Rupture wound treatment. Treatment of open wounds with folk remedies. What is a laceration

Laceration Repair (Wound Repair)

Description

Laceration- an injury that occurs when the skin, tissues, and/or muscles are torn or cut. Wounds can be deep or superficial, long or short, wide or narrow. Treatment of lacerations - cleaning, preparation and closing of the wound.

Reasons for the procedures

Minor wounds and cuts (small, small, non-bleeding and clean) do not require medical intervention. It is enough to treat the wound with an antibiotic and apply a bandage. Some require medical attention. The reasons are:

  • Damage to muscles, tendons, bones;
  • The wound shows dirt and foreign objects remaining after washing and processing;
  • Sensations of a foreign body in depth, even if nothing is visible on examination;
  • Risk of developing tetanus (for example, a deep, lacerated wound, burn, feces, dirt, or saliva entering the wound);
  • Symptoms of tetanus develop 3-21 days after the injury: spasm or stiffness of the muscles of the jaw, neck, abdomen, or in the area near the wound;
  • Bleeding that continues after pressing the wound for 10-15 minutes;
  • The edges of the wound are torn or uneven;
  • Wound more than 2 cm, located in the area of ​​the joint and / or near it (knee, wrist, ankle);
  • The edges of the wound have parted and cannot be moved together;
  • The wound is located in the area of ​​application of high loads (joints, arms, legs, chest);
  • To reduce the risk of scarring.

Possible complications of laceration treatment

If a laceration is planned to be treated, the doctor will review the list possible complications which may include:

  • Infection;
  • Bleeding;
  • Noticeable scars;
  • Poor wound healing;
  • Allergic reaction to anesthesia.

Anesthesia

The type of anesthesia used depends on the type of wound, for example:

  • Local Anesthesia - Anesthetizes only a specific, usually small area. Used as an injection, used for small lacerations;
  • General anesthesia - blocks pain and immerses the patient in a state of sleep. Used for severe lacerations.

In some cases, the treatment and treatment of wounds is carried out without anesthesia.

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Description of the laceration procedure

Wound preparation:

  • Cleaning:
    • Hair that will interfere with access and wound healing is removed;
    • The wound is washed sterile water, which will wash away dirt and debris;
    • An antiseptic or soap may also be used if the wound is deep and heavily soiled;
  • Wound preparation:
    • Torn edges can be cut off. This will reduce the likelihood of scars;
    • Damaged or dead tissue will be removed to prevent infection;
  • Wound closure:
    • The procedure is carried out after cleaning and disinfection of the wound;
    • The doctor chooses one of several ways to close the wound:
      • Dermabond skin glue;
      • A special patch, such as Steristrips;
      • Surgical staples.

Dermabond - Dermabond

Dermabond is a special adhesive that allows you to connect the edges of the wound together. Dermabond is used to treat wounds on the face, arms, legs and torso. It can also be used for lacerations smaller than 1-3 centimeters.

Dermabond is not suitable for lips, lacerations near the joints, deep lacerations, and lacerations on the arms and legs. The doctor brings together the edges of the wound. Then he inflicts thin layer glue. Warmth may be felt when the adhesive is applied. Dermabond is applied in three layers. The wound is fixed in a fixed position for 60 seconds. The doctor may apply a bandage to the wound. In some cases, additional suturing is needed.

Note: The adhesive acts as a protective coating. It is not applied directly to the wound or between its edges. Never attempt to apply Dermabond at home on your own. Getting glue inside the wound can prevent proper healing.

Steristrips

This adhesive tape is used for small lacerations that:

  • Clean;
  • Have relatively smooth edges;
  • Edges can be easily closed;

The doctor brings together the edges of the wound, and then puts a strip of plaster on top.

seams

Stitches are used to treat deep, bleeding wounds that have jagged edges, or damaged fat or muscle. The wound area is treated with iodine, after which a surgical protective film can be applied. This will maintain sterility.

If the wound is deep and there is damage to the muscles, surgery may be necessary to stitch them together. This will restore muscle and tissue. Sutures used under the skin are resorbable by the body. They don't need to be removed.

If the wound is not deep, or suturing under the skin is completed, the edges of the wound are sutured. Once the wound is sutured, the surgical area is treated with saline. Can also be applied antiseptic ointment. A bandage or elastic bandage may be applied over the seam.

Staples

Braces are best for the scalp, neck, arms, legs, torso, and buttocks. The skin around the wound is treated with iodine. The edges of the wound will be brought together and aligned. Staples are placed along the wound.

doctor uses saline solution to clean the area around the wound, after which it is treated with an antibiotic ointment. It is recommended to apply a transparent film dressing, such as Tegaderm, or a regular gauze dressing over the treated wound. A bandage will be used to protect the wound.

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How long will the wound treatment take?

It depends on the type of laceration. The procedure can take from 15 minutes to an hour or more.

Will it hurt?

Soreness also depends on the type of wound. Severe lacerations will be very painful. The decision to use anesthesia is made by the doctor.

Wound care

In the hospital

After the procedure, staff can provide the following assistance:

  • Provides painkillers and antibiotics;
  • A blood test is performed. This is done most often after a bite or dirt getting into the wound;
  • The tetanus vaccine is given.

home care

When you return home, follow these steps to ensure a normal recovery:

  • Be sure to follow your doctor's instructions, such as:
    • Avoid strenuous activities;
    • Take antibiotics and painkillers as directed;
  • Ask your doctor about when it is safe to shower, bathe, or expose the surgical site to water:
    • If you need to keep the wound area dry, wrap it in a plastic bag while showering;
    • After a shower or bath, pat the wound dry without rubbing. In addition, no need to apply hydrogen peroxide or iodine. This will lead to tissue damage and slow healing.

Removal of material covering the wound depends on its type:

  • Dermabond falls behind on its own after 5-10 days;
  • Steristrips are usually removed in 5-10 days;
  • The stitches will be removed after 5-14 days;
  • Staples are removed after 5-10 days.

Note: Do not attempt to remove material covering the wound. Removing it on your own can lead to infection, scarring, or open wounds.

After healing of lacerations, scars may remain. The degree of scarring depends on the following:

  • Predisposition to the formation of scars (keloids);
  • Location, type and size of the wound;
  • The skill of the doctor.

Poor wound care, scratches, infections can lead to poor healing. If appears noticeable scar, plastic surgery may be used to reduce the appearance of the scar.

Communication with the doctor after treatment of a laceration

After returning home, you should consult a doctor if the following symptoms appear:

  • The wound reopens;
  • redness, warmth, swelling, discharge, or heavy bleeding at the site of the wound;
  • signs of infection, including fever, chills, or red streaks on the arms or legs;
  • Any other questions.

The first thing that is recommended to be done when treating an open wound in the leg area is to stop the bleeding, a tourniquet or a tight bandage is applied. After the procedure, they begin to process the boundaries of the wound. It will be necessary to thoroughly clean the wound from foreign substances (pieces of dirt or rust from a nail), anoint the edges of the wound with brilliant green, and apply a sterile bandage.

If it is noticeable that the process of infection of the leg has begun, it is necessary to immediately wash the injury, treat it with antiseptic substances, and at the end apply a bandage to the sore spot.

It is required to treat an open wound of human legs carefully, it is possible to harm the patient. If a person wants to treat an injury on his own, you should know the things that absolutely cannot be done:

Treatment of an open wound in the area of ​​human legs

With proper treatment, treatment can be carried out at home. The first step is to stop the bleeding of the injured area of ​​\u200b\u200bthe human leg. There are two types of bleeding: venous and arterial.

The first way to stop bleeding is direct, just take and press down the affected area (it doesn’t matter if the person cut the limb or pierced it). If the blood runs too fast, beats in a pulsating stream - there is arterial bleeding(there was a puncture, a cut of the artery). With such bleeding, it is worth applying a tight tourniquet above the affected area. If desired, a soft base can be placed under it (for further patient comfort). The tourniquet needs to be looked after, it is required to loosen forty minutes after application. You can’t keep the tourniquet in one place for more than 2 hours on your legs, you need to move it a little higher or lower each time previous place. When applying, the main thing is not to pinch the arteries, this will lead to the death of living tissues.

If the blood has a dark red, burgundy hue, slowly flows out of the affected area, venous bleeding develops (cut, puncture of the vein). This type requires a tourniquet or an extremely tight bandage below the wounded area; it also cannot be strongly pinched.

At the second stage, treatment consists in treating the wound. If a person pierced his leg with a rusty nail, you need to remove the object, then decontaminate the affected area. Use sterile tweezers. If the foreign body is stuck too deep, do not irritate the injured area once again, it is better to leave the work to professionals. After cleaning the surface of the puncture, the edges of the wound are treated; as a preparation, it is permissible to use brilliant green or medical alcohol, but never iodine. If you use a brown antiseptic when treating an open wound, there is a chance of serious medical burns.

Treatment at the third stage consists in disinfecting the damaged area with antiseptic substances. For example, grind a streptocide tablet into powder, cover the affected surface. In place of the antiseptic, it is permissible to use a three percent solution of hydrogen peroxide, a five percent or ten percent synthomycin ointment. In the absence of the listed available, it is allowed to treat the wound on the leg with green paint.

If a person pierces a limb with a rusty nail, but does not take action in time, does not disinfect the injured area of ​​the skin, infection will occur and develop. Better try to create right conditions to restore the skin on the legs, phagocytosis and exudation, restore the bactericidal and immunobiological state of the human body, help cleanse the affected area from foreign substances. The main thing is not to stop the treatment of the wound, preventing complications.

Treatment of various types of open wounds on the leg, their features, how to avoid unwanted complications

If a person has pierced a limb and received an open wound, treatment is carried out with surgical intervention (especially with deep wound). Signs of the inevitability of surgical intervention:


If the wound did not become infected, the object that pierced the limb did not affect the nerves, arteries and vital important organs, damage along the edges is treated with various antiseptic substances, not sutured, a sterile bandage is applied on top. If a foreign substance is found in the depth of the wound, for example, rust from a nail puncture, the edges of the wound are expanded and the object is removed, then a suture is applied. If the wound is contaminated with earth, the injured person in without fail you need to get vaccinated against tetanus.

If a stab wound discovers great depth, treatment will be carried out using surgical intervention. During the operation, the boundaries of the wound are expanded, a foreign body or substance is removed, and a suture is applied.

In case of damage to the joint (from a puncture with a nail or other sharp long object), the surgeon opens the cavity in order to carry out an audit, cleans the inside of blood clots and foreign substances. The joint cavity is washed with various antiseptic substances, sutured with a drainage tube.

An important part in the treatment of incised wounds is disinfection. There are important points in the process:

  • It is necessary to try as much as possible to disinfect the affected area, avoiding infection.
  • The medicine should be comfortable for the patient and not harm the wound.
  • The dose of the antiseptic substance should be recommended by a specialist, and not the maximum. This will help avoid side effects.

At chopped wound present extremely big chance damage the bones (chopping off fingers, an ax stuck in the leg). In such cases, it is worth establishing the anatomical integrity of the body, bones. This type of wound requires suturing, for more accelerated healing, but in most cases of a severed wound, recovery and treatment is virtually impossible, human body it is not common to restore lost parts of the body.

If the wound is lacerated important point during treatment, the anatomical integrity of the skin is restored human body, you need disinfection of the affected area, vaccination against tetanus and gas gangrene. The suture of the wound on the leg should not be continuous; drainage is left to aerate the wound. After such injuries, scars remain, requiring mandatory surgical intervention for cosmetic correction and maximum masking of the wound.

Treatment of the scalped open wounds special attention is paid to the anatomical restoration of the skin and cleaning the affected area from foreign bodies and substances. Typically, overlay cosmetic suture carried out with the leaving of the drainage tube.

What to do to avoid possible leg injuries

If you want to avoid excruciating pain and complications after injury, you should be careful with cutting objects. Injuries are not always obtained in the form of a puncture with a knife, an awl or a nail, damage can be obtained by falling, normal walking, in short - almost everywhere.

be afraid rusty nails they are ubiquitous. It happened that a person, not knowing the territory of the seabed or wasteland, accidentally pierced his leg, simultaneously receiving two injuries of the skin - stabbed and torn. The first sensation with such an injury is a momentary pain, then a sensation of shock sets in, the patient does not feel his feet, cannot walk, the treatment process is also painless. After 3 hours, severe pain begins, preventing normal walking.

Nail wounds are more often penetrating (if the objects are long), which gives a double degree of danger to the injury received by the patient. The affected area should be treated on both sides. It is better for a person who pierced the lower limb to lie down for a while, not to strain the leg with physical exertion.

Lacerations are formed under the influence of hard blunt objects acting under acute angle to the surface of the body. A feature of a lacerated wound is a significant detachment, as well as scalping of the skin over a very large area. Moreover, the exfoliated area of ​​\u200b\u200bthe skin may lose nutrition and become necrotic. In addition, the uneven edges of lacerated wounds slow down the healing process.

A laceration on the leg is a fairly common occurrence. The most susceptible to the formation of such wounds are gardeners and summer residents, with careless handling of garden tools, as well as children, fishing enthusiasts, hunters and many others. No one is immune from this trouble.

What to do if a laceration occurs? It should be remembered that all wounds that are accidentally formed are bacterially contaminated, therefore, in order to prevent additional penetration of bacteria into the wound, when providing first aid, cotton swab moistened with an antiseptic solution (alcohol, iodine), remove contamination from the surrounding wound skin. Then lubricate the edges of the wound 5% alcohol tincture iodine, alcohol or brilliant green solution and apply aseptic bandage. In this case, it is not necessary to remove foreign bodies from the wound and wash it, when providing first aid. In addition, with extensive soft tissue injuries lower extremities, as well as fractures, to prevent even greater damage, immobilization is used. In the future, you should go to the hospital to the surgeon, who will determine further tactics laceration treatment.

If the laceration is small in size, then it can heal on its own, without the help of a specialist. But if, after a few days, swelling, redness appear around the wound, body temperature rises, you should consult a doctor immediately. Features of lacerations, in the form of uneven edges and significant exfoliation (scalping) of the skin, require careful treatment by a specialist. deep wounds need to be operated on. They are sewn up to speed up healing and prevent the formation of rough scars. This must be done on time so that there are no complications. The surgeon performs a wound dissection and revision of the wound channel, then cuts out the edges, walls and bottom of the wound, stops the bleeding and sutures the wound. As a result, the wound turns from torn and infected into incised and aseptic, which contributes to its rapid healing by primary tension.

Healing of lacerations usually occurs within two weeks. This process depends on many factors. Among them are:

Age of the patient: wounds heal most quickly in children.

Body weight: cachexia and obesity slow down the healing process.

The presence of secondary infection of the wound, which significantly lengthens and worsens the result of healing.

Chronic accompanying illnesses(tumors, cardiac vascular insufficiency, diabetes), which slow down the reparation process.

Radiation therapy and anti-inflammatory drugs for early dates can slow down the healing process.

It should be remembered that a wound, even the smallest one, can lead to the development of sepsis (blood poisoning) and further to lethal outcome. Also, at improper treatment, the development of nonspecific purulent infection, as well as anaerobic infection, tetanus, rabies. Therefore, one should not be surprised why wounds heal poorly. Ultimately, the patient may even lose a leg. Therefore, it would be better to consult a specialist immediately after receiving this injury and not to self-medicate.

- this is damage to the skin or mucous membrane, resulting from an impact that exceeds the ability of tissues to stretch. The cause of the occurrence is contact with a hard blunt object, "catching" on the skin and soft tissues. The laceration has uneven edges, significant detachment and scalping of the skin are often observed. Accompanied by bleeding, damage to muscles, nerves and blood vessels is possible. Diagnosis is based on history and clinical picture. Surgical treatment.

ICD-10

S41 S51 S71 S81

General information

A laceration is a violation of the integrity of the skin, mucous membranes and soft tissues, resulting from a rupture under the action of a solid object. In most cases, it is located within the skin and subcutaneous tissue. Sometimes there is damage to muscles, blood vessels and nerves. Integrity violation internal organs is extremely rare. The laceration may be isolated injury or combined with other injuries: fractures of the bones of the extremities, fracture of the spine, damage to the chest, TBI, fracture of the pelvis, damage to the kidney, rupture Bladder and blunt abdominal trauma. Treatment of fresh lacerated wounds is carried out by traumatologists, infected - by surgeons.

The reasons

A laceration can form in domestic accidents, traffic accidents, criminal incidents, falls from heights, and industrial accidents. In summer residents, as a rule, it occurs during careless work with garden tools. Cyclists, motorcyclists, hunters, fishermen and heavy workers often suffer. physical labor. It is often observed in children, especially in the summer.

Pathogenesis

Distinctive features of lacerated wounds are irregularly shaped patchwork edges, significant tissue damage in the walls of the wound channel, tissue exfoliation, skin scalping areas. The formation of a tissue defect due to their complete separation is possible. The depth of the wound channel, as a rule, is insignificant, while the affected area can reach large sizes in length and width. Bleeding is less than with incised wounds. Fabrics are often heavily contaminated, which is facilitated by the mechanism of injury: damage by a dirty garden tool, falling from a bicycle or motorcycle onto asphalt or gravel, falling on pieces of coal while working in a mine, etc.

because of large area tissue damage and necrosis, lacerated wounds heal worse and suppurate more often than incised wounds. Healing by secondary intention or under a scab is characteristic. Healing by primary intention is possible in favorable circumstances: with a small amount of damage, a relatively small area of ​​necrosis, the absence of gross defects in the skin and soft tissues, slight microbial contamination, and a good state of the immune system.

Infection in lacerations develops faster than in stab or cut wounds. The first signs of infection (edema, hyperemia of the edges, sanious or mucous discharge) can be detected within a few hours after the injury, while in cut wounds, the infection usually develops about a day after the injury. This necessitates early medical attention and further worsens the prognosis.

The wound process proceeds in three stages. At the stage of inflammation, necrotic tissues are destroyed and removed from the wound along with pus. Initially, the surrounding tissues swell, the lumen of the canal narrows or disappears, and blood clots and dead areas are "squeezed" out. Then the inflammation becomes purulent. The remaining dead tissue is melted. A demarcation shaft is formed around the damage zone, separating necrotic tissues from healthy ones.

After complete cleansing, the regeneration (recovery) phase begins, during which granulation tissue. Granulations gradually fill the entire defect and become denser. Then comes the epithelialization phase, ending with the formation of a scar. With extensive soft tissue defects, self-healing becomes impossible, it is necessary to close the granulations with the help of skin grafting. The duration of each phase of healing depends on the size of the injury, the degree of bacterial contamination, the amount of necrotic tissue, the presence of other traumatic injuries and somatic diseases etc.

Symptoms of a laceration

When injured, pain occurs. The degree of dysfunction depends on the size, location and characteristics of the wound. An external examination reveals an irregularly shaped defect with uneven, often crushed edges. At the bottom of the defect is visible adipose tissue, less often - muscles and fragments of tendons. Abundant contamination with earth, gravel, coal and other components that have been in contact with tissues at the time of injury is possible. Sometimes pieces of clothing, metal, wood, etc. are visible in the wound.

In some cases, large scalped skin flaps(the skin hangs from the edge of the wound), detachment, complete crushing or separation of individual sections is observed. Hemorrhages and hematomas often form around the laceration. Bleeding, as a rule, capillary or mixed, insignificant due to tissue crushing. When damaged large vessels bleeding is profuse, blood can pour out not only outside, but also in the area of ​​detachment.

If the tendons are damaged, the loss of function of the corresponding fingers is revealed. With compression or (less often) violation of the integrity of the nerves, disorders of sensitivity and movement are noted. At open fractures deformation and pathological mobility are detected, bone fragments are sometimes visible in the wound. A particularly severe picture is observed in traumatic amputations: the distal part of the torn off segment has uneven edges with hanging pieces of skin, protruding fragments of bones, muscles and tendons.

The general condition of the patient depends on the nature of the laceration. With minor injuries, the condition remains satisfactory, with extensive injuries, traumatic shock may develop due to both blood loss and neuropsychic stress associated with trauma, as well as severe pain caused by damage to large areas of the skin. Characterized by excitement, followed by lethargy and apathy. Initially, the patient is anxious, frightened, sometimes aggressive, cries, screams, complains of pain. The pupils are dilated, there is tachycardia, rapid breathing, clammy sweat, tremors and muscle twitching. Then the patient becomes lethargic, drowsy, indifferent. The skin is pale, lips with a bluish tinge, while maintaining tachycardia, there is a drop in blood pressure. AT severe cases possible loss of consciousness.

Diagnostics

The diagnosis is established during the consultation of a traumatologist when contacting a trauma center or emergency room of a hospital. When determining the type of injury, the anamnesis is taken into account and appearance wounds. If damage to the vessel is suspected, an examination is required vascular surgeon, with signs of loss of nerve function - consultation of a neurosurgeon.

laceration treatment

Treatment small damage carried out in the conditions of an emergency room or an outpatient surgical reception. Fresh wounds are washed abundantly, if possible, non-viable tissues are excised, sutured and drained. With successful healing, the sutures are removed for 8-10 days. infected wounds washed, if necessary, expand or open, remove pus and non-viable tissue and drain without suturing.

Patients with extensive fresh lacerations are hospitalized in the Department of Traumatology and Orthopedics. In traumatic shock, anti-shock measures are taken. The tactics of treatment are chosen taking into account the characteristics of the damage. If possible, carry out PST under local anesthesia or general anesthesia if not possible, wash and apply bandages with furacilin. The scalped areas of the skin are sutured, having previously applied perforations for a better outflow of fluid. With a significant tension of the edges on the sides, laxative incisions are made. The wound is drained. AT postoperative period prescribed antibiotics and analgesics.

With extensive suppuration, hospitalization in a surgical hospital is indicated. The wound is treated, if necessary, purulent streaks are opened, necrotic tissues are excised, washed and drained. Spend antibiotic therapy taking into account the sensitivity of the pathogen. To stimulate necrolysis, proteolytic enzymes are used, which also have anti-edematous and anti-inflammatory effects. Vacuuming, laser and ultrasound treatment, cryogenic exposure and other methods are used to speed up wound cleansing.

In the healing phase, general strengthening treatment is prescribed, careful dressings are carried out using antibacterial and indifferent ointments that improve tissue trophism. In the presence of a large defect, after cleansing the wound and the appearance of granulations, secondary sutures are applied and free skin grafting or plastic surgery is performed with a displaced flap.

- this is damage to the skin or mucous membranes due to mechanical impact with a hard blunt object. These types of wounds tend to have jagged edges throughout the injury. In addition, tissue trauma is accompanied by severe pain, intense bleeding, as well as damage to the muscle layer, blood vessels and nerves. Treatment and diagnosis is carried out by surgical specialists.

A lacerated wound is accompanied by a violation of the integrity of soft tissues. The striking surface can be of various depths and lengths, it depends on the object causing damage and the strength of the blow itself.

Causes of a laceration

The reasons for getting a long-standing type of injury can be:

  • accidents at home;
  • consequences of criminal incidents;
  • careless handling of the car - road accidents;
  • industrial injuries;
  • falling from a great height.

Most often injured are cyclists, motorcycles, workers hard work, hunters or fishermen. AT summer period to the ambulances medical care quite often deliver children. Summer residents can be divided into a separate category, injury occurs when garden tools are mishandled.

Symptoms

The severity of symptoms in a wound with torn edges primarily depends on the degree of damage caused:

  • pain syndrome;
  • infection of the damaged area of ​​\u200b\u200bthe skin due to the ingress of elements environment(dirt, fragments, pieces of clothing, and so on);
  • the edges of the wound are crushed, irregularly shaped;
  • detachment of some areas of the skin;
  • severe bleeding, gaping wounds;
  • the formation of hematomas;
  • sensory disturbance in the area of ​​the injury;
  • excessive anxiety, sometimes even aggressiveness;
  • lethargy;
  • pronounced apathy;
  • tachycardia;
  • cases of development traumatic shock;
  • sticky sweat;
  • dizziness;
  • loss of consciousness.

Most often, injuries in the form of a laceration are accompanied by serious fractures of the limbs, spine, chest, skull or pelvis. When the damage is localized in the area abdominal cavity possible rupture of the bladder or spleen.

A typical type of laceration is a scalped injury to the head, resulting from a sharp impact on the hair and tearing off the skin directly along the hairline. Characterized given state profuse bleeding, severe pain syndrome and, as a rule, psychological trauma.

For lacerations, there are a number of typical pathological and physical signs:

  • most often an object with the help of which a large damage was inflicted and has a heavy weight, while the blow is carried out directly at an acute angle, which contributes to the formation of exfoliated skin;
  • the skin flap, which is formed due to the exfoliation of the skin, necratizes, creating difficulties in further treatment and healing wound surface;
  • as a rule, the resulting wound does not gape, its edges are uneven, which significantly complicates the healing process by primary intention;
  • the great depth and uneven edges of the wound entail severe pain and severe bleeding;
  • development purulent complications due to the entry of infected elements into the wound.

Diagnostics

Validity of future appointments medical measures largely depends on the quality of the diagnostics performed at all stages of the recovery process: initial examination patient, surgical treatment and postoperative period.

Diagnosis of a laceration is based on the data of the collected anamnesis, laboratory and instrumental studies.

Anamnesis

When collecting an anamnesis, it is very important to find out what kind of object was damaged, the duration of the events occurring and the amount of prehospital care.

Objective research

At this stage of diagnosis, the level of severity of the inflicted injuries is assessed according to the general condition of the victim, the color of the skin and mucous membranes, according to the level of consciousness, measurement data blood pressure and heart rate.

At severe condition diagnostics should be carried out in parallel resuscitation. Such conditions require a thorough examination of the entire body of the victim for the presence of any other injuries. An unnoticed wound, even the smallest, can lead to the death of the victim.

An equally important step in objective research plays an assessment of damage to the main vessels. To clinical manifestations include: pallor and moisture of the skin, tachycardia, shortness of breath, the development of hemorrhagic shock.

Local manifestation of damage to the main vessels:

  • the wound corresponds to the projection of the course of the vessel;
  • an increase in the damaged area in volume due to the formation of a subfascial hematoma;
  • ischemia of the wounded organ;
  • violation of functionality;
  • the presence of swelling;
  • weakening of the pulsation in the periphery.

When an infection is attached, the body reacts more pronouncedly:

  • increase in body temperature;
  • increased pain at the site of injury;
  • the presence of hyperemia in the area of ​​damage;
  • swelling of surrounding tissues;
  • necrotizing.

Laboratory research

Before starting treatment with surgical intervention, the patient must undergo a series of standard laboratory tests:

  • general blood analysis;
  • general urine analysis;
  • blood chemistry;
  • blood type;
  • Rh factor, RW;
  • HIV AIDS;
  • glucose level;
  • markers hepatitis B, C and A;
  • fluorography;
  • electrocardiogram.

Instrumental diagnostic methods

This diagnostic stage is necessary to determine the depth of the wound and the presence of other damaged elements.

Radiography is one of best practices diagnostics, with which you can determine the presence of foreign bodies in the wound, the depth of damage, various kinds fractures.

Computed tomography is a more advanced technique that can more accurately determine the nature of associated injuries, such as bone fractures, general state internal organs, signs of hemorrhages or hematomas formed.

magnetically resonance imaging is the most effective method studies of internal organs and tissues, as well as blood vessels. With this diagnostic method, you can diagnose all possible damage caused by serious damage.

First aid

First aid for an equal wound, as with any other injury, consists of several main stages.

  1. Stop bleeding. This is the most milestone in helping the victim. In order to stop the bleeding, you first need to determine the amount of blood loss. With minor damage, finger pressure on the damaged artery is enough to stop. If the bleeding is massive and it is difficult or simply impossible to determine the location of the rupture of the vessel, it is necessary to apply a tourniquet or a tight gauze bandage. If there is no medical tourniquet nearby, you can use dense fabric, shawl or scarf. The tourniquet is applied just above the damage in the summer for no more than 2 hours, in the winter - 1.5 hours.
  2. Wound decontamination. To prevent infection of the wound surface, the damaged area is treated disinfectants- hydrogen peroxide. Antibiotic ointment will help protect the wound from further infection. For cupping pain syndrome painkillers are used, which are most effectively injected directly into the wound.
  3. Wound dressing. This stage prehospital care is needed to ensure the relative sterility of the wound. If the damaged area is small, it can be isolated with adhesive tape or plaster. More serious wounds should be bandaged with a sterile bandage or gauze.

Treatment

To date, there are two main methods of treatment of lacerations:

  • Conservative. This method of treatment is intended for minor injuries that do not require serious surgical intervention. Treatment is usually carried out in an emergency room or in an emergency room. surgical department. The wound is thoroughly washed and disinfected antibacterial agents. If necessary, the edges of the wound are excised, and the wound itself is sutured and drained. With a favorable course recovery period stitches are removed on the 7-8th day.
  • Surgical. This method of treatment is used for extensive damage, involving not only the surrounding tissues, but also the surrounding organs. In cases where the patient is delivered to the surgical or trauma department in a state of traumatic shock, the operation is contraindicated, therefore, an intensive antishock therapy. After removing the patient from critical condition operation is carried out according to indications. The first step will be the primary surgical treatment. The wound is necessarily drained, as the risk of infection is quite high. In the postoperative period, antibiotic therapy and analgesics are prescribed.

With extensive necrotic tissue damage, the patient is hospitalized in the department for planned operation by excision of necrotic tissue, opening of purulent streaks or abscesses. After the surgical operation antibiotics are also prescribed taking into account individual sensitivity to the pathogen.

During the healing period of the wound, immunomodulatory treatment and vitamin therapy, regular dressings with the use of indifferent and antibacterial ointments are prescribed.

There are two main types of wound healing after all medical procedures:

  • wound healing by primary intention is the most favorable outcome of any type of injury, in which the edges of the wound are even and close to each other. In addition, the wound field is clean - no infection and bleeding. Healing occurs after one to two weeks, it depends on individual characteristics organism and the quality of wound care. After this type of healing, there is no rough scar left in some cases, this is the key.
  • wound healing by secondary intention is a more complex process of healing the resulting wound, since the edges are usually uneven, torn or crushed and are found far from each other. This is the difficulty of recovery. Such wounds heal for a long time, as the formed void is gradually filled with new tissue. This period can vary from several weeks to several months, depending on the depth of the damage. In most cases, a rough scar remains in the final version.

Prevention

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