment or not is up to you, but it’s really not necessary.

It helps to cover a cut with an adhesive bandage, but remember to change the bandage every day and wash the cut with soap and water.

Wound treatment

directions

We provide treatment of stab, cut and laceration wounds. We specialize in mild to moderate wounds. We work without breaks and days off. We use high-quality, self-absorbing materials for sutures. If necessary, we carry out local anesthesia before treatment.

Medical specialists

Traumatologist-orthopedist

Traumatologist-orthopedist

Traumatologist-orthopedist

Traumatologist-orthopedist

Traumatologist-orthopedist

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Traumatologist-orthopedist

Traumatologist-orthopedist

Currently, work is underway on the site to change the price list, check the current information by phone: 640-55-25 or leave a request, the operator will contact you.

Prices for services

• Toilet wounds, no surgical debridement
  400a

• Plaster sutures
  420a

• Surgical treatment of a wound or infected tissue 1 category (wound up to 15mm long)
  640a

• Bandaging for violations of the integrity of the skin of the 1st category (wound up to 15 mm long)
  760a

• Surgical treatment of a wound or infected tissue, category 2 (wound length 15-30mm)
  940a

• Bandaging for violations of the integrity of the skin of the 2nd category (wound 15-30mm long)
  1160a

• Surgical treatment of a wound or infected tissue, category 3 (wound length 30-45mm)
  1240a

• Bandaging for violations of the integrity of the skin of the 3rd category (wound length 30-45mm)
  1660a

• Bandaging for violations of the integrity of the skin of the 4th category (wound with a length of more than 45 mm)
  2460a

• Bandaging for muscle disease category 1 (wound up to 15mm long)
  2460a

• Bandaging for muscle disease category 2 (wound 15-30mm long)
  2760a

• Dressings for muscle disease category 3 (wound length 30-45mm)
  3160a

• Open wound suturing (without skin grafting)
  1600a

• Appointment (examination, consultation) of a doctor – surgeon repeated
  880a

• Appointment (examination, consultation) of a surgeon primary
  990a

• Preventive appointment (examination, consultation) at a traumatologist-orthopedist
  660a

• Appointment (examination, consultation) at a traumatologist-orthopedist primary
  1100a

The information and prices presented on the site are for reference only and are not a public offer.

Our clinics in St. Petersburg

Medical Center South-West

Marshal Zhukov Ave. 28k2
Kirovsky district

• Avtovo
• Veterans Avenue
• Leninsky Prospect

You can get detailed information and make an appointment by calling
+7 (812) 640-55-25

Our services

• Treatment of stab wounds. We treat penetrating and blind stab wounds. Deep puncture wounds are dangerous by infection, suppuration, profuse bleeding, and damage to internal organs. We diagnose the wound, stop bleeding, apply a bandage, and give recommendations for further care. In case of damage to internal organs, we are sent to the hospital.
• Treatment of cut and lacerated wounds. Cut and laceration wounds are dangerous due to profuse bleeding, damage to internal tissues, the formation of scars and scars.We examine the wound, disinfect it, apply stitches and a bandage. Depending on the nature of the wound, we prescribe further treatment or give recommendations for care.
• Treatment of purulent wounds. Suppuration is a sign that an infection has entered the wound. Purulent wounds are dangerous for the further spread of infection in the body. We remove the suppuration, disinfect the wound, and prescribe further treatment.

Stages of wound treatment

1. Diagnostics. Upon admission to the emergency room, the doctor assesses the nature of the damage.In case of damage to internal organs, the patient is sent to the hospital to the appropriate specialist. If there is a suspicion of a foreign body in the wound – a glass shard, a piece of wood, a splinter – an x-ray is taken. Further actions are planned based on the diagnostic results.
2. Stopping bleeding. Some types of wounds are characterized by profuse bleeding. To avoid serious blood loss, the doctor will ease or stop the bleeding before further manipulation.
3. Foreign body extraction. If there is a foreign body in the wound, it must be removed. If this is not done, the likelihood of suppuration and infection is high. In some cases, excision of the wound edges is required to remove a foreign body. Before excision, the doctor gives the patient anesthesia.
4. Disinfection. Any wound must be disinfected to prevent infection and subsequent infection from entering the body. The doctor thoroughly rinses the wound with a disinfectant solution, making sure that there is no dirt and clotted blood left in the wound.
5. Stitching. If the wound has wide ragged or cut edges, suturing may be required. Stitches tighten the edges of the wound, speed up healing and reduce the likelihood of scarring at the site of lacerations. For suturing, the doctor uses self-absorbable materials, the threads of which dissolve on their own over time.
6. Bandage application. The bandage protects the wound from dirt and damage to the seams. in some cases, periodic dressing is required.

Depending on the nature of the wound, after first aid, the doctor will prescribe a referral to the appropriate specialist or give recommendations for further wound care. Do not neglect the recommendations of the traumatologist in order to prevent complications.

Our advantages

• Daily trauma center. The emergency room works without days off and breaks. We are ready to help you when you need it.
• Qualified personnel. The trauma center employs doctors of the highest qualification category. If necessary, specialized specialists are involved in providing assistance.
• Quality materials. For disinfection and suturing, we use materials and preparations approved by the Ministry of Health of the Russian Federation.

1318,981,1405,948,1326,841

Darya

thirty.06.2021

16:58
medi-center.ru

Thank you for the work of the endoscopist Trofimova Leyla Shahmardan Kzy. The doctor is very attentive and delicate, trying to minimize the inconvenience to the patient during endoscopy. It is also very pleasant that the specialist gives comments after the examination, does not limit himself to issuing an opinion, and answers questions.

Ekimova Yanina

eleven. 02.2021

19:21
medi-center.ru

I would like to thank the ENT doctor A.S. Saranchin. for a sensitive, attentive attitude to patients and professionalism. Thank you so much.

Hello. Thank you for the well-coordinated work of the staff of the Medical Center. Has applied with signs of acute respiratory infections. 1. At the reception, they described in sufficient detail the rules of attachment and conditions of admission in the absence of attachment under the OMS policy.2. Excellent work of the treatment room, as well as m / brother, who carries out the collection of smears at home. 3. My therapists: Polovodova E.A. and Artyukh L.Yu. Thank you for everything!
4. Excellent work of the call-center and personal account is just SUPER!

I would really like the review to be found by everyone who is mentioned. Thank you!

Alexander Garagan

08/20/2020

09:59
medi-center.ru

In July 2020, he broke his arm, turned to the traumatology department at Medicenter on Okhtinskaya Alley, d18 for help. A month and a half was observed in this traumatology. I want to express my deep gratitude to traumatologists working in trauma for the qualified and timely treatment. I was very pleased! The center is modern, very qualified and friendly staff, modern equipment, very good organization of treatment, attached under the compulsory medical insurance.Thank you!

Alexey Gruzdev

08/09/2020

16:34
medi-center.ru

Passed an endoscopic examination by a group of doctors consisting of: Anna Akhatovna Mordvintseva, Timur Ruslanovich Suydyumov, Alexandra Vladimirovna Lokotkova. The attitude to the patient is attentive, responsible.The work is done professionally, confidently, without fuss. Thank you!

I want to express my deep gratitude to Agamurat Ozarmamedovich Dzhoraev, in Murino on Okhtinskaya alley.
The child had a dislocation of the elbow joint, he did everything very quickly, put it in place, found an approach to the crying child !!
Thanks to your center for excellent doctors !!!

90,000 First aid for injuries and bleeding

The most effective wound healing mechanism is provided by nature itself. You just need to know how to provide first aid in case of injury in order to start the healing process. Natural processes aimed at wound healing are reduced to sequential cleansing, granulation and epithelialization.

Cleansing begins after the bleeding stops. Leukocytes penetrate through the capillary walls to the wound, cleaning and protecting against infection. The action of leukocytes provokes local inflammation and the release of fluid from the wound. Due to local inflammation, non-viable tissues are rejected, and the surface of the wound is cleaned.To help the body, you need to cleanse the injured area, remove the exudate without overdrying and additional trauma to the tissues.

Granulation is the process of division of epithelial cells, which allows the wound to heal. The foci of granulation are especially sensitive to damage, drying out, and infection. It is advisable to remove excess fluid, but maintain a hydrobalance, protecting tissues from infections.

Epithelialization is the formation of a scar on a dry wound. At this stage, it is advisable to maintain moderate moisture in the wound and to protect the new skin from damage.

Basic rules for first aid for various injuries

To properly provide first aid for injuries and bleeding, you need to assess the type and extent of damage. The general algorithm of primary actions is approximately the same. After assessing the condition of the victim, it is necessary to call a medical team, and before their arrival, stop the bleeding, carry out dressing, give the victim an optimal posture and monitor his condition.

Important nuances to remember when providing first aid for wounds and injuries:

1. Hands must be clean.

2. Do not pour water or medicine, alcohol or iodine on the wound.

3. It is forbidden to remove foreign bodies and blood clots from wounds, as this is fraught with bleeding.

4. You can not try to return to the place of the organs that have fallen out.

5. If limbs are crippled, they need to be fixed so as to restrict movement.

Rules for emergency care for severe wounds

The stages of providing emergency first aid for bleeding and injuries are as follows:

1. Stop blood loss.

2. Disinfect the wound with an antiseptic.

3. Close the wound surface with gauze, bandage or improvised means.

Depending on the type of bleeding, the steps for first aid and wound care will differ. There are 4 types of bleeding:

• arterial. The blood is bright red, pulsating. Rapid, critical blood loss;

• venous.The blood is deeply dark in color, moves continuously in a uniform stream;

• capillary. Droplets of blood appear on the injured surface;

• parenchymal. Associated with deep trauma and damage to internal organs.

If the victim is bleeding, it is necessary to stop it by applying a tourniquet (tight bandage). The place of overlap is the nearest large vessel – a vein or artery on the shoulder, forearm or thigh.

Common types of injuries with injuries

Before deciding on first aid for wounds, you need to understand what such injuries are, what they are. Wounds mean a violation of the integrity of the skin, mucous membranes, tissues with expanding edges, sometimes with an abundance of blood. Depending on the cause of damage, wounds are divided into lacerated, stabbed and cut, gunshot and bruised.Chopped, crushed wounds and those obtained as a result of animal bites are distinguished separately.

First aid for injury should take into account the depth of the wound: superficial, deep, penetrating and non-penetrating. Stab and cut wounds have smooth edges. If the doctors sew up correctly, there will be almost no trace left. Bruised wounds are accompanied by abrasions, dangerous dying tissues. The most dangerous are penetrating wounds, since they are fraught with infection and severe blood loss. Regardless of the type and depth of the wounds, they are all potentially infectious.

What definitely shouldn’t be done?

Having roughly understood the sequence of correct actions, it is important to exclude from the list those that can be harmful. It is strictly forbidden to handle open wounds on the head, doctors will deal with this. Shards and other foreign objects in the wound, despite the potential source of contamination, must not be removed. Outside the walls of the operating room, such actions pose a danger to the victim. If a person is wounded in the chest, he cannot drink, eat, speak or breathe deeply.

If the medics have not arrived yet, and the bandage on the wound is soaked in blood, it cannot be torn off. The correct action is to put a new bandage on top. The tamponade will become more reliable, and the doctor will be able to predict the amount of blood lost by the number of dressings.

The application of a tourniquet requires correct action. This procedure is carried out exclusively if indicated and is considered an extreme measure in case of profuse arterial bleeding. A tourniquet must not be applied to burnt skin without a protective layer of gauze or cloth.The site of the tight bandage is above the bleeding. If the tourniquet is not tightened enough, more blood will flow out. A bandage that is too tight will compress the nerves, which is also bad.

Expert advice on the use of wound care products

In order for the wound to heal faster and the victim to recover, it is necessary to exclude mechanical injuries, the addition of a secondary infection, as well as overdrying and waterlogging of the wound. It is worth starting from this, providing first aid for bleeding, injury and subsequent care.A great option is special wound care products.

Atraumatic dressings are made on the basis of a mesh impregnated with an active drug. Cotton mesh cells are large and small, but in each case, the medicinal composition is evenly distributed. It can be a healing balm or an antiseptic soak. These dressings do not stick to the wound, maintain optimal moisture and protect against infection.

It is recommended to lay sterile wipes on top of the ointment dressing to absorb the released liquid.This secondary compress does not interfere with air exchange and is held securely in place with a self-locking bandage. The latter does not require tying and is simply pressed against the previous layer. If very little fluid is released from the wound, a self-adhesive sterile plaster with an absorbent pad in the center is suitable instead of a secondary compress. The liquid remains inside the pad and does not flow back even when pressed.

Atraumatic dressings with medicated ointments can be left on the wound for 3-7 days (indicated in the instructions).The choice of a particular dressing depends on the type of wound. Some are indicated for abrasions, lacerations and burns, bedsores and trophic ulcers. Others are used when there is a high risk of wound infection.

Dressings and medications for a quick response in case of injury should be in every first-aid kit.

90,000 Facial soft tissues – Center for Maxillofacial Surgery and Dentistry

Non-gunshot trauma to the soft tissues of the face accounts for 40-50%.

The nature of soft tissue damage depends on the force of the impact, the type of traumatic agent and the location of the injury.

Contusions

Occurs with a weak blow to the face with a blunt object, while the subcutaneous fat, muscles and ligaments are damaged without rupture of the skin. The result is a hematoma (hemorrhage) and post-traumatic edema. The hematoma lasts 12-14 days, gradually changing color from purple to green and yellow.

Abrasion

Occurs when the integrity of the surface layers of the skin is violated, which does not require suturing.More often observed in the chin, zygomatic bone, nose and forehead.

Wound

Formed when the skin is damaged by impact with a sharp or blunt object with sufficient force, which breaks the integrity of the skin.

Complaints

Bruises, abrasions, bruised wound, bite wound, laceration – general complaints are usually absent.
Cut wound, stab wound, chopped wound – complaints will depend on the severity of the injury: pallor of the skin, dizziness, weakness.It occurs due to blood loss.

Treatment of soft tissue injuries of the face

Emergency care: carried out at the prehospital stage to prevent wound infection and bleeding from small vessels. The skin around the wound is treated with iodine solution, bleeding is stopped by applying a bandage.

In case of abrasions, the primary dressing can be performed using a protective film made of film-forming agents applied to the wound. With simultaneous damage to the bone, transport immobilization is applied.

Treatment of a patient in a hospital setting

Indications: bruises, abrasions, cut, stabbed, lacerated, bruised and bitten wounds of small size, requiring a small excision of its edges and subsequent simultaneous suturing.

Treatment of a bruise: cold in the first two days, then – heat for resorption of the hematoma.

Abrasion treatment: antiseptic treatment, heals under the crust.

Treatment of cut, stabbed, lacerated, bruised, bitten wounds.The PHO of the wound is carried out.

PHO is a set of measures aimed at speedy and without complications wound healing. The PSC must be radical, instantaneous and final.

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90,000 Tetanus: Why Take a Risk When You Can Protect Yourself?

Tetanus is an acute infectious disease with symptoms of toxicosis and tonic-clonic seizures resulting from damage to the motor cells of the central nervous system by the toxin.

The causative agent of the disease bacterium Clostridium tetani , in the form of rods, forms a strong exotoxin that acts on the nervous system.

Prevalence . Tetanus bacillus is widespread in nature. It is usually found in the soil around settlements, where it enters with the feces of herbivores. Can be found in the intestines of healthy people without causing them disease.

Infection occurs when the pathogen enters through damaged skin or mucous membranes.The contamination of lacerated and puncture wounds is especially dangerous, although infection is also possible when microtraumas are infected that have gone unnoticed.

In children, the most common cause of infection is leg injuries – foot injuries when walking barefoot, injections with sharp objects, thorns, etc. In newborns, the entrance gate can be the umbilical cord, infected when the rules of asepsis and antiseptics are violated. Tetanus is more common in children aged 3 to 7 years. At this age, they are especially mobile and more often receive various injuries.

Natural immunity does not exist. Immunity after an illness is short-lived. The susceptibility is very high in people of all age groups.

Clinic . The disease usually begins acutely. There are unpleasant sensations in the wound in the form of burning, tingling, pain with irradiation along the nerve trunks. With an acute onset, the first symptom is trismus (convulsions) of the masticatory muscles. During trismus, the patient cannot open his mouth, food intake is difficult, speech is impossible.In severe cases, the teeth are clenched, it is not possible to open the mouth even with a spatula. Immediately after trismus, convulsions of facial muscles appear. The patient’s face takes on a peculiar expression: a smile is combined with crying (“sardonic smile”). The forehead is collected in wrinkles, the mouth is stretched in width, its corners are lowered. After a while, a general convulsive syndrome occurs. There is an opisthotonus – the patient bends on the bed in the form of an arch, leaning only with the heels and the back of the head. With the further development of the disease, convulsions arise from the slightest irritants and continue almost continuously.With the growing phenomena of asphyxia and circulatory disorders, a lethal outcome can occur.

Vaccination course and routine vaccinations.

Infant tetanus vaccine . To create immunity against tetanus, all children from 3 months of age are injected with tetanus toxoid, which is part of the domestic DTP vaccine (ADS) and its foreign analogues (Pentaxim, Infanrix, Infanrix Hexa). Vaccination is carried out three times with an interval of 45 days and a single revaccination 12 months after the 3rd vaccination, i.e.That is, at 18 months of life. Further, according to the vaccination calendar, revaccination is carried out with ADS-toxoid at 7 and 14 years old and then every 10 years.

Adult tetanus vaccine . Tetanus vaccination in Russia for adults is carried out once with the combined vaccine ADS-M every 10 years, starting from the last vaccination at the age of 14-16 years (further at 24-26 years old, 34-36 years old, etc. ). If an adult does not remember when he was vaccinated against tetanus the last time, he needs to receive the ADS-M vaccine twice with an interval of 45 days and with a single revaccination 6-9 months after the introduction of the 2nd dose.

Tetanus vaccination is available free of charge in all health clinics in your community as part of the compulsory health insurance program.

Emergency tetanus prophylaxis.

Emergency prophylaxis of tetanus is carried out at:

90,029 90,030 injuries with violation of the integrity of the skin and mucous membranes;

90,030 frostbite and burns (thermal, chemical, radiation) of the second, third and fourth degree;

90,030 penetrating injuries of the gastrointestinal tract;

90,030 community-acquired abortions;

90,030 births outside medical facilities;

90,030 animal bites.

Emergency prophylaxis of tetanus consists in the primary surgical treatment of the wound and the simultaneous administration of the vaccine (ADS or ADS-M). Emergency tetanus immunization should be carried out as early as possible and up to 20 days after injury, given the length of the incubation period for tetanus disease.

For the purpose of emergency prevention of tetanus, it is necessary to contact the district trauma centers (around the clock):

• Center for Traumatology and Rehabilitation, St. Petersburg State Budgetary Healthcare Institution “City Polyclinic No. 114” for adults and children, st.General Khrulev, house 7a;
• Traumatology department of the polyclinic department № 121 of St. Petersburg GBUZ “City polyclinic № 114” for adults, st. Kamyshovaya, 50, building 1,

or to the emergency room of SPb GBUZ “Clinical infectious diseases hospital named after SP Botkin” at the address: st. Mirgorodskaya, 3 (round the clock).

90,000 Stab wound – causes, symptoms, diagnosis and treatment

Puncture wound is a tissue injury in which the depth of the wound channel exceeds the width of the entrance opening.It has smooth edges and is applied with a thin sharp object (awl, sharpening). Massive external bleeding with puncture wounds, as a rule, is absent, the condition in the initial stages often remains satisfactory, which can lead to an underestimation of the severity of the injury. The diagnosis is made on the basis of anamnesis and external examination data. If there is a suspicion of damage to internal organs, additional studies are required: chest x-ray, laparoscopy, etc. Surgical treatment: PSU, suturing, dressings.

General information

Puncture wound – a wound with smooth edges, a small entrance opening and a deep wound channel. Puncture wounds are rare in their pure form. In trauma practice, combined injuries are more often observed – stab and cut wounds inflicted with a knife or dagger. The wound can penetrate into the natural cavity of the body (abdominal, chest, joint cavity), accompanied by damage to the nerves, blood vessels and internal organs. Sometimes combined with head injury, bone fractures, closed chest injury, blunt abdominal trauma and damage to the genitourinary system.

Stab wound

Causes

Possible causes of a stab wound can be a criminal incident (sharpening blow), an accident (falling on a pin), a traffic accident, an industrial or natural disaster.

Pathogenesis

Features of damage depend on the location of the puncture wound. It should be noted that such injuries should be treated with particular vigilance, not excluding severe injuries due to the small size of the inlet and the patient’s satisfactory condition.For wounds inflicted by sharpening, the depth of the wound canal can be 15-20 cm with an entrance hole of only 1-2 cm.The wounds inflicted with an awl reach 8-10 cm in depth, and the length of the canal left by a metal pin is completely impossible to predict without PHO.

Injuries in the area of ​​the neurovascular bundles may be accompanied by damage to blood vessels and nerves. At the same time, the absence of massive external bleeding does not exclude damage to the vessels, since after the removal of a sharp object, the tissues are sometimes displaced, clog the narrow wound channel, and the blood is poured not outside, but into natural cavities or surrounding tissues.

The likelihood of damage to internal organs depends on the location. With a wound in the chest area, damage to the lungs and heart is possible, in the abdominal area – damage to the liver, spleen, intestines, in the neck area – damage to the trachea, larynx and esophagus, in the lumbar area – damage to the kidney, etc. injury to an internal organ depends not only on the anatomical zone, but also on the direction and depth of the wound channel. So, with a puncture wound of the abdomen, inflicted from the bottom up, damage can be observed not only to the liver, spleen or stomach, but also to the organs of the chest.And with a similar location of the inlet, but the wound channel directed from front to back, damage to the kidney is possible.

Another distinctive feature of such wounds is the increased likelihood of wound infection. This feature is due to the fact that bacteria and contaminants that have penetrated into the wound cavity are poorly washed out by the blood and remain in the tissues. In addition, the blood that is not poured out, but into the surrounding tissues, creates a favorable environment for the reproduction of microbes.

Classification

Taking into account the depth of penetration in traumatology and orthopedics, all wounds are divided into through and blind.Taking into account the features that have a significant impact on the prognosis and treatment tactics, there are wounds without damage and with damage to internal organs. Taking into account the presence of local complications, wounds are isolated, complicated by massive bleeding or partial prolapse of internal organs.

Symptoms of a puncture wound

With fresh wounds, a small round wound hole with smooth edges is revealed on the skin. If a traumatic object (for example, a pin) remains in the wound, its edges are bent inward.The bleeding is usually mild. With stab wounds, the opening is slit-like or angular, the edges are even, one or both ends of the wound are sharp. Bleeding is usually not intense, but more blood is poured out than with puncture wounds.

Other clinical manifestations depend on the location of the wounds, the presence or absence of damage to internal organs, nerves and blood vessels. A rapid increase in the volume of the damaged anatomical zone in combination with weakness, dizziness and fainting indicates bleeding into the surrounding tissues, increasing shortness of breath in case of injury in the chest area – lung damage, pneumothorax or hemothorax, weakness, shock phenomena and percussion dullness of sound in case of injuries to the abdominal area – about possible damage to the parenchymal organs (liver, spleen).

The edges of the infected wound are hyperemic, local hyperthermia is detected. Serous or purulent discharge is seen in the wound channel. Due to the development of infection in depth and poor outflow of the contents, significant swelling of the surrounding soft tissues is often observed. Patients complain of intense twitching or throbbing pain. Symptoms of general intoxication are observed: fever, chills, weakness, weakness, headaches.

Diagnostics

The diagnosis of a puncture wound is established on the basis of anamnesis and the results of an external examination.The volume of additional studies depends on the patient’s condition and complaints, the location of the wound, the intended direction and depth of the wound channel. To assess blood loss, a complete blood count is done. If lung injury is suspected, a chest X-ray and a consultation with a thoracic surgeon are shown, if damage to the abdominal organs is suspected, an abdominal surgeon’s consultation and laparoscopy (if there are sufficient grounds). Suspicion of damage to a large vessel is the basis for consulting a vascular surgeon, suspicion of nerve damage – for consulting a neurosurgeon.

Treatment of a puncture wound

At the prehospital stage in case of moderate bleeding, the skin around the wound should be washed and disinfected, and then a sterile bandage should be applied. In case of massive bleeding, it is necessary to apply one of the methods for temporarily stopping the bleeding (apply a tourniquet or pressure bandage, tamponade the wound). If a sharp object (pin, sharpening) remains in the wound, it should not be removed, as this can lead to increased bleeding and the development of shock. All patients with stab wounds are subject to immediate evacuation to a specialized medical institution.

Traumatologists-orthopedists are engaged in the treatment of fresh puncture wounds without damage to internal organs. Patients with suspected damage to internal organs, nerves and blood vessels are referred to the appropriate specialists: chest surgeons, abdominal surgeons, cardiac surgeons, urologists, vascular surgeons, neurosurgeons, etc. Treatment of infected puncture wounds is carried out by surgeons.

In the presence of a fresh, uncomplicated puncture wound, PCO is indicated, which is usually performed under local anesthesia.The doctor flushes with solutions of peroxide and furacilin, examines the wound canal with a finger or a probe, excises contaminated areas if possible and sutures the tissue layer by layer. To improve the outflow, puncture wounds must be drained with half-tubes or rubber graduates. The drains are removed 1-3 days after the operation, the sutures are removed on the 8-10th day.

Patients with deep wounds, muscle damage and significant blood loss should be hospitalized in the trauma department. With minor soft tissue injuries, outpatient treatment in a trauma center is possible.In the postoperative period, UHF and antibiotic therapy are prescribed.

Injury to an internal organ is an indication for an appropriate abdominal operation. If a lung is injured, a thoracotomy is performed, if the abdominal organs are damaged, a laparotomy is performed, etc. The doctor performs an audit, sutures the damaged organ and performs other therapeutic measures (the list of measures and tactics of surgical treatment depends on the characteristics of the wound). All patients with internal injuries are hospitalized.

Infected wounds are opened, washed and drained. Local treatment is carried out against the background of antibiotic therapy. First, antibiotics of a wide spectrum of action are used, then a drug is prescribed taking into account the sensitivity of the detected microorganisms. Depending on the patient’s condition, treatment can be both inpatient and outpatient.

Forecast and prevention

The forecast for uncomplicated stab and stab-cut wounds is more favorable than for lacerated and lacerated-bruised wounds.Relatively clean and even edges provide the best healing conditions. However, the risk of infection with such wounds is higher than with shallow cut wounds. The outcome for complicated wounds depends on the characteristics of the injury (the severity of damage to certain organs, the amount of blood loss, the presence or absence of shock). Prevention includes measures to prevent injury.

90,000 types of wounds and stopping bleeding

According to statistics, 70% of deaths from various wounds occur in cases of inaction of eyewitnesses or illiterate pre-medical actions, while the victim dies even before the ambulance arrives.Many deaths could be avoided if people knew what to do in an emergency and how to help the injured person.

In the article we will talk about injuries such as wounds, give their classification and show you how to provide first aid before the arrival of doctors.

Types of wounds and their description

Wound is an injury characterized by a violation of the integrity of the skin and mucous membranes. There are many types of wounds:

1. In the presence of infection – purulent, freshly infected and aseptic.
2. By the nature of the damage – open and closed.
3. By association with anatomical cavities – penetrating and non-penetrating.
4. By the nature of the damage – simple and complex.
5. By location – wounds to the head, abdomen, arms or legs, etc.

Wounds are also classified according to the methods of their application – into gunshot and non-firearms. Let’s talk about the last group of damage below

Types of wounds and their description

Cut wounds

They are characterized by smooth edges, the length of the mucosal lesion exceeds the depth.A cut wound differs from damage of other types in a lesser degree of damage to adjacent tissues, but the depth of damage can be large.

Cut wound is caused by a sharp object such as a knife, glass or razor. The pain with such damage is of moderate intensity, and the bleeding can be profuse. Damage to blood vessels or opening of cavities is a potential threat to the victim’s life. If the wound is shallow, there is no serious danger, the damaged tissue will recover quickly.

Puncture wounds

Puncture wounds are formed under the influence of any narrow and sharp object – a needle, nail, awl. Such damage is distinguished by a significant excess of depth over the area of ​​damage to surfaces. The pain with stab wounds is moderate, blood may not come out of the hole, but there is a risk of profuse internal bleeding.

Such injuries can be complicated by damage to nerve fibers, blood vessels or internal organs.Under certain circumstances, there is a threat to the victim’s life due to internal bleeding or infection.

Lacerated wounds (contused)

It is applied tangentially with a blunt, heavy object and is characterized by a large area of ​​damage. The force of the impact significantly exceeds the elasticity of the soft integument, which leads to the detachment and removal of the skin, destruction of tissues. The area of ​​damage is usually significant.

In lacerated wounds , the supply of certain tissue sites with nutrients is disrupted, which leads to the development of necrosis.In most cases, the lesions are not deep, but extensive. The intensity of bleeding may be less in comparison with different and chopped wounds, but the infection will be more pronounced due to the greater contamination.

Chopped wounds

Formed upon impact with a heavy and sharp object, most often an ax. They differ in a large depth of damage with a relatively small area. Chopped wounds have signs of cut and bruised, and the integrity of internal organs, anatomical cavities, bones and blood vessels may be impaired.

Chopped wounds are almost always complicated by the development of necrosis. The pain is very severe, bleeding of moderate intensity, can be both external and internal.

General first aid measures

Open wounds are associated with an increased risk of developing infectious processes, in addition, they are manifested by heavy or moderate bleeding that threatens the victim’s life. Much depends on how competently the first aid is provided, which must be carried out in a certain order.

Stopping bleeding

Bleeding is the main threat to the victim’s life. So, with a blood loss of 1-2 liters (25% of the total), the risk of shock and death increases several times. Therefore, when providing first aid, it is important to correctly determine blood loss. If the victim is lying on the ground and the amount of blood leaked out is not visible, this can be done by probing the pulse. If it is about 100 beats / min.- so we can talk about blood loss of 1 liter or more.

However, the main danger is not the amount of blood lost, but the rate of bleeding.

Temporary stop of bleeding in case of wounds

Therefore, you must immediately stop the bleeding in one of the following ways:

1. Apply pressure to the wound. The method is suitable for chipped and cut injuries. The injured person should be placed on their back, applied to the injury with a napkin or handkerchief, and pressed on the wound with your fingers.
2. Press the artery with your finger. The method is good in combination with the previous one and allows you to reduce the intensity of blood loss, which is important for assessing the situation and choosing further actions. Depending on the location of the wound, the temporal, carotid, brachial or femoral arteries are pressed against the bone.
3. Make a tamponade. The method is suitable for stopping bleeding with cut or chopped open wounds with a large depth of damage. The wound canal is tamponed with a clean napkin (not paper), a handkerchief or a piece of cloth.
4. Apply a pressure bandage. It is applied to the wound to reduce the rate of blood loss. Before applying, it is important to make sure that there are no foreign bodies in the wound channel, otherwise the bleeding will intensify.
5. Bend and fix the limb. A tissue twisted with a tourniquet is preliminarily placed in the glenoid cavity. The method can be used in the absence of fractures and dislocations.

The application of a tourniquet is used only in two situations: if there is severe arterial bleeding or a limb is torn off.In other cases, such a measure of assistance is impractical and will do more harm than good.

Disinfection of an open wound

After the bleeding has stopped, measures should be taken to prevent infection through the wound channel.

This can be done in the following sequence:

1. Treat hands and wound edges with a disinfectant solution (iodine, alcohol, cologne, etc.).
2. Place a clean handkerchief or piece of tissue over the open wound.
3. Apply a bandage. It should completely cover the wound and not be too tight.

If a wound has formed on a leg or arm, measures must be taken to immobilize them. For this, splints are applied or the limb is fixed with a bandage (kerchief) in a suspended state. Such measures will help prevent the appearance of a purulent wound and facilitate further treatment of the victim.

Applying dressings on wounds

Pain relief

The third step, the purpose of which is to prevent the development of painful shock.

Depending on the situation, the following drugs and techniques can be used to relieve pain:

• Analgin tablets;
• tramadol;
• bags with ice, snow or cold water.

In case of severe pain syndrome, administration of promedol, fentanyl or other drugs may be required.

If the ambulance team for some reason cannot quickly arrive at the scene of the accident, you should try to organize the transportation of the victim to the nearest hospital.It is important to monitor the position of his body in order to reduce the risk of complications and alleviate suffering. For example, in case of a lacerated wound on the leg or an injury to the abdomen, the victim should be placed on his back, and if he is injured in the chest, he should be placed slightly tilted forward.

Nuances of first aid for injuries

Most often, eyewitnesses try to help the victim, but they do it wrong, which leads to a longer recovery, and in severe cases – to death before the arrival of the ambulance brigade.In addition to the first aid algorithm, you need to know a number of rules.

1. In case of damage to the carotid artery, you need to press on the wound with your fingers, then “fill” the wound channel with napkins or a clean cloth, applying a bandage on top.
2. In case of significant blood loss (pulse from 100 beats per minute), emergency measures must be taken to stop the bleeding, then give the victim a drink of water and raise his legs a little.
3. At the slightest suspicion of a fracture, do not raise or bend the limbs.
4. If the pressure bandage is soaked in blood, it must not be removed. Better to put another layer of gauze or cloth on top.
5. In case of profuse bleeding, including from a cut wound, it is better not to waste time disinfecting your hands, but immediately proceed to first aid.

It is impossible to independently remove piercing objects from the wound, as well as any foreign bodies – fragments of glass, iron, bones. In this case, you need to make a ring using a bandage or gauze swab rolled into a tourniquet.It should end above the foreign object, leave it free and be fixed. A sterile or clean bandage is applied on top. If the foreign object is small and shallow, you can try to wash it with running water.

Before the arrival of doctors, you must not leave the victim unattended, you need to encourage him in every possible way, talk about his actions, monitor his well-being. It is better to take off the clothes, if it does not work out, cut them. Upon arrival, the ambulance team must inform the doctors about the actions taken, the drugs administered, the time of injury.This information will help save precious minutes and increase the victim’s chance of survival.

The stages of first aid given in the article are relevant for wounds of any localization, including open wounds of the abdomen, head, chest. Moreover, each situation has its own subtleties. So, with an open cut wound of the abdomen, the blood is stopped by the tamponade method, and the fallen organs cannot be set on their own. They are surrounded by a ring of bandage twisted with a tourniquet, or clean cloth, covered with a clean bandage on top and fixed.Such a victim is transported only on the back.

In case of a penetrating wound in the chest area, it is necessary to create conditions for sealing the wound, using a film, oilcloth, adhesive plaster. The wound is disinfected, a sealing material is applied on top and tightly fixes it with an adhesive plaster. Cold can be applied to the wound to relieve pain.

In case of head injuries, it must be fixed. A foreign object cannot be removed from the wound. If there are symptoms of a brain injury, it is forbidden to give the victim any pain relievers.It is necessary to provide the injured with peace and hospitalize as soon as possible.

Sources:

• B.A. Samura. First aid. 2004.
• Textbook by D.V. Marchenko. First aid for injuries and accidents. 2009.

Treatment and dressing of wounds in the KIT clinic – Krasnoyarsk

Soft tissue injuries are a common occurrence. Damage to the skin or mucous membranes, as well as deeper structures (muscle tissue) can be complicated by infection, inflammation, and suppuration.Complications can be avoided by regularly treating the wound with antiseptics and dressing on time.

The experienced surgeons of the KIT clinic are always ready to provide you with qualified assistance.

Receptions are conducted by traumatologists

Denis Ivanovich Burmakin – Deputy Director for Medical Department, traumatologist-orthopedist. Extensive experience in emergency traumatology, pediatric orthopedics, rehabilitation after injuries.

Bryukhanov Anatoly Valentinovich – doctor microsurgeon.

Bryukhanov Vladimir Innokentyevich – traumatologist-orthopedist, highest qualification category, Honored Doctor of the Russian Federation, work experience over 35 years.

Zotov Vyacheslav Viktorovich – traumatologist-orthopedist.

Pospelov Yuri Vladimirovich – traumatologist-orthopedist.

Klimov Vladimir Alexandrovich – traumatologist-orthopedist. Operating traumatologist-orthopedist.

Scherbovich Dmitry Anatolyevich – traumatologist-orthopedist, chiropractor, physiotherapist, first medical category, 13 years of work experience.Head of the Department of Rehabilitation.

What is a wound and what they are

A wound is tissue damage, which is accompanied by a violation of the skin or mucous membranes. Wounds are distinguished by the scale and depth of damage (deep, superficial), type (stab, torn, cut, gunshot, burn, etc.). There are also clean and purulent (complicated) wounds. Treatment methods for different types of injury will vary.

Types of surgical treatment of wounds and treatment of burns

Depending on the stage at which the trauma received by a person is located, primary and secondary wound treatment is distinguished. Initial surgical treatment is a set of measures that is carried out when the patient has sought help after receiving injuries.

The surgeon determines the strength of bleeding, assesses the general condition and risks, the degree of damage, treats the wound in order to protect it from infection, applies a sterile bandage. If the wound is gaping, excision of its edges and suture may be required.

Surgical treatment of the wound during repeated treatment depends on the condition of the tissues, the presence of complications.So, in the case of the formation of necrotic areas, they are excised, the surface is mechanically cleaned of pus. Treatment of a purulent wound requires the use of special tools: for example, ointments with an antibiotic in the composition.

Treatment of burns depends on the degree of damage (burns of 1, 2, 3 and 4 degrees are distinguished with different levels of damage to the epidermis and different prospects for healing). Serious and extensive injuries often require hospital treatment.

When contacting a surgeon with an open wound, the patient is also administered tetanus toxoid.

Wound dressing

To reduce the likelihood of infection and avoid additional damage to the skin, a protective dressing should be worn until healing. Wound dressing is usually done every one to two days.