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• “integument” – covering
• Adult skin covers 3000 sq. inches of the
surface area of the body
• Weighs around 6 lbs.
(twice the weight of the brain and liver)
• Receives around 1/3 blood of the body
• It is flexible and has the capacity to
regenerate itself
Injury to any of the tissues of the body,
especially that caused by physical
means and with interruption of
continuity is defined as a wound.
DISRUPTION IN THE INTEGRITY OF BODY TISSUE
Tissue is defined as a collection of
similar cells and the intercellular
substances surrounding them. Four
basic tissues in the body:
1)epithelium
2)connective tissues, including blood,
bone and cartilage
3)muscle tissue
4)nerve tissue.
CLASSIFIED AS:
1. OPEN or CLOSED
2. ACUTE or CHRONIC
3. ACCORDING TO SEVERITY (superficial /
deep)
4. ACCORDING TO RISK OF INFECTION (clean /
contaminated / infected)
a. Contusion
: is a bruise
• the most common type of closed wound
(blood trapped under the surface of the
skin.)
• The epidermis remain intact, but cells and
blood vessels in the dermis are damaged.
• There is pain, swelling (a collection of
blood), and discoloration at the wound site.
• May indicate of internal injuries and related
internal bleeding.
b. Hematoma
: involves a larger amount of tissue
damage, including damage to larger blood
vessels with greater blood loss.
• Tumor like mass of blood trapped under the
skin
1. Manage the victim airway, breathing, and
circulation. Apply high- concentration
oxygen by non-re breather mask.
2. Manage as if there is internal bleeding
and provide care for shock(assess for any
possibility of internal injuries)
3. Splint extremities that are painful, swollen,
or deformed.
4. Stay alert for the victim to vomit.
5. Continue to monitor the victim for the
development of shock and transport as
soon as possible. 10
a. Abrasion
: includes a simple scrapes and
scratches in which the outer layer of
the skin is damaged
- usually the least serious type of
open wound.
11
b. Laceration:
• occurs when Sharp or
pointed object tears tissues
• results in wound with jagged
(irregular) edges
•May also result in tissue
avulsion
c. Puncture:
•when a sharp, pointed object
passes through the skin or
other tissue
•a puncture wound has
occurred.
Stab
Incision of the skin with well
defined edges, usually
caused by a sharp
Cut
instrument
• Deeper than long incision of the
skin with well defined edges,
usually longer than deep
d. Avulsion:
• in an avulsion, flaps of skin
and tissues are torn loose or
pulled off completely.
• tearing away from
supporting structures
22
e. Amputation
the extremities are sometime
subject to amputation.
•Control bleeding.
•Treat for shock.
•Recover amputated part.
•Wrap part in gauze, place in a bag,
and keep bag cool.
•Transport the part with the victim.
f. Crush injury
• A crush injury occurs when force or
pressure is put on a body part. This type of
injury most often happens when part of the
body is squeezed between two heavy
objects.
• CHRONIC ILLNESSES
• RADIATION THERAPY
• TISSUE HANDLING — Keeping tissue trauma to a
minimum promotes faster healing.
• MAINTAINING MOISTURE IN TISSUES
• REMOVAL OF NECROTIC TISSUE AND FOREIGN
MATERIALS — Adequate debridement of all
devitalized tissue and removal of inflicted foreign
materials are essential to healing, especially in
traumatic wounds. The presence of fragments of dirt,
metal, glass, etc., increases the probability of infection.
CLEAN WOUND
• Seventy-five percent of all wounds (which
are usually elective surgical incisions)
• An uninfected operative wound in which
no inflammation is encountered and the
respiratory, alimentary, genital, or
uninfected urinary tracts are not entered.
• These elective incisions are made under
aseptic conditions and are not predisposed
to infection.
Clean-contaminated wounds
• wounds in which the respiratory, alimentary, genital, or
urinary tracts are entered under controlled conditions
and without unusual contamination.
• Specifically, operations involving the biliary tract,
appendix, vagina, and oropharynx are included in this
category provided no evidence of infection or major
break in technique is encountered.
• Appendectomies, cholecystectomies, and
hysterectomies fall into this category, as well as
normally clean wounds which become
contaminated
Contaminated wounds
• include open, traumatic wounds or
injuries such as soft tissue lacerations,
open fractures, and penetrating
wounds;
• operative procedures in which gross
spillage from the gastrointestinal tract
occurs; genitourinary or biliary tract
procedures in the presence of infected
urine or bile;
• M.V.A