Wounds: Types, Recognition, and First Aid Guide
Wounds epidemiology and condition
A wound is any damage to the soft tissues of the body. It usually results in the escape of blood from the blood vessels into surrounding tissues, body cavities or out of the body. A wound can be either open or closed:
Open wound—a break in the outer layer of the skin
Closed wound—no break in the outer layer of skin but there is internal bleeding. The aim in the care of wounds is to stop the bleeding and prevent infection. Although some bleeding may help to wash contamination from the wound, excessive blood flow must be stopped quickly to minimize shock.
Other types of wounds
Contusions or bruises
Contusions or bruises are closed wounds. The tissues under the skin are damaged and bleed into surrounding tissues, causing discoloration. A bruise may be a sign of a deeper, more serious injury or illness.
Abrasions or scrapes
Abrasions or scrapes are open wounds where the outer protective layer of skin and the tiny underlying blood vessels are damaged. The deeper layer of the skin is still intact
Incisions
Incisions are clean cuts caused by something sharp such as a knife.
Laceration
Lacerations are tears in the skin and underlying tissue with jagged and irregular edges.
Puncture wounds
Puncture wounds are open wounds caused by blunt or pointed instruments that may have a small opening, but often penetrate deep into the tissue.
Recognition
A wound is minor when: It is a small superficial cut, a graze with slight bleeding, not affecting a body orifice or the eyes.
A wound is major when: it is extensive and affects several places; it is deep, revealing bones, muscles or other tissues; it affects the face, eyes, neck, chest, abdomen or genitals; an object is lodged in the wound. If there is the slightest doubt, the rescuer must treat the wound as major and call the emergency services.
What to do
If the wound is minor:
Wash your hands with soap and water or use hand sanitizer if available, before providing first response. If tap water is not available, use a bottle of water. If possible, put on protective disposable gloves to avoid any contact with the casualty's blood.
Clean the wound-Rinse the wound lightly under clean running water, if possible. A compress may be used to remove dirt. Use an alcohol-free wipe if available.
Protect the wound-Dry thoroughly and apply a dressing that extends beyond the edges of the wound. Leave the dressing in place to allow the wound to heal. Wash your hands immediately after providing first response, if possible
If the wound is major:
In the case of an eye injury, Lay the casualty down flat on his/her back, with the head supported, advising him/her to close his/her eyes and not to move. If there is a foreign body in the eye, do not remove it.
In the case of an abdominal wound, Help the casualty to lie on his/her back, with thighs and knees bent, to relax the abdominal muscles and reduce the pain. Cover the wound with a sterile or clean dressing, if available.
In the case of a wound to the chest, Place the casualty in a semi-sitting position to facilitate breathing.
In all cases of serious wounds, call the emergency services. If there is an object in the wound, do not try to remove it In the case of any major wound, monitor vital signs while waiting for emergency services.
Dressing
A dressing is a protective covering put on a wound to help control bleeding, absorb blood from the wound, and prevent further contamination. A dressing should be:
Sterile, or as clean as possible
Large enough to cover the wound • Highly absorbent
Compressible, thick and soft
Non-stick and lint-free to reduce the possibility of sticking to the wound.
Dressings are available in a variety of sizes and designs. The dressings used most often in first aid are:
Adhesive dressings – prepared sterile gauze dressings with their own adhesive strips
Wound closures – adhesive strips that bring the edges of the wound together to assist healing.
Gauze dressings – packaged gauze available as sterile single packs or in bulk packaging
Pressure dressings – large sterile dressings of gauze and other absorbent material, usually with an attached roller bandage. They are used to apply pressure to a wound with severe bleeding
Improvised dressings – prepared from lint-free sterile or clean absorbent material such as a sanitary pad
Hemostatic dressings – pressure dressings impregnated with clot promoting agents used to stop serious bleeding.
These dressings are not designed for all wound types.
Prevent further contamination
Extend the dressing beyond the edges of the wound
If blood soaks through a dressing, leave it in place and cover with more dressings
Secure a dressing with tape or bandages