Wound Basic And Diagnostic

DefinitionsGreek word tpavua'an injury or wound. Structural alteration and/or physiologic imbalance that results when energy is imparted or vital functions compromised during interaction with physical or chemical agents. Wide range of mechanisms of injuryOxford Textbook of Surgery (3-Volume Set) 2nd edition (January 15, 2000): by Peter J. Morris (Editor), William C. Wood (Editor) By Oxford Press

Classification by OnsetAcute woundRecent wound that has yet to progress through the sequential stages of wound healing. Chronic woundwound that is arrested in one of the wound-healing stages (usually the inflammatory stage) and cannot progress further. Usually defined as 30 days

Acute WoundsChronic Wounds

Mechanism of TraumaBluntMotor vehicle crash, Fall, Assault, CrushPenetratingStab, Gunshot, Laceration by Foreign bodiesPoisoningSolid, LiquidsDivingBurnsThermal, Electrical, RadiationBites and StingsOxford Textbook of Surgery (3-Volume Set) 2nd edition (January 15, 2000): by Peter J. Morris (Editor), William C. Wood (Editor) By Oxford Press

Crush Injury

Blunt trauma

Penetrating Wounds

Thermal Injury

Bites and Stings

Incised Wounds- Clean cut, sharp instrumentContused Wounds- Blunt force, bruising and swelling not breaking the skinLacerated Wounds- Tissues tearing jagged, irregular edgesPuncture Wounds- By pointed instruments ice pick, bullet, nailAvulsion Wounds- Strong shearing forces and friction significant tearing and tissue destructionBurn Woundsthermal, chemical, electrical

Wounds TypeWound and Skin Care Clinical Guidelines April 2007

Incised Wound

Contused Wounds

Lacerated Wounds

Avulsion Wounds

Puncture Wounds

Burn Wounds

Classification By Infection RateACS Surgery, Principles and Practice (2004)

ClassificationWound CharacteristicInfection Rate (%)Clean (Class I)Atraumatic, uninfected, no entry of GU, GI or respiratory tract (RT)1.5 5.1Clean Contaminated (Class II)Minor break in sterile technique, entry of GU, GI or RT without significant spillage7.7 10.8Contaminated (Class III)Traumatic Wounds, gross spillage into infected tissue, bone, urine or bile15.2 16.3Dirty (Class IV)Drainage of abscess, debridement of soft tissue infection28.0 40.0

Wound Healing Stage ClassificationEpithelialsing TissueTranslucent colour, small island of epithelial cells from hair follicels, sebaceous sweat glands.Granulating TissueGranular, slightly uneven, pinky red colourSloughy TissueYellow, dry / slimy, adherent to wound bedInfected TissueInflamation, pus, odor, pain, exudate, darkNecrotic TissueBlack leather, hard skin, depth unknownMalignant (Fungating) TissueRaised malignant tissue, bleeds, odor to bacterial colonisisation

Epithelialising TissueTranslucent coloursmall island of epithelial cells from hair follicels, sebaceous sweat glands.

Granulating WoundGranular, slightly uneven, pinky red colour

Sloughy TissueYellow, dry / slimy, adherent to wound bed

Infected TissueInflamation, pus, odor, pain, exudate, dark

Necrotic TissueBlack leather, hard skin, depth unknown

Malignant Tissue

The wound characteristics (size, depth, infection, necrotic tissue component, edema, drainage) are documented, and local wound care is initiated

Consult to the consultantopen fractures of long bonesnerve or vascular injuriesexor tendon disruptionsjoint capsule disruptionsrepair of specialized structures, such as the parotid or lacrimal ductreplacement of skin loss by a ap or graftextensive debridement