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Skin Wound

  • Definition

    A skin wound is damage to the surface of the skin. There are several types of skin wounds including:
    • Puncture—This wound is often caused by a sharp or pointed object. It pierces through the skin. It can also affect the soft tissue beneath it.
    • Laceration—With this wound, the skin is torn or cut open. It can vary in size and shape and be deep or shallow.
    • Avulsion laceration—With this laceration, the skin is torn off completely or there is a flap of skin.
    • Pressure sore—These sores are lesions on the skin. They are caused by long periods of pressure over a bony part of the body. The hip and heel are common sites for this wound.
    • Incision—This is a cut caused by a sharp object like a knife, broken glass, or scissors.
    • Abrasion—With this wound, the skin is scraped or rubbed off. Minor abrasions affect only the top layer of skin. Deep abrasions affect deeper layers of tissue and are more likely to leave a scar.
    Pressure Sore (Skin Ulceration)
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  • Causes

    There are many different causes of skin wounds. Some possible causes include:
    • Injury, such as a fall or blow
    • Animal bite or human bite
    • Long periods of time spent in one position
  • Risk Factors

    There are different risk factors for each type of skin wound. Some examples of risk factors include:
    • Being in an accident
    • Handling sharp objects (puncture, incision, or laceration)
    • Being confined to bed or wheelchair (pressure sores)
    • Occupation or activity choices that involve risky behavior
  • Symptoms

    Besides the obvious damage to your skin, you may also have:
    • Bleeding
    • Pain
  • Diagnosis

    Your doctor will ask about your symptoms and medical history. Your wound will be examined.
    Depending on the type of wound, your doctor may stage it. This means the doctor will assign a level that describes how serious the wound is. This will help decide how it should be treated.
  • Treatment

    Your treatment will depend on the type of wound and how severe it is. Options include:
    Self Care
    Minor wounds can be treated with self care:
    • Wash the wound with soap and water.
    • Apply pressure with a clean towel to stop bleeding.
    • Seek medical care if bleeding does not stop within 15 minutes.
    • Use a sterile bandage to cover the wound. Keep the bandage clean and dry.
    • If possible, elevate the wound above the level of your heart.
    • Check the wound regularly for signs of infection. This may include redness, new or worsening pain, and heat.
    Steristrips
    Steristrips are adhesive strips that can be used to bring the edges of a minor wound together. This will help the wound heal and keep it clean. They may be used for wounds that are clean, have straight edges that line up well, and are easy to push closed.
    Skin Glue (Dermabond)
    Skin glue is used to hold a wound together and allow it to heal. It is most often used on the face, arms, legs, and torso. If you have skin glue on a wound, you will need to keep the area clean and dry.
    Sutures
    Sutures are used for deep, bleeding wounds. These wounds may have jagged edges that are otherwise difficult to close. In deep wounds, stitches may be needed under the skin before the wound can be closed. These stitches will be absorbed by your body. Your doctor may ask you to come back to remove stitches on the surface of your skin. Keep the area clean and dry.
    Staples
    Staples are best for wounds on the scalp, neck, arms, legs, torso, and buttocks. The wound edges are closed and lined up. The staples are placed along the wound.
    Hair Tying
    Hair tying may be used for scalp lacerations. Hair is gathered in a way that pulls the wound shut. The hair is then held together with a rubber band or dermabond while the wound heals.
    Skin Grafts
    Skin grafts may be used when the skin around the wound is too damaged to heal together. This may happen with pressure sores or after skin has been removed in surgery. Skin grafts take healthy skin from another area of the body. This healthy skin is then placed over the wound.
    Medications
    Your doctor may prescribe an antibiotic to treat or prevent infection. You may also be given an antibiotic ointment to put on the wound. Depending on how you got your wound, you may need a tetanus or rabies vaccine to prevent infections.
    If your wound is severe, your doctor may also prescribe a pain medicine.
  • Prevention

    There are many causes of skin wounds. Often, they may be due to accidents, which can be difficult to prevent. To help reduce your chance of getting a skin wound, take these steps:
    • Be careful when doing activities that can cause skin wounds. For example, use caution when handling sharp objects, such as knives and scissors.
    • Avoid going barefoot, especially if you have diabetes.
    • If you are confined to bed due to injury or bed rest, change your position often to prevent pressure sores. Check your skin for early signs of stress.
  • RESOURCES

    American Academy of Family Physicians http://www.aafp.org/

    American College of Surgeons http://www.facs.org/

    CANADIAN RESOURCES

    Canadian Association of Wound Care http://www.cawc.net/

    Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/

    References

    Kornusky J, Grose S. Pressure ulcers: staging. EBSCO Nursing Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/nrc-about. Updated November 11, 2011. Accessed May 23, 2012.

    Laceration management. EBSCO DynaMed website. Available at:http://www.ebscohost.com/dynamed/. Updated March 28, 2012. Accessed May 23, 2012.

    Neff D. Discharge instructions for puncture wound. EBSCO Patient Education Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/perc-about. Updated December 1, 2011. Accessed May 23, 2012.

    Puzanov I. Laceration repair. EBSCO Patient Education Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/perc-about. Updated December 1, 2011. Accessed May 23, 2012.

    Stahl RJ. Discharge instructions for avulsion laceration (not requiring sutures). EBSCO Patient Education Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/perc-about. Updated January 1, 2012. Accessed May 23, 2012.

    Stephen-Haynes J. Skin tears: achieving positive clinical and financial outcomes. EBSCO Nursing Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/nrc-about. Accessed May 23, 2012.

    Wood D. Animal bites. EBSCO Patient Education Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/perc-about. Updated September 1, 2011. Accessed May 23, 2012.

    Wood D. Pressure sores. EBSCO Patient Education Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/perc-about. Updated September 1, 2011. Accessed May 23, 2012.

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