Cut wounds & Bite wounds
Written by Rhiana Devadasan
Cut wounds = a break or opening in the skin caused by scissors or sharp knives. (aka laceration)
Characteristics of the wound:
- May be smooth or jagged
- May be near the skin's surface or a deep wound
- If cut is deep, it can affect tendons, muscles, ligaments, nerves, blood vessels & bone.
- Symptoms: bleeding, pain, problems w/ function.
Treatment: For minor cuts:
- Wash your hands with soap or antibacterial cleanser to prevent infection
- Then, wash the cut thoroughly with mild soap and water
- Use direct pressure to stop the bleeding
- Apply antibacterial ointment and a clean bandage that will not stick to the wound
Vulnus morsum = wounds caused by human, animal or insect bites (e.g. snake bite = vulnus morsum serpentibus; cat bites; dog bites)
Characteristics of the wound:
- In the form of a point or dot
- Symptoms: severe pain & vasodilation, resulting in redness & edema
- Can cause allergic reactions → shock → lethal outcome
- Characteristics of snake bites: 2-point wound, edema, reness, pain, dyspnea, vomitting/nausea, blurred vision, sweating, salivating
Classification of bite wound: (based on severity)
- Grade I - superficial skin lesion; torn skin; scratched skin; bite canal; crushing injury
- Grade II - wounds extending from the skin to the fascia, muscle or cartilage
- Grade III - wounds with tissue necrosis or tissue loss
Infections of Bite wounds depend on:
- The nature of the wound
- Deep (punctate), contaminated wounds
- Wounds with marked tissue destruction, edema, poor perfusion
- Wounds on the hands, feet, face, and genitals
- Wounds with suspected joint involvement
- Bite wounds near a prosthetic joint implant
- The characteristics of the patient
- Impaired immune response (immune deficiency, chronic hepatic disease, asplenism, age <2 years, diabetes mellitus)
- Pre-existing venous or lymphatic stasis in the area of the bite
- Prosthetic heart valve
- The species of the biting animal:
- Human bite
- Cat bite
Treatment & Infection Prophylaxis
- Cleansing (e.g., with 1% organic iodine solution)
- Irrigation (normal saline)
- Debridement of devitalized tissue
- Primary wound closure or healing by second intention
- Limb immobilization
- Inpatient treatment/outpatient follow-up
Infection prophylaxis:
- Indications for immunization =
- Tetanus
- Rabies
- Antibiotics =
- Wounds with a high risk of infection
- Reporting to the authorities, if legally mandated