In medicine a wound is a type of injury in which skin is torn ,cut or puncture (an open wound) or where blunt force trauma causes a contusion (a closed wound ) in pathology , it specifically refers to a sharp injury which damages the dermis of the skinClassification
Open wounds can be classified according to the object that caused the wound. The types of open wound are:-
Incisions or incised wounds, caused by a clean, sharp-edged object such as a knife or razor or a 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
- Puncture wounds, caused by an object puncturing the skin such as a 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."
Closed wounds have fewer categories, but are just as dangerous as open wounds. The types of closed wounds are:
Contusions, more commonly known as bruises, caused by a blunt force trauma that damages tissue under the skin.
Hematoma also called a blood tumor, caused by damage to a blood vessel that in turn causes blood to collect under the skin
Crush injury, caused by a great or extreme amount of force applied over a long period of time
Chronic and Acute Acute or traumatic wounds are the result of injuries that disrupt the tissue. Chronic wounds are those that are caused by a relatively slow process that leads to tissue damage. Chronic wounds include pressure, venous, and diabetic ulcers. Typically, an insufficiency in the circulation or other systemic support of the tissue causes it to fail and disintegrate. Infection then takes hold of the site and becomes a chronic abscess. Once the infection hits a critical point, it can spread locally or become systemic (sepsis).
Anyone can develop a wound or infection. There are however some people who may have poor healing abilities like the elderly because of declining immune system. Individuals who are malnourished or who do not eat right foods and lack vitamins, nutrients or have protein deficiency are at risk too. Those who are chronically ill, bedridden or non ambulatory also have high risk factors as well as people who have undergone prolonged corticosteroid use or have been administered a potent immunosuppressive drug. Radiation therapy patients as well as diabetics, the obese and those that have had a stroke or some sort of peripheral vascular disease are also more likely to develop some sort of wound infection.
The treatment depends on the type, cause, and depth of the wound as well as whether other structure beyond the skin are involved. Treatment of recent lacerations involves examination, cleaning, and closing the wound. If the laceration occurred some time ago it may be allowed to heal by secondary intention due to the high rate of infection with immediate closure. Minor wounds like bruises will heal on their own with skin discoloration usually disappears in 1–2 weeks. Abrasions which are wounds with intact skin usually require no active treatment except keeping the area clean with soap and water. Puncture wounds may be prone to infection depending on the depth of penetration. The entry of puncture wound is left open to allow for bacteria or debris to be removed from inside.
For simple lacerations cleaning can be accomplished using a number of different solutions including tap water, sterile saline solution, or antiseptic solution. Infection rates may be lower with the use of tap water in regions where water quality is high. Evidence for the effectiveness of any cleaning of simple wound however is limited.
The effectiveness of dressings and creams containing silver to prevent infection or improve healing is not currently supported by evidence
Bacterial infection of wound can impede the healing process and lead to life threatening complications. Scientists at Sheffield University have identified a way of using light to rapidly detect the presence of bacteria. They are developing a portable kit in which specially designed molecules emit a light signal when bound to bacteria. Current laboratory-based detection of bacteria can take hours or even days.