WOUNDS AND BLEEDING

WOUNDS greater and the wound’s ragged edges do not

reading line up.
- Any break in soft tissue of the body that results
 A puncture would be greater than its length,
in BLEEDING
therefore there is usually little bleeding around
the outside of the wound and more bleeding
inside, causing discoloration.
TYPES

 Open Wounds
- Break in the outer layer or skin, results in OPEN WOUNDS EXAMPLES
bleeding and allow microorganism (germs)
 Laceration Wound
 Close Wounds
- No break in the outer layer of the skin.

TYPES OF WOUNDS
C – Contusion
 Incision Wound
A – Abrasion
L – Laceration
I – Incision
P – Puncture
G – Gun Shot
A – Amputation
 Abrasion Wound
D – Degloved/ Crushing

SPECIFIC SYMPTOMS FOR SPECIFIC WOUNDS

The general symptoms of a wound are
localized pain and bleeding. Specific symptoms
include:

 An abrasion usually appears as lines of  Punctured Wound

scraped skin with tiny spots of bleeding.
 An avulsion has heavy, rapid bleeding and a
noticeable absence of tissue.
 A contusion may appear as a bruise beneath
the skin or may appear only on imaging tests;
an internal wound may also generate
symptoms such as weakness, perspiration
and pain.
 A crush wound may have irregular margins  Avulsion Wound
like a laceration; however, the wound will be
deeper and trauma to muscle and bone may
be apparent.
 A cut may have little or profuse bleeding
depending on its depth and length; its even
edges readily line up.
 A laceration too many have little or profuse
bleeding; the tissue damage is generally
 WOUNDS AND BLEEDING

 Degloved /Crushing Wound 3. Wash the wound area daily and reapply a
clean dressing until it is completely healed.
4. When washing sterile area do not scrub as
you will damage the wound more.

PUNCTURE WOUNDS

 Amputated Wound How to treat?

- Puncture wounds are difficult to clean. If the
object has penetrated the bone, it is especially
risky.
1. Flush the area thoroughly with water,
cleaning well and on a number of occasions.
2. Elevate the wound, and if signs of infection
manifest (redness, swelling, persistent pain,
pus, or fever), contact a health professional.

 Gunshot Wound
MAJOR WOUNDS
How to treat?
1. For severe bleeding, apply constant
pressure to the wound with a sterile dressing.
2. Hold for up to twenty minutes.
3. If there is foreign object in the wound don’t
press directly, but apply pressure along the
CLOSED WOUNDS EXAMPLE wound area.
4. If broken bones, or dislocations are
 Contusion/ Hematoma suspected, DO NOT move the affected limb.
5. If you are sure there are no broken bones or
dislocations, you can gently elevate and
support the part while keeping pressure on it.
This action should minimize bleeding.

NATURE OF INJURY
- Wounds can be divided into three main groups
to emphasis their seriousness, these groups
are;
 Minor Cuts and Scrapes
 Puncture wounds
 Major wounds
MINOR CUTS AND SCRAPES
How to treat?
1. Wash the affected area thoroughly with soap
and water removing any foreign material,
which may cause infection.
2. Cover with sterile bandage.
 WOUNDS AND BLEEDING

wound environment = wound infection.

Foreign bodies (including sutures) potentiate
wound infection.
 D = Drugs: steroids and antimetabolites
impede proliferation of fibroblasts and
collagen synthesis.
 N = Nutritional problems: protein-calorie
malnutrition and deficiencies of Vitamin A
(collagen synthesis, antioxidant), C (collagen
synthesis), and zinc (fibroblast proliferation).
- Malnutrition – impaired organ function,
impaired collagen synthesis, impaired
immune function, and reduced antioxidant
activity.
 T = Tissue necrosis: from local or systemic
ischemia or radiation injury. Blood supple is
important.
 H = Hypoxia: -especially the distal extent of
the extremities. Blood volume deficit,
unrelieved pain, or hypothermia – sympathetic
over activity --- local vasoconstriction –
inadequate tissue oxygenation.
 E = Excessive tension on wound edges:
local tissue ischemia and necrosis.
 A = Another wound: competition for the
substrates required for wound healing.
 L = Low temperature: (relatively) distal
aspects of the upper and lower extremities (a
reduction of 1- 1.5 Celsius [2-3 Fahrenheit]
from normal core body temperature) is
responsible for slower healing of wounds at
these sites.

FACTORS THAT AFFECT WOUND HEALING

- In general, remember “DIDN’T HEAL”
 D = Diabetes: diminished sensation and
arterial inflow + acute loss of diabetic control
– diminished cardiac output, poor peripheral
perfusion, and impaired polymorph nuclear
leukocyte phagocytosis.
 I = Infection: potentiates collagen lysis.
Bacterial contamination + susceptible host +