Wound and types of wound

Wound

Wound is a break in the continuity of soft tissue caused by physical, chemical or biological insult. Disruption in the continuity of soft tissue is called as wound.

Types of wound

Types of wound are based on-

• Type of wound based on the openness
• Type of wound based on the cleanliness

Type of wound based on the openness-

According to the openness of the wound wounds are two types-

1. Closed wounds
2. Open wounds

1. Closed wounds

Closed wounds is a wound in which there is no break in the continuity of the skin, but, the underlying tissues are damaged to a varying degree.

Closed wounds is also known as Internal or Interstitial Wound.

Bruise is a mild degree of contusion characterised by rupture of capillaries in the skin giving rise to reddish blue coloration of the skin (echymosis).

Contusion is produced by the blunt objects. There is damage to subcutaneous tissues, without breaking the continuity of the skin surface.

Depending upon the extent of injury; it can be further subdivided into three categories.

• First-degree contusion: there is rupture of capillary vessels of the skin and subcutaneous tissue.
• Second degree contusion: there is rupture of larger vessels leading to haematoma.
• Third degree contusion: the tissues are considerably damage and gangrene may set in.

Haematoma is the collection of blood in an abnormal cavity. It is frequently seen subcutaneously or submucously.

2. Open wounds

Open wounds or external wound is a wound in which there is discontinuity in the skin or other covering tissues to a varying depth. They are further sub-divided into different categories as per their etiology.

• Abrasion: In abrasion there is damage to the skin, consisting of loss of the epidermis and portions of the dermis.
• Avulsion: It is a wound characterized by tearing of the tissue from its attachments.
• Incised wound: It is wound created by sharp objects. The edges of the wound are smooth, with minimal tissue trauma to the surrounding tissues.
• Lacerated wound: It is an irregular wound created by tearing up tissues, causing variable damage to both superficial and underlying tissues.
• Punctured Wound: It is caused by sharp pointed objects like nails. They have relatively small opening, but, damage to deeper structures may be substantial. Contamination and subsequent infection is a common problem.
• Penetrating Wound: These are deep wounds communicating with cavities like abdomen, thorax, trachea, joints etc.
• Gunshot wound: Such wounds are caused by firearms. The point of entry is marked by a small opening on the skin, but, the exit will have a larger wound depending upon the velocity of the firearm.
• Bite wounds: These wounds result from snake, dog or wild animal’s bite. There is significant degree of tissue damage.
• Virulent wounds are caused by bacteria or virus leading to formation of pustules or vesicles e.g.: FMD, anthrax.
• Granulating wound is one in which there is a tendency to heal within expected time.
• Aseptic wound is surgical wound made under aseptic conditions where chances of bacterial contamination are negligible.
• Contaminated wound is one where there is presence of micro organisms.
• Infected / septic wound: A contaminated wound may become infected after a period of 6 -8 hours where bacterial multiplication may occur and liberation of their toxin.

Type of wound based on the cleanliness-

Wounds are four types based on the cleanliness-

1. Clean Wounds
2. Clean contaminated wounds
3. Contaminated wounds
4. Dirty and infected wounds

1. Clean Wounds

Clean Wounds are surgically created under aseptic precautions.

2. Clean contaminated wounds

Clean contaminated wounds have minimal contamination which can be effectively removed.

3. Contaminated wounds

Contaminated wounds have gross contamination with foreign derbies. e.g. Dog bite wound.

4. Dirty and Infected wounds

Dirty and Infected wounds are characterised by an existing infectious process.