TOPIC 13. KINDS OF WOUNDS – CUTTING, CONTUSION, LACERATION, AVULSION AND LACEROCONTUSED
Clinical approach
- Identify the mechanism because it predicts depth, contamination and the structures at risk.
- Assess bleeding, distal pulses, capillary refill, sensation, motor function and joint/tendon function.
- Look for foreign bodies, fracture, joint penetration and injury to underlying vessels or nerves.
- Use appropriate imaging when a retained foreign body or fracture is suspected.
- Debride only clearly non-viable tissue while preserving viable skin and important structures; specialist input is needed for complex hand, face, tendon, nerve or vascular injuries.
Distinguish: An incised wound has relatively clean edges; a laceration is torn and irregular; a contusion is blunt tissue injury; an avulsion tears tissue away from its attachment; a lacerocontused wound combines tearing and crushing.