What is a wound?
A wound is any damage or break in the surface of the skin. It can be said to be a break in the continuity of any bodily tissue due to violence, where violence is understood to encompass any action of external agency, including, for example, surgery.
Wounds can be:
- Accidental for example, burns, abrasions, paper cuts, skin tears
- Surgical for example an incision to remove a diseased appendix
- Occur because of underlying disease for example diabetic and vascular ulcers
- Some skin conditions may also develop into a wound for example eczema or psoriasis
Types of wounds
Wounds are generally classified into two (2)
- Open wounds and
- Closed wounds
What is an open wound?
An open wound is an injury involving an external or internal break in body tissue, usually involving the skin. Nearly everyone will experience an open wound at some point in their life. Most open wounds are minor and can be treated at home.
Open wounds can be classified according to the object that caused the wound:
- Incisions or incised wounds – Caused by a clean, sharp-edged object such as a knife, razor, or glass splinter.
- Lacerations – Irregular tear-like wounds caused by some blunt trauma. Lacerations and incisions may appear linear (regular) or stellate (irregular). The term laceration is commonly misused in reference to incisions.
- Abrasions (Grazes) – Superficial wounds in which the topmost layer of the skin (the epidermis) is scraped off. Abrasions are often caused by a sliding fall onto a rough surface such as asphalt, tree bark or concrete.
- Avulsions– Injuries in which a body structure is forcibly detached from its normal point of insertion. A type of amputation where the extremity is pulled off rather than cut off. When used in reference to skin avulsions, the term ‘degloving’ is also sometimes used as a synonym.
- Puncture wounds – Caused by an object puncturing the skin, such as a splinter, nail or needle.
- Penetration wounds – Caused by an object such as a knife entering and coming out from the skin.
- Gunshot wounds – Caused by a bullet or similar projectile driving into or through the body. There may be two wounds, one at the site of entry and one at the site of exit, generally referred to as a “through-and-through.”
- Critical wounds – Including large burns that have been split. These wounds can cause serious hydro-electrolytic and metabolic alterations including fluid loss, electrolyte imbalances, and increased catabolism.
What is closed wounds
Closed wounds are wounds where the damaged tissues are not exposed to the exterior.
Closed wounds have fewer categories, but are just as dangerous as open wounds:
- Hematomas (or blood tumor) – caused by damage to a blood vessel that in turn causes blood to collect under the skin.
- Hematomas that originate from internal blood vessel pathology are petechiae, purpura, and ecchymosis. The different classifications are based on size.
- Hematomas that originate from an external source of trauma are contusions, also commonly called bruises.
- Crush injury – caused by a great or extreme amount of force applied over a long period of time.
Important difference between closed wounds and open wounds
The most important distinction is between open and closed wounds. Open wounds are those in which the protective body surface (the skin or mucous membranes) has been broken, permitting the entry of foreign material into the tissues. In closed wounds, by contrast, the damaged tissues are not exposed to the exterior, and the process of repair can take place without the interference that contamination brings, in greater or lesser degree. Further divisions may be made on the basis of the mode of production of the wound.
First aid for wounds
Applying appropriate first aid to a wound can speed up the healing process and reduce the risk of infection.
See first aid for wounds.
Healing of wounds
- Wounds heal at different rates, and may depend on a number of factors such as:
- General state of health
- Age – Older skin repairs itself at a slower rate than younger skin
- Pre-existing medical conditions, such as diabetes
- Some types of vascular disease, immune diseases and cancer
- Diet – skin needs good nutrition to repair
- Stress and wellbeing
- Medications – Some may slow healing (discuss with doctor or pharmacist)
- Further trauma to the wound, such as friction/rubbing or pressure
- Alcohol excess
- Whether or not the wound becomes infected.
Most minor acute wounds heal well and can be managed at home with appropriate first aid.