Wound care laceration: Open Wounds and Lacerations
Open Wounds and Lacerations
An open wound involves a break in the skin or tissue that may be caused by, among other things, accident, injury or animal bite. A laceration is a type of open wound, one with jagged, irregular edges. Open wounds and lacerations typically involve bleeding, redness, swelling, pain, and tenderness. They can occur nearly anywhere on the body, with the upper extremities being a common location for open wounds/lacerations caused by accidents or falls. Deeper wounds or lacerations may require medical attention to prevent infection and loss of function, due to damage to underlying structures such as bone, muscle, tendon, arteries and nerves. Medical care for wounds and lacerations focuses on promoting healing, preventing complications and preserving function. While important, cosmetic results are not the primary consideration for wound repair.
Diagnosis of Open Wounds and Lacerations
A physician assesses the severity of the injury by performing a physical examination, asking about how the injury occurred and gaining information about any pre-existing medical conditions that the patient may have. They may also look for any signs of weakness or numbness in the injured area and may test nerve and muscle function. X-rays may also be performed if more serious injuries to bones or tissue are suspected.
Treatment of Open Wounds and Lacerations
The first step of treatment is to stop the bleeding of a wound or laceration. While treatment depends on the type and severity of the injury, it can often initially be treated at home by cleaning and bandaging the wound and applying pressure. Severe wounds or lacerations may require emergency medical care. Medication to numb the injured area may be given and wound and laceration repair usually includes cleaning and preparing the wound, and then closing it with staples, special surgical glue or adhesive strips. Deeper cuts may require stitches to repair deep structures, such as connective tissue. Stitches to the skin surface can also help to stop bleeding, protect underlying tissues, and lessen scarring. Antibiotics may also be prescribed to fight infection. In severe cases, minimally invasive surgery may be performed to remove or graft skin. Follow-up care is often required to remove stitches or other materials used to close the laceration, and to monitor the healing process.
Bennett Podiatric Medical Center
3117 Joseph Howe Dr
Halifax, Nova Scotia, B3L -4h3
Brendan Bennett: Podiatrist. BSc (Hons) Pod. FFPM RCPS (Glasg). FC Pod Med
Wales Center for Podiatric Studies; University of Wales.
Brendan Bennett is a member of the following pr
Rebecca Bennett: Podiatrist BSc (Hons) Pod BSN. MCP
Wales Center for Podiatric Studies: University of Wales.
University of Pittsburgh: BSN
Rebecca Bennett is a member
Nicole Beatty Podiatrist. Dip Pod Med.
Mitchener Institute Toronto Ontario.
Nicole Beatty is a member of the following professional organizations:
Nova Scotia Pod
Wound Care after an Injury
If you’ve had a traumatic injury, you may have skin wounds — bruises, scrapes, or cuts. (Cuts may be called “lacerations” by your doctor.)
Cuts are treated based on where they are, what caused them, how deep they are, and other factors. Sometimes cuts will heal on their own, without extra treatment. Or, the Trauma Service might have treated them with sutures (stitches), staples, plastic bandages, or dermabond (a type of surgical “super glue”). This fact sheet explains how to care for your wounds at home.
Caring for scrapes and minor cuts
Here’s how to care for scrapes (also called abrasions), minor cuts, and “road rash” at home:
- Clean them daily with mild soap and water. If your doctor prescribed antibiotic ointment, apply a thin layer of ointment once or twice a day. Or, you can use over-the-counter antibiotic ointment if you’d like.
- Check daily for signs of infection — see the following “Warning Signs”
Caring for large wounds or wounds with stitches or staples
- If you were prescribed antibiotic pills, take them as directed until they are gone.
- Change your dressings (bandages) as directed.
- Keep the wound dry for 48 hours after it was treated.
- After the first 48 hours, wash the wound as needed with mild soap and water. Then put a very thin layer of antibiotic ointment over the stitches or staples, if your healthcare provider directs you to.
- Do not soak the wound until it’s fully healed. This includes baths, long showers, saunas, and hot tubs.
Warning signs — when to get help
Go to the emergency department or call the Trauma Service if you notice signs of infection, such as:
- Pus that drains from the wound — pus is white, green, or yellow and often smelly. (A small amount of clear drainage is normal.)
- Red streaks or areas of tenderness that are very hot and tender to the touch around the wound.
Removing stitches or staples
See your discharge instructions for details on when to have your stitches or staples removed. If stitches or staples are left in too long, they can cause scars and infections.
Stitches may be removed by your regular doctor or at the Trauma Service clinic. Generally, stitches are removed in 5 days if they’re on the face, in 10 days if they’re on the chest or belly, and in 10 to 14 days if they’re on an arm or leg.
Almost all cuts result in some type of scar. How much you scar often depends on your genetic makeup. Factors such as sun, infection, and the type of cut can also affect scarring. To help reduce scars:
- Keep the wound out of the sun while it heals (this can take 3 months to a year). After it heals, use high SPF sunblock on the wound for a full year.
- Keep the wound free of infection by applying a thin layer of antibiotic ointment daily for 3 to 6 months.
- Keep the wound from getting too hot or too cold.
Wounds first aid
A wound is any damage or break in the surface of the skin.
Applying appropriate first aid to a wound can speed up the healing process and reduce the risk of infection.
Wounds including minor cuts, lacerations, bites and abrasions can be treated with first aid.
Use a clean towel to apply light pressure to the area until bleeding stops (this may take a few minutes). Be aware that some medicines (e.g. aspirin and warfarin) will affect bleeding, and may need pressure to be applied for a longer period of time.
Wash your hands well
Prior to cleaning or dressing the wound, ensure your hands are washed to prevent contamination and infection of the wound.
Rinse the wound
Gently rinse the wound with clean, lukewarm water to cleanse and remove any fragments of dirt, e.g. gravel, as this will reduce the risk of infection.
Dry the wound
Gently pat dry the surrounding skin with a clean pad or towel.
Replace any skin flaps if possible
If there is a skin flap and it is still attached, gently reposition the skin flap back over the wound as much as possible using a moist cotton bud or pad.
Cover the wound
Use a non-stick or gentle dressing and lightly bandage in place; try to avoid using tape on fragile skin to prevent further trauma on dressing removal.
Contact your GP, nurse or pharmacist as soon as possible for further treatment and advice to ensure the wound heals quickly.
Wounds can be painful, so consider pain relief while the wound heals. Talk to your GP about options for pain relief.
Where to get help
See your doctor or nurse if the wound:
- shows signs of infection
- continues to bleed
- you are unable to realign the skin
- has dirt, glass, a thorn or other foreign body in the wound
- seems large or deep
- is not healing, or is very slow to heal (e.g. not healed after 4 weeks)
- you have an underlying medical condition
- you have another injury or hit your head at the time of the injury (you may have a concussion or fracture)
- there is a risk of further injury
- you are unsure how to manage the wound, or have any concerns.
This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.
Care for a Skin Wound
Skin wounds, including animal or human bites, need thorough cleaning to reduce the risk of infection and scarring and to promote healing.
You may be able to do this yourself for minor wounds. You’ll have to stop any bleeding, clean the wound, and perhaps bandage the wound.
Stop the bleeding
Before you clean the wound, try to stop the bleeding.
- Put on medical gloves, if available, before applying direct pressure to the wound. If gloves aren’t available, put something else between your hands and the wound. You can use many layers of clean cloth, plastic bags, or the cleanest material available. Use your bare hands to apply direct pressure only as a last resort.
- Hold direct pressure on the wound, if possible, and elevate the injured area.
- Remove or cut clothing from around the wound. Remove any jewelry from the general area of the wound so if the area swells, the jewelry will not affect blood flow.
- Apply steady, direct pressure for a full 15 minutes. Use a clock—15 minutes can seem like a long time. Resist the urge to peek after a few minutes to see whether bleeding has stopped. If blood soaks through the cloth, apply another one without lifting the first. If there is an object in the wound, apply pressure around the object, not directly over it.
- If moderate to severe bleeding has not slowed or stopped, continue direct pressure while getting help. Do not use a tourniquet to stop the bleeding. Do all you can to keep the wound clean and avoid further injury to the area.
- Mild bleeding usually stops on its own or slows to an ooze or trickle after 15 minutes of pressure. It may ooze or trickle for up to 45 minutes.
Clean the wound
If you are not going to see your doctor immediately, rinse the wound for at least 5 to 10 minutes. Let the injured person clean his or her own wound, if possible.
- Wash your hands well with soap and water, if available.
- Put on medical gloves before cleaning the wound, if available.
- Remove large pieces of dirt or other debris from the wound with cleaned tweezers. Do not push the tweezers deeply into the wound.
- Wash the wound under running tap water (the more the better) to remove all the dirt, debris, and bacteria from the wound.
- Scrub gently with a washcloth. (Moderate scrubbing may be needed if the wound is very dirty.) Hard scrubbing may actually cause more damage to the tissue and increase the chance of infection. Scrubbing the wound will probably hurt and may increase bleeding, but it is necessary to clean the wound thoroughly.
- If you have a water sprayer in your kitchen sink, try using the sprayer to wash the wound. This usually removes most of the dirt and other objects from the wound. Avoid getting any spray from the wound into your eyes.
- Large, minor, dirty wounds may be easier to clean in the shower.
- If some dirt or other debris remains in the wound, repeat the cleaning.
Bandage the wound
Consider bandaging the wound if you need to protect it from getting dirty or irritated. Choose the bandage carefully. There are many products available. Before you buy or use one, be sure to read the label carefully and follow the label’s instructions when you apply the bandage.
- Be sure you have thoroughly cleaned the wound.
- You may cover the wound with a thin layer of petroleum jelly, such as Vaseline, and a nonstick bandage.
- Apply more petroleum jelly and replace the bandage as needed.
- If needed, use an adhesive strip called a butterfly bandage to hold the edges of the wound together. You can make one at home or buy them already made. Always put the butterfly bandage across a cut, not lengthwise, to hold the edges together.
- Watch for signs of infection. If an infection develops under a bandage, you may need to see your doctor.
- Take the bandage off and leave it off whenever you are sure the wound will not become irritated or dirty.
Large, deep, or very dirty wounds
You may need to see a doctor for a large, deep, or very dirty wound. You may also need to see a doctor if the wound is too painful to clean or you cannot remove dirt, debris, or a foreign object. The doctor will also know if you need antibiotics or stitches.
Most wounds that need stitches should be treated within 6 to 8 hours after the injury to reduce the risk of infection. Very dirty wounds may not be stitched to avoid the risk of infection.
If you are going to see a doctor immediately, the wound can be cleaned and treated at the medical facility.
When to get stitches
A quick test to determine whether you need stitches is to stop the bleeding, wash the wound well, and then pinch the sides of the wound together. If the edges of the wound come together and it looks better, you may want to consider getting stitches. If stitches may be needed, avoid using an antiseptic until after a doctor has examined the wound.
- Most cuts that require treatment should be stitched, stapled, or closed with skin adhesives within 6 to 8 hours after the injury. Some cuts that require treatment can be closed as long as 24 hours after the injury. Your risk of infection increases the longer the cut remains open. Occasionally a wound that is at high risk of infection will not be stitched until after 24 hours. Or it may not be stitched at all, so that adequate cleaning can be done first to prevent infection.
- A cut from a clean object, such as a clean kitchen knife, may be stitched from 12 to 24 hours after the injury depending on the location of the cut.
- A facial wound may be treated to reduce scarring.
Taking off a bandage
Removing tape or a bandage may damage healing skin or cause thin skin to tear. Unless the bandage is soiled, avoid changing it too often. To remove, hold the skin with one hand, and gently pull the tape or bandage toward the wound.
If the tape holding the bandage is stuck to the skin or hair on the skin, use bandage adhesive remover before trying to take the tape off. You can buy adhesive remover at the store where you get bandages. Read and follow the instructions on the label.
If the bandage is stuck to the wound, wet the bandage with saline solution until it loosens and then gently roll the dressing off the skin.
Laceration | injury | Britannica
Laceration, tearing of the skin that results in an irregular wound. Lacerations may be caused by injury with a sharp object or by impact injury from a blunt object or force. They may occur anywhere on the body. In most cases, tissue injury is minimal, and infections are uncommon. However, severe lacerations may extend through the full thickness of the skin and into subcutaneous tissues, including underlying muscle, internal organs, or bone. Severe lacerations often are accompanied by significant bleeding and pain.
Appropriate treatment of lacerations is important to decrease the risk of excessive scar formation. The first step in the management of lacerations is hemostasis, or the termination of bleeding. Direct continuous manual pressure to the area of injury with sterile gauze is helpful for achieving hemostasis. Once bleeding has stopped, the wound may be explored to determine the severity and extent of involvement of bone, muscle, tendons, nerves, or blood vessels. Exploration may reveal the presence of foreign debris, such as concrete or sand, within the wound.
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Lacerations typically are treated through irrigation with a sterile saline solution, which helps to remove dead tissue fragments and foreign debris. The wound is then closed. The type of wound closure used depends on the extent and severity of the laceration. Primary healing of a laceration occurs when the wound is closed with skin adhesives, tissue tapes, or sutures. Secondary healing occurs when the wound is left open to heal by the formation of granulation tissue (a covering of connective tissue and capillaries), contraction (the drawing of wound edges near to one another), and epithelialization (the growth of new epithelium over the site of injury). Infected wounds typically heal through secondary healing. Delayed primary closure is often used for lacerations that are not considered to be clean enough for primary closure. The wound is left open to heal for 5 to 10 days in a moist wound-healing environment, and then it is sutured closed. A moist wound-healing environment is created through the use of dressings that retain moisture to improve pain control, that encourage autolytic debridement (natural enzymatic breakdown of dead tissue), that provide physical and bacterial barriers, and that promote the formation of granulation tissue. Examples of such wound dressings are hydrogels, alginates, hydrocolloids, foams, and films. Hydrocolloids are favourable, as they do not require a secondary dressing, are fibrinolytic, are absorbent, increase angiogenesis (the formation of new blood vessels), and are bacterial and physical barriers. Delayed primary closure decreases the risk of infection through achieving bacterial balance, and granulation tissue formation creates an optimal environment for the wound’s oxygen requirements.
Full-thickness lacerations, which are associated with delayed healing and increased scarring, may require closure with sutures. Burst or jagged laceration edges may be repaired with trimming to create a more linear and smooth edge, which is better for approximation of the wound for closure with sutures. After sutures have been removed, the addition of tissue tapes may be needed to add strength to the healing wound.
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Antibiotics generally are not needed for the treatment of simple lacerations. A wound that has remained open for several hours or is heavily contaminated may require a 7–10-day course of antibiotics. Lacerations from human bites may also require antibiotics as well as tetanus prophylaxis.
Treatment for Wounds and Lacerations
If you or a loved one has experienced a wound or laceration, you may be in shock and wondering whether to go to the emergency department or urgent care. Treatment for wounds all depends on the location and the size of the cut.
Should I Go to the ED or Urgent Care?
Different kinds of injuries lead to different kinds of wounds including abrasions, lacerations, crush wounds, puncture wounds and avulsions. For something that is less than three inches, the patient can come to eMedical Urgent Care for immediate care and treatment. If the cut is longer than three inches or extremely deep, tendon or deep tissue may be damaged. In those cases, go to the ER so they can give more intensive repair including a possibly surgery.
At-Home Wound Care
For bleeding lacerations, before you make your way to urgent care or the ER (based on the location and size mentioned above), the first thing you should do is to apply direct pressure. Place a clean rag or gauze on the cut and hold pressure. If you can’t control the bleeding, don’t take the bandage off; rather, keep that one on and put another one on top. Ice can also be helpful in stopping the bleeding and can decrease swelling as well. If the wound is dirty, wash it with warm water and soap to remove any large particles of dirt and debris. Also, keep the injury elevated above the heart level to slow the bleeding. For treatment of wounds less than three inches, go to eMedical Urgent Care for a physical evaluation, proper cleaning of the cut and possible suture repair. However, if the bleeding “pulses,” this could indicate an artery has been cut, call 9-1-1 immediately.
Keep Wounds Clean and Dry
The best way to take care of a suture wound is to keep it clean and dry. When an area is wet, it doesn’t heal as well. If a bandage or it gets wet or dirty, change it. Also, watch for signs of redness, swelling or discharge which could indicate a sign of infection. Sunlight can inhibit the healing process, so keep the area covered and protected from ultraviolet light. If the cut doesn’t require stitches, the best at-home wound care is washing the area with soap and water regularly to clean out any germs. Put small amounts of antibiotics ointment on the wound to speed up the healing process as well. It’s important to keep the area clean and dry to prevent scarring or infection.
Dog, cats and human bites are considered puncture wounds and can introduce bacteria into the wound. This can lead to infection, so antibiotics are typically prescribed. If the bite was from a wild animal such as bats, snakes or rabid dogs, you may need a rabies vaccination from the ED.
Tetanus is a bacteria that is found in dirt. If a victim is cut by a rusty nail, fence other questionable object, tetanus is commonly a concern. Adults should have a tetanus shot every 5 years to stay protected. eMedical Urgent Care conveniently offers the tetanus shot; in fact, the vaccine most commonly given in our offices is a combination of Tetanus, Diphtheria and Pertussis, called the TDaP vaccine.
If you need medical attention for a non-life-threatening illness or injury, eMedical Urgent Care is open during the evening and weekend hours to treat walk-in patients. Treatment for wounds, cuts and lacerations is available at eMedical Urgent Care in Middletown and Berkeley Heights, NJ.
Wound Management: The Days After…
Wound Management: The Days After…
I put in a fair amount of stitches. I also decide NOT to put in stitches. Sometimes I use skin glue, and occasionally, I don’t close up a laceration at all. I’ve come to know pretty well which cuts need which treatment. But medical decision making aside, if I look at how I spend my time at work, a not small amount of it is dealing with kids who have fallen, run into a door or edge of a table, or cut themselves some other way.
To stitch or not to stitch?
When kids get cuts (or lacerations when we’re using their fancy name), there’s generally a lot of focus placed on whether or not stitches are required. That’s understandable, right- getting a good closure helps the healing process and decreases scarring, and that’s pretty important stuff. There’s a lot written about this topic: from what kinds of cuts should be stitched or glued, to how long stitches should stay in, to whether or not the absorbable kind should be used. As with much of medicine, art and science collide here and there are really a wide range of answers to most management questions on this topic.
What I find doesn’t get a lot of attention are the details surrounding the days AFTER the initial treatment of the laceration. There are a few key points to remember, and if they go well, they can really have long term effects on the outcome.
First, it’s important to think about what the wound looked like before it got treated.
Was there a bunch of dirt and debris in it?
Was it deep?
Was it located on a part of the body that is near fluids and possibly more prone to being in contact with bacteria?
These are all important questions to ask because “dirty” wounds have a higher risk of getting infected, and while all wounds need to be watched very closely because anytime the skin barrier is disrupted a chance of infection exists, dirty wounds need extra close observation. In fact, kids who sustain a dirty cut will often be asked to return 24-48 hours after the initial exam to be re-evaluated, or to have what we call a “wound check”- before the stitches are ready to come out, just to make sure that healing is progressing as it should.
There’s no real diplomatic way to say this, but most cuts look sort of terrible for the first 1-3 days after they happen.
They are red and angry and sore, even when they’re not infected. They look that way because they are inflamed, because the body is doing its job to help heal the wound. I expect this, and you should too. That being said, there’s a fine art of understanding when wounds go from this healing phase to getting infected. There are a few telltale signs—increasing pain, redness and swelling rather than decreasing is often concerning, and cloudy yellowish drainage that we call pus. Sometimes there may even be fever. Wound infections can be treated successfully with antibiotics but the early they are caught the better, so if there’s any question in your mind about whether or not a wound is infected, get it checked out by a healthcare professional—better to err on the side of caution.
For the first 24-48 hours, wounds shouldn’t get wet.
People often ask about when their child can wash the affected area after stitches. Keeping the area dry for a day or two can really help the healing process. Getting the skin barrier closed is the goal, and so it’s important to jump start this by initially keeping the area dry, then after about 24-48 hours the area can be washed with soapy water and patted dry, then covered with an antibiotic ointment. Avoid completely submerging a wound until it is well healed (showers only for a week or so). When a wound that hasn’t completely healed gets submerged, dirt can seep into it and it can delay the healing process as well.
A few other tips to aid the wound healing process:
- Try to keep the wound covered until it is dry and no fluid is draining out. This just acts as a barrier between a partially open wound and dirt that may potentially get in.
- Don’t scratch or pick at the wound. Sometimes they can be very itchy, but healing will be improved and scarring will be less if the wound hasn’t been agitated.
- Eat a nutritious diet! A well rounded diet full of minerals and vitamins will help the body heal faster.
Your healthcare professional will let you know if/when any stitches should be removed, and please remember this—we want to keep stitches in for enough time to make sure that the wound edges are lined up nicely for healing, but not too much time that they get embedded and become difficult to get out. If they stay in for too long, they can be irritating and the body may react against the stitches themselves, which is also not optimal. So if the stitches are supposed to come out in a week, make it so.
And finally, I’ve said it in this forum before but it bears repeating:
COVER ALL SCARS with SUNSCREEN, even well healed ones.
Scars absorb more sunlight and can darken quicker than intact skin, so make sure that they are well covered, even in winter. All the dermatologists and plastic surgeons in the world say thank you. And so will your skin.
Remember that the care plan is only just beginning when a wound gets treated at a medical visit, and that the bulk of care comes in the days following. Pay attention to any small changes in the appearance and follow all the directions you were given closely. Get any concerns checked out on the early side, and remember sun protection even months and years after the injury. Optimizing results here is a marathon not a sprint, which always seems ironic to me given that the injury itself usually happens in the blink of an eye.
May all your wounds heal quickly and easily.
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Skin Tear is damage to the top layer of the skin. It often happens in older people with thin, fragile skin. This can happen after a fall or other injury.
Keep the wound clean and dry. If the dressing is and it gets wet or dirty, change it. Otherwise, do not bandage for the first 24 hours, and then change the bandage once a day or as directed.
If stitches were applied , clean the wound daily.
After removing the dressing, wash the wound area with soap and water. Use a damp cotton swab (Q tip) to soften and remove any dried blood or crust.
Then apply a thin layer of Neosporin or Bacitracin ointment. This will keep the wound clean and make stitches easier to remove. Put on a new bandage.
After 24 hours, you can remove the dressing and shower as usual, but do not immerse the affected area in water (do not swim) until the stitches are removed.
If Steri-Strips were used, the wound should remain clean and dry. If the damaged area gets wet, pat it dry with a towel.
If Skin Adhesive was used, do not scratch, rub or peel off the adhesive tape. Do not stick the patch directly onto the tape. While the film remains in place , , do not apply liquid solutions , ointments or creams to the wound.Do not cleanse the wound with peroxide or apply ointment. Avoid sweating activities until the film falls off. Protect the wound from prolonged exposure to direct sunlight or tanning lamps. You can shower as usual, but do not immerse the wound in water (do not take a bath or swim).
Acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) can be taken to relieve pain if no other medication has been prescribed. [ NOTE. If you have chronic liver or kidney disease, or have had a stomach ulcer or gastrointestinal bleeding, consult your doctor before taking these drugs.]
Most skin wounds heal within ten days. However, even with proper care, wound infection sometimes occurs. Therefore, inspect the wound so as not to miss the warning signs listed below.SEAMS must be removed within 7-14 days. If you have used Steri-Strips, remove them yourself if they do not come off after 10 days. If skin glue was used, the film will fall off by itself after 5-10 days.
Seek Medical Care Immediately
for any of the following:
Wound pain worsening;
redness, swelling, or pus coming out of the wound;
At a temperature of 100.4єF (38єC) or higher, or as recommended by a healthcare practitioner.
stitches have come apart or Steri-Strips have fallen off in less than seven days;
the edges of the wound parted;
numbness of the hand or foot after discharge of anesthesia;
bleeding that does not stop when the wound is clamped.
90,000 A wound in a dog, first aid, how to treat
Treating dog wounds is a routine procedure for any dog breeder.Of course, representatives of some breeds, due to the specifics of behavior, get wounds much more often, but any pet owner needs to know how to provide first aid in case of injury.
The nature of wounds, their danger
Wounds in a dog can be of different nature, therefore they pose different risks. Moreover, this danger does not always correlate with the appearance: sometimes extensive damage with profuse bleeding carries less risk to life and health than a small puncture on the skin.
Wounds are classified according to the method of application:
- Chipped – small, profusely bloody only in rare cases. The danger depends on the place of application, as well as on the depth, so you need to be very careful about the symptoms.
- Cut – can have different lengths and depths. If only the skin is affected, then they practically do not carry a risk, but at greater depth they can provoke massive bleeding.
- Bitten or torn – have an irregular shape, can be very different in nature, consequences.Bite injuries are often infected, therefore, antiseptics are used when treating them.
- Chopped – affects deep layers of tissue, muscle or bone. They are aggravated by bruising or crushing.
- Firearms – can be very dangerous, especially when injured in the chest, abdominal cavity, neck (there are large vessels) or head.
Often, pets receive combined injuries – they are even more dangerous due to the overlapping of symptoms.
First aid for injuries
If the injury is not dangerous, then you can cope with the problem yourself. For this:
- The wound surface is cleaned. All foreign objects, as well as wool, are removed from the cavity. Tissues are washed with running clean water.
- Bleeding stops – short-term pressing of blood vessels, treatment with hydrogen peroxide helps.
- Antiseptic treatment is performed to protect the animal from infection.
It is advisable to close the wound (at least temporarily) with a sterile dressing. To avoid licking or brushing, a special collar is put on the pet.
If there is even a slight fear that the wound poses a threat to the life and health of the dog (for example, profuse blood loss is observed, while the bleeding does not stop), it is necessary to deliver the animal to the veterinary clinic as soon as possible. Before that, you need to stop the bleeding using a vessel clamp, tourniquet or pressure bandage – this makes it possible to take the animal to the veterinarian.In the clinic, the doctor will stop the bleeding (including by surgical methods), perform treatment and suture, ensuring rapid tissue fusion at the site of injury.
How to treat a dog’s wound?
To treat damaged skin or superficial tissue, you can use:
- Hydrogen peroxide – does not damage healthy tissues, brings a minimum of discomfort during processing.
- Chlorhexidine – copes well with most pathogenic microorganisms, suitable for primary disinfection.
- Furacilin – gently affects the epidermis, suitable for treating clean and purulent wounds in a dog.
- Miramistin – resists bacterial or viral infection. Prevents the development of purulent processes. Stimulates regeneration.
A special approach is needed for wet surfaces. When choosing how to treat a wet wound in a dog, veterinarians usually prefer powders or powders with antiseptics. Such funds not only kill pathogenic microflora, but also “draw out” excess moisture.
Of course, not every wound in a dog is dangerous, so some can be dealt with by the owner himself. But in some cases, the veterinarian’s surgery can save the pet’s life.
Postoperative wounds: rules and features of care
Stages of wound healing
Postoperative wound care
The postoperative wound remains after surgical interventions and belongs to the category of cut wounds. It is closed with the help of suture sutures.
With proper care, recovery from surgery takes about 2-3 weeks. It is very important, in the postoperative period, to thoroughly wash the wound with a sterile Prontosan solution, to change the postoperative dressings in a timely manner, and to carry out visual control for signs of infection.
Stages of wound healing
- Inflammation – 5-7 days
because the body does not distinguish between postoperative “useful” wounds from ordinary ones and begins to actively produce substances that accelerate blood clotting and formation of blood clots. This is important for stopping bleeding and for protection.
- Granulation – 10-30 days
The process promotes successful healing and represents the formation of young tissue, the appearance of which differs depending on the stage. Inflammatory cells, connective tissue, newly formed vessels form granulation tissue, which fills the incision cavity. At first, this granular tissue bleeds easily. the vessels have thin walls, but the closer the end of this stage is, the denser and lighter the tissue becomes, and the graininess and bleeding disappear.
- Epithelialization – 30-90 days
Epithelial cells formed at the edges of the wound and connective tissue gradually completely fill the damaged area. The number of vessels decreases, a scar is formed.
- Scar formation – from 3 months to 1 year
Vessels completely disappear, collagen and elastin fibers gradually complete the scar formation – the duration of this process depends on the patient’s age, state of health, the severity of the operation and many other factors.
Postoperative wound care
For each of the four stages to pass without complications, you need appropriate care and strict adherence to all the recommendations of the attending physician.
In the first stage, the surgeon plays the main role. Correct suturing prevents possible pulling and tearing of the sutures. Primary protection against external microorganisms is also important. During this period, the patient will need sterile dressings, for example, Cosmopor E, Askina Soft, Dokaplast with Miramistin or Omnistrip strips.
Wound Care Manual (Part 2)
Abrasions are usually sharp and in most cases heal almost no matter what is done. In particular, simple abrasions, if left untreated by a healthcare professional, form a scab that eventually falls off, revealing the healed area underneath.
However, the problem here is that this type of healing is slow and can lead to an unacceptable scar.
The best treatment for an abrasion is to stop the bleeding, cleanse the area well with an antiseptic and then apply mesh to protect the superficial wound and allow new tissue to form quickly without damage in the first dressing. Mesh dressings for this purpose include: Mepitel ™ , Urgotul ™ or Hydrotul ™ .
Secondary dressing on this mesh is usually light absorbing adhesive layer , Such as Cutipast Sterile ™ or Primapore ™ , A secondary waterproof dressing is usually not recommended for this first dressing due to the risk of infection – excessive heat and humidity create an environment, favorable for the growth of bacteria.
At the next dressing change, if there are no signs of infection, then a waterproof dressing can be used as a secondary dressing.
After careful evaluation, a small, simple tear is usually managed with an antiseptic scrubbing, Steristrips ™ and either waterproof , light absorbent dressing or waterproof, lightweight, absorbent, adhesive dressing , using the principles previously mentioned on contamination risk . .. More complex lacerations may be sent to the emergency room or surgeon after an initial assessment.
When faced with a difficult wound care case, many early or novice clinicians ask, “What is this wound? What kind of clothes should I use? How will this wound heal?
Aspect wound treatment An often overlooked definition of the wound itself. Wound care guidelines have always focused on identifying the wound, identifying any related factors that may affect the healing process, and then choosing the appropriate wound dressing or healing device to achieve the goal and help the healing process.
This structured approach is important because the most common mistake in managing wound disposal is choosing the most recent and newest new wound dressings without actually giving thought to the wound etiology, tissue type, and immediate target.
This wound and dressing overview will identify some of the more common wound types and will guide you in setting your care goal and choosing a product or device to achieve that goal.
90,000 National Association of Advocates of Ukraine – If you have a knife in your pocket. Self-Defense: Principles and Mechanics of Striking
You have probably noticed more than once that a lot of people carry a small pocket knife with them for everyday purposes, a kind of a new trend.
At the same time, catastrophically few people understand how to use it, for self-defense, and what it can subsequently result in.
What is the basic information about the use of a knife as a means of protection, you need to own.
First of all, everyone should clearly learn two things that:
1. The use of a knife against another person is considered armed violence (even the usual demonstration of a knife can be regarded as a crime in many cases, except when it was a clear act of self-defense).
2. If you still got a knife in self-defense, your actions must be provoked by more than 110% and you must act quickly and brutally.
If you do not know how to do this or you do not have enough inner spirit, my advice to you – do not take out the knife.
This article is not an advice from a lawyer, but is only aimed at describing cases and actions when using a knife for self-defense purposes.
If you use the knife for other purposes, you will most likely end up in prison .
So, if you carry a knife for self-defense, you must clearly understand whether you can stab or pierce another person with a knife, possibly killing him to death.
The use of a knife as a weapon is a very serious matter, you will need to get close to the attacker almost close, controlling your movements, cold-bloodedly cut living flesh and see really a lot of blood, and possibly the death of a person.
Can you do this to another person?
Only fully understanding and realizing your own answer to this question and truly understanding the consequences of your actions, you can carry and use a knife for self-defense.
It is possible that your offender will change his mind and run away when he sees a knife in your hand, but the chances of such a development of events are very small.
If this does happen, and the person attacking you retreats, you must immediately do two things:
1.Leave this territory immediately;
2. Immediately report the incident to the police.
You need to leave the scene very quickly, as criminals have a habit of returning with reinforcements. You also need to contact the police and tell about what happened so that the criminal whom you just scared does not do it first, because the story from his lips will be completely different. For example: how exactly did you threaten him with a knife, while he helped an elderly woman, tried to rob them, etc.d.
Now, regarding the direct process of using a knife as a weapon of self-defense.
The first is knowledge of the basics of anatomy:
For those who have studied anatomy, this diagram is not accurate, but it is quite enough for an illustrative example.
When using a knife as self-defense, you must master two basic techniques: the ability to make cuts and stabs with a knife.
Considering that the human body is more or less symmetrical, the places shown in the following figure correspond fairly accurately to cuts and punctures , both on the left and on the right side of the body.
Point A – superficial temporal artery, which is located between the skin and the skull bone and passes through the temple. If you touch it, there will be severe bleeding.
Point B – an area of the neck and throat, almost at the level of the Adam’s apple. At this point, the carotid artery and the jugular vein are located. If at least one of them is hurt, the attacker will very quickly bleed and die. The carotid artery extends about an inch and a half below the surface of the skin, so it can only be touched with a deep cut, but if you cut it open, it will go unconscious in about 5-15 seconds. Remember, if the attacker is under the influence of drugs, the fight can go on for almost a minute.
Point C is the trapezius muscle, which is responsible for most of the movement of the shoulder joint.
Point D – incision on the outside of the pectoral muscles. This cut needs to be made stronger. If the incision is made horizontally and extended to the arm, it can cause a major vein to rupture, leading to severe bleeding.
Point E – an incision across the deltoid muscle.But don’t overdo it – the incision can rupture the main muscle.
Point F – incision of the biceps brachii. This muscle is responsible for most of the movement in the arm and there are many veins around it.
Point G – incision of the inner part of the elbow joint. In addition to numerous veins, this area also contains ligaments that control the movements of the forearm.
Point H – horizontal incision on the forehead. This area is heavily vein-filled and will bleed profusely when cut, blinding the attacker.
Point I – a vertical incision through the cheek and jaw. Some of the major nerves of the face are located in this area, and the cut will be very painful.
J-point – horizontal incision through the neck and throat. In this area, not only the jugular vein, but also the trachea and ligaments responsible for head movements.
Point K – trapezius muscle, closer to the neck.
Point L – strong incision of the pectoral muscle. With such a wound, the attacker will not be able to deliver strong punches.
Point M – strong vertical incision of the abdominal cavity. Damage to the abdominal wall will immobilize the attacker, and may also lead to the loss of viscera.
Point N – strong horizontal incision of the abdominal cavity. It can also immobilize the enemy and lead to the loss of entrails.
Point O – an incision that penetrates the inside of the forearm, between the radius and ulna. If the cut is deeper than 2 centimeters, it will provoke rupture of many veins and, as a result, rapid blood loss.
Point P – incision on the back of the head, passing from above the back of the ear and almost to the middle of the skull. There is a group of arteries that run along the surface of the skull, and if it ruptures, it will bleed very much.
Point Q is an incision on the outside of the scapula that can completely immobilize the shoulder.
Point R – vertical incision between the scapula and the spine. The muscle group in this area is responsible for most of the upper body movement.
Point S – vertical incision above the chest and kidney.It will be very painful and as a result – the attacker will lose mobility.
Point T – horizontal incision at the back of the head. In addition to a large number of veins, there are muscles that control most of the head movement.
The U-point is an incision in the back of the trapezius muscle that will result in loss of shoulder mobility.
Point V – An incision through the muscles of the back, between the lower edge of the scapula and the spine, following the edge of the scapula. This cut will be especially painful and will result in a loss of upper torso mobility.
Point W – horizontal incision on the lower back. There are a lot of nerve endings in this area and, as a result, the cut will be extremely painful, which will immobilize the upper body.
Beware of cuts and pricks that will kill the attacker and drastically change your position.
Point A – brachial artery that runs along the arm. This artery is thick enough, but its rupture will provoke loss of consciousness in 15 seconds, and death in 90 seconds.
Point B – many veins and arteries in the inner part of the elbow joint.
Point C – radial artery (it passes through the upper part of the radius, literally 5-7 centimeters from the base of the thumb. Rupture of the radial artery will lead to loss of consciousness in 30 seconds and death in two minutes .
On the body:
Point A – part of the neck behind the Adam’s apple, 5-7 cm from the front of the throat. When struck with a blade perpendicular to the spine, it will cut the front of the neck.This incision ruptures the carotid artery and opens the trachea, resulting in loss of consciousness in 5 seconds, and death in 12 seconds.
Point B – The inner part of the right armpit, the blade runs parallel to the ribs. If the thrust is correct, the blade will pass between the third and fourth ribs, severing the right lung. This will result in massive internal hemorrhage and rapid death of the attacker.
Point C – a puncture wound on the right side of the chest, its presence at an angle of 45 degrees, will lead to liver damage, loss of consciousness in 1 minute, or death within 5 minutes.
Point D – the subclavian artery, which is located about 5 cm from this point, just behind the clavicle. A ruptured subclavian artery will cause loss of consciousness in 2 seconds and death in 5 seconds.
Point E – the inner part of the left armpit, the blade enters parallel to the ribs. Such a cut between the third and fourth ribs, cutting the left lung and heart, provided that the blade is of sufficient length, will result in instant loss of consciousness and death within 3 seconds.
Point F – center of the abdominal cavity, 2.5-6 cm above the navel. About 12 centimeters under the skin are the descending aortic arch (the main artery in the human body) and the inferior vena cava (the main vein in the human body). The rupture of any of them will lead to loss of consciousness in 1-2 seconds and death in 3-5 seconds.
G-spot – the area slightly behind the earlobe. This is the only point on the head through which a knife can penetrate into the skull. Long, narrow blades are best at the brain.A severe cut at this point will result in instant death.
Point H – incision at the kidney. Damage to any of the kidneys can lead to almost instant loss of consciousness, and then death within 1 minute. The kidneys are connected to the body by sufficiently thick adrenal veins, so that even if the kidney is not touched, an incision at this point can rupture one of these veins, leading to rapid loss of consciousness.
Given the above, you should clearly understand for yourself that carrying a pocket knife for household purposes and carrying a knife for self-defense are two huge differences.
In the first case, your consciousness, absolutely sound, should prompt you and direct your actions to escape from conflict, search for ways of salvation and escape from an obvious threat.
In the second case, your consciousness should clearly record and control your actions during active defense and inflicting deadly strikes. Control instincts and the most important line beyond which you cannot cross.
Only with this basic knowledge, and even better with the experience of practical training and stable psychological reference points, you can carry, take out and use a knife for self-defense.
Author of the publication: Oleksandr Nagorny
Attorney at law, firm partner of the law office “Monitum”
Pressure ulcers in children – together
Pressure ulcers, also known as decubitus or decubital ulcers, form when the skin is pressed against or rubbed against a hard surface for a long time, such as a bed, chair, or medical device.This happens when the baby is in the same position for too long, or when medical equipment is pressing against the skin. When the skin is pressed against a hard surface, less blood flows to the area due to the pressure. The skin becomes more fragile and easily damaged.
In the early stages, pressure sores may appear as red, discolored or darkened areas of the skin. In later stages, the skin may rupture, due to which blisters or open sores form.
Causes of bedsores
Pressure sores often appear when the patient lies in bed for a long time or sits in a chair or wheelchair without changing position. In children, the most common cause of pressure ulcers is medical equipment pressing against the skin. It is:
- Cuffs of pressure gauges
- Surgical drapes
- Orthopedic products
The greatest risk of pressure ulcers in children is possible in the following cases:
- When they cannot change position without help
- When it is difficult for them to rise due to illness, weakness or age (infants)
- If the skin is dry or fragile
- With a decrease in skin sensitivity
- When the skin is moist from urine, sweat or other secretions
- With restless sleep, throwing on the bed
- In case of insufficient or malnutrition
- Low body weight
- With low blood pressure, low content of blood cells or low oxygen content in the blood
- When taking certain medications (for example, steroids), the side effect of which is thinning and fragility of the skin
Prevention of pressure sores
The prevention and treatment of pressure ulcers is essential.At the first sign of pressure ulcers, relieve pressure on the affected area of skin to protect it from further damage. Ulcers can become infected, especially in children being treated for cancer because their immune systems are weakened. Without proper care, these ulcers can even penetrate deep into the epithelium and expose muscle or bone.
There are several simple ways to reduce the risk of pressure sores.
Check your baby’s skin.
Medical staff and family members caring for the patient should regularly check the condition of the child’s skin. Health care providers can explain to loved ones of the patient how to check the condition of the skin and what changes in the condition of the skin should be monitored.
Parents should be aware of the condition of the child’s skin. Check your baby’s skin daily. Undress your baby, including removing socks, pajamas, underwear, diapers and other clothing, to examine the skin underneath. Many children and adolescents are reluctant to discuss skin damage until they experience severe discomfort.In addition, the child may be shy and reluctant to agree to check certain areas of the body.
Check the condition of the skin all over the body, especially the parts of the body most susceptible to pressure ulcers:
- The back of the head is the most common place for pressure ulcers in children.
- Feet, including heels, ankles and soles of the feet
Pay particular attention to areas where medical devices can press on the skin.Such places should be checked twice a day.
Watch for reddened or darkened areas of skin, blisters and sores. On darker skin, the first signs of pressure sores are more difficult to notice. Pay special attention to the areas the child is complaining about, even if they are only slightly sore or sensitive. Pressure ulcers can manifest as open or closed ulcers. Tell your doctor about any changes in the appearance of your skin.
Change the position of the child.
The best way to prevent pressure ulcers is to change position frequently.As often as possible, force the child to change posture: sit down, stand up, walk. If the child needs to stay in bed, the parent or health care provider should help the child change position every 2 hours. Children in a wheelchair should change their position once an hour.
Rollers can be placed to relieve pressure on body parts most prone to pressure ulcers. Be sure to talk to your healthcare team about which rollers are best to use. Some types of cushions can only worsen the situation.
Tips for changing the position of your child in bed:
- Alternate body positions. If the child is lying, change position, alternating sides (right, left, back). Remember which side should be next.
- Call someone for help. Only two people should turn the child over.
- Never drag or pull the child to change his position in the bed. Lift the baby completely with the sheet and then move him to a new position.
- Support the child with your entire palm. If you need to support the child, do it with your entire palm. Holding your baby with only your fingers increases the risk of pressure sores.
- Use suitable pillows and bedding. Check with your doctor or nurse about which pillows, bolsters, and sheets to use and how to fit them under your baby.
- Make sure that the child does not slide down. Raising the head of the bed too high can cause the baby to slide down, putting additional pressure on the skin.
Protect baby’s skin.
Proper skin care will reduce the risk of pressure ulcers as well as the risk of infection if ulcers develop.
- Keep patient’s skin clean. Use a mild soap. Don’t rub your skin. Blot with a towel to dry.
- Keep patient’s skin dry. After urinating or having a bowel movement, immediately cleanse your baby’s skin and change diapers or underwear.Diapers or absorbent pads can help wick urine, sweat, and other secretions away from your skin.
- Report any rash or diarrhea. Tell the doctor or nurse if your child has skin irritation or diarrhea.
- Moisturize dry skin. After water and hygiene procedures, use a non-fragrance moisturizer recommended by your doctor.
- Be careful not to rub or scratch the patient’s skin. Touch your baby’s skin gently to avoid damaging the skin.
- The patient must adhere to a healthy diet. Proper nutrition is an integral part of the healing process.
- Watch out for anything that could harm the baby’s skin. Avoid tight clothing or clothing that has buttons or zippers pressing against your skin. Clothes and bed linen must be free from creases. Make sure the wheelchair or orthopedic products are suitable for the child and do not rub against the skin.
In some cases, doctors may recommend to prevent a bandage or bandage the part of the body most susceptible to the formation of pressure ulcers.
Tell your doctor or nurse about any signs of pressure ulcers you find. Treating pressure ulcers early is faster and easier.
Postpartum suture care
Perineal sutures are usually also applied with self-absorbable sutures. Nodules from them disappear on their own for 3-4 days. If a suture was applied with a non-absorbable material, it is also removed for 3-4 days.
When caring for your crotch stitches, it is important to follow the rules of personal hygiene. To do this, change the pad or the padding diaper every two hours, regardless of their filling.You should use loose cotton underwear or special disposable panties.
It is strictly forbidden to use shaping underwear, because it puts significant pressure on the perineum, disrupting blood circulation and preventing healing.
It is necessary to wash every two hours (it is obligatory after each visit to the toilet, and it is necessary to go to the toilet exactly with such frequency, not allowing the overflowing bladder to interfere with the contraction of the uterus).
In the evening and in the morning, while taking a shower, you should wash your crotch with soap, during the day you can wash it with plain water. The suture on the perineum should be washed especially thoroughly by directing a stream of water at it. After washing, the perineum and the area of the seams should be dried with a dabbing motion of a towel.
A woman who has stitches on the perineum is not allowed to sit down for 7-14 days (depending on the degree of damage). At the same time, you can sit on the toilet already on the first day after childbirth .
Now about the toilet. Many women, fearing severe pain, try to skip a bowel movement, which leads to increased stress on the muscles and increased pain.
Because of the cleansing enema that the woman was given before childbirth, and also because she did not eat during childbirth, stool usually appears 2-3 days after childbirth. To avoid constipation, you should not eat foods that have a firming effect.
If the problem of constipation is not new to you, you should drink a tablespoon of vegetable oil before each meal.Then the stool will not interfere with the healing process of the stitches, as it will be soft.
On the 5-7th day after childbirth, the woman is allowed to gently sit down on the buttock, which is opposite to the side of the injury. You must sit on a hard surface. You can sit on both buttocks for 10-14 days.
Occasionally, scars after sutures have healed cause pain and discomfort. They can be treated by warming up – but not earlier than 2 weeks after delivery, after waiting for the complete contraction of the uterus.
Use infrared “blue” or quartz lamps for this. The procedure should be carried out for 5-10 minutes from a distance of at least half a meter. If a woman’s skin is sensitive, in order to avoid burns, the distance should be increased up to a meter. After consulting a doctor, the procedure can be done at home on your own or in a physiotherapy room.