Wounds

Wounds are any damage to the skin and tissues caused by an injury. They can be open, with visibly damaged skin and exposed tissue (cuts, scratches, punctures, lacerations), or closed when there is tissue damage beneath intact skin (bruises, burst capillaries).

An open wound is an injury that involves an external or internal disruption of body tissue that affects the skin. Most open wounds are minor and can be treated at home. However, more serious open wounds caused by sharp objects or in traffic accidents require immediate medical assistance. This is especially important if bleeding cannot be stopped for more than 20 minutes.

Types of wounds

There are several types of open wounds, classified based on their causes.

Scratches – occur when the skin comes into contact with a rough or hard surface. They usually don’t bleed much, but the wound should be cleaned to prevent infection.

Lacerations, cuts (shallow and deep) – Shallow cuts don’t cause significant bleeding and heal quickly. Deep cuts occur from handling sharp objects, knives, tools, and machinery. In the case of deep wounds, bleeding can be rapid and profuse.

Puncture wounds – Punctures occur from long, pointed objects such as nails or needles. Sometimes a gunshot can cause a puncture wound. Puncture wounds may not bleed much, but they can be deep enough to damage internal organs. Therefore, even for smaller puncture wounds, it’s advisable to seek medical attention.

Wounds caused by the violent tearing of tissues – involve partial or complete tearing of the skin and underlying tissues, often including bones. They usually occur during traffic accidents, shootings, crush injuries, or animal bites. Avulsion injuries bleed heavily and quickly.

Burns – tissue damage caused by exposure to heat, excessive sunlight or other radiation, as well as chemical or electrical contact with the skin. Burns can range from mild, requiring no treatment, to life-threatening.

Symptoms of wounds

The most common symptoms of wounds are:

• Pain
• Swelling
• Bleeding
• Redness
• Pus

Depending on the location and type of injury, some wounds may cause more pain, bleeding, swelling, or a burning sensation than others. Minor wounds such as cuts and scratches are very common and usually do not require medical intervention. However, larger wounds measuring more than one centimeter or infected wounds require treatment to preserve the function of the affected body part and prevent complications.

 

Symptoms by Wound Types

Scratches: pain, redness, rash, swelling, or bleeding at the site where the skin has rubbed against a hard surface. Dirt or gravel may enter the wound.

Cuts and lacerations (shallow and deep): slight redness of the skin around the injury, pain, inflammation, damage to structures beneath the skin, bleeding, infection (severe pain, pus, redness beyond the wound edges, fever, excessive swelling of the wound), visibility of tendons, muscles, or bone if the cut is deep; and possible future scarring.

Punctures: bleeding that may be profuse, discharge of pus, warmth or swelling around the puncture wound.

Torn wounds: profuse bleeding, burning sensation around the wound, painful swelling, skin redness, pus, bruising, muscle pain, difficulty in movement, pain spreading to surrounding areas.

Burns: Depending on the degree of the burn, symptoms may include redness and mild pain, blisters, dark discoloration and numbness of the affected area, intense pain.

Complications of wounds

When open wounds are not treated in a timely manner, potentially serious complications can arise. The main complication of an open wound is the risk of infection.

If an infection goes undiagnosed or untreated, it can lead to cellulitis – a painful bacterial infection of the skin – or osteomyelitis – if it spreads to the tissue and bone.

Infection can result in permanent damage or even require limb amputation. A severe wound can lead to loss of function in the affected area.

The complications of wounds include rabies – the condition is caused by infection with bacteria that cause tetanus, as well as necrotizing fasciitis – a severe soft tissue infection caused by various bacteria (clostridia, streptococcus) that can lead to tissue loss and sepsis – a life-threatening condition.

IMPORTANT: Seek medical attention immediately if you have sustained wounds from punctures, accidents, or if you are experiencing profuse bleeding and signs of infection.

 

Causes of wounds

The most common causes of open wounds are:

• Falls
• Accidents with sharp objects
• Traffic accidents

Causes can also include:

• Firearm injuries
• Burns
• Exposure to chemical agents
• Conditions that prevent wound healing: diabetes, anemia, cancer, arthritis, varicose veins

 

Population at risk of wounds

-Individuals in certain occupations such as various tradespeople, firefighters, drivers, farmers…

-Older people are at a higher risk of wounds, especially if they have limited mobility, poor motor skills, or are prone to falls, or if they are bedridden.

-Individuals with poor overall health: there is a greater likelihood that individuals with a compromised immune system (the body’s ability to fight off infection) will develop wound infections if the skin rupture occurs.

-Individuals who use steroids: increased risk of wound infection and slower healing of open wounds.

-Individuals undergoing radiation therapy and chemotherapy: radiation can cause burns, and chemotherapy can result in a rash that often appears as a cluster of small pustules and blisters.

-Diabetics: diabetes can cause wounds to heal more slowly, increasing the risk of infections and other serious complications.

-Individuals prone to unhealthy habits such as smoking, unhealthy diet, or inactivity.

-Children: increased physical activity during play or exercise is a common reason for the occurrence of wounds in children of all ages.

 

Medical consultation

For larger, more serious wounds that are bleeding, it is important to seek medical attention. A doctor will examine the wound to determine the extent and severity of the injury, assess the likelihood of infection, and evaluate the risk of complications. The doctor may order blood and urine laboratory tests, as well as a bacterial culture to check for infection in the wound. If the wound is deep and significant, it may require stitches and administration of a tetanus vaccine.

Treatment options

Home treatment: Wound healing is most successful in a clean and warm environment. Some wounds, such as minor cuts and scrapes, can be treated at home. Stop bleeding by applying direct pressure and clean the wound with water using a clean cloth or cotton pad. Soap or hydrogen peroxide is not necessary to avoid further irritation. Apply an antibiotic ointment and cover the wound with a sterile dressing or adhesive bandage. Change the dressing or bandage every day or when it becomes wet. If you notice any spreading redness from the wound after two days or if you see yellow pus in the wound, seek medical attention immediately.

When to see a doctor: Superficial larger and deeper wounds can be serious. Seek immediate medical help if the wound is bleeding heavily and the bleeding cannot be stopped. All individuals with wounds from animal bites or human bites, as well as serious puncture wounds and lacerations, should see a doctor.

If an object such as a nail or fishhook is still embedded in the wound, DO NOT remove it. Apply pressure to stop bleeding and go to the hospital. Skin grafting may be necessary for some severe injuries.

 

Treatment of wounds

Cleaning and suturing the wound: The doctor will determine whether the wound can be closed with sutures immediately after cleaning or if it needs to remain open due to contamination. Infected wounds are not sutured until they have successfully healed.

Medications: The doctor may prescribe painkillers to prevent pain, antiseptics to clean contaminated wounds, medical dressings, antibiotics for bacterial infections or sepsis, corticosteroids, and tetanus vaccine.

Surgical and other procedures: Serious wounds may require surgical treatment, which involves removing burned and/or contaminated tissue, skin grafting, and draining abscesses (collection of pus surrounded by inflamed tissue).

Follow-up appointments: Most wounds that have been treated and sutured by a doctor require follow-up appointments. Based on the examination, the doctor will assess whether the wound is healing well, if further wound cleaning is needed, or if additional medications and procedures should be included.

 

5 signs that a wound requires medical treatment

If the wound is deep and underlying structures such as tendons or muscles are visible, it is essential to seek medical help. Additionally, puncture wounds caused by rusty nails are at risk of tetanus infection.

Animal bites: Immediate administration of oral antibiotics is necessary as there is a high chance of wound infection. Several diseases can be transmitted through animal bites, such as rabies and cellulitis. If suturing the wound is necessary, it may be delayed, and the wound left open until the doctor is sure there is no risk of infection.

Infection: Symptoms such as increased pain, significant redness, wound discharge, persistent bleeding, and high fever are reasons to visit a doctor who may prescribe antibiotic therapy in such cases.

Non-healing wound: If the wound does not heal after two or three days, it can become a chronic wound. Early detection of a chronic wound can help heal faster. There are many different types of wound bandages and medications used in the treatment of wounds.

Non-healing wound: If a wound does not heal after two or three days, it may become a chronic wound. Early detection of chronic wounds can help speed up the healing process. There are various types of wound dressings and medications used in wound treatment.

Predisposition to chronic wounds: Even a minor wound can be more serious for individuals with diabetes and weakened immune systems (immunocompromised). People with these conditions are more susceptible to rapidly developing wound infections. Antibiotics and debridement (removal of dead or inflamed tissue) are more likely to be necessary for individuals with these conditions. Seek assistance for any wound if you have one of these conditions, particularly if you are diabetic and have a foot ulcer (diabetic foot).

Stages of wound healing

Wounds, even small ones, do not heal overnight. They go through several stages of healing:

Hemostasis: Bleeding is the first step in the healing process as it helps clean the wound. Blood cells will then begin to clot, aiding in the formation of a scab and stopping the bleeding.

Inflammation: In this stage, blood vessels bring fresh blood and nutrients to the wound site, assisting the immune system in fighting infection while new tissue develops.

Growth and Regeneration: As the stage of growth and rebuilding begins, scar tissue may form as cells produce collagen, which helps close the wound and build new tissue. Scar tissue can help strengthen the healing wound.

Strengthening of new tissue: It may take several weeks, but over time, the new tissue will strengthen. For larger wounds, the entire healing process can take months to years, especially if there are any complications.

Natural preparations that aid in the healing of minor wounds

The use of these preparations is recommended exclusively for minor, superficial wounds. They should always be applied after cleaning the wound.

Honey: It has antioxidant, antibacterial, and anti-inflammatory properties. Apply a thin layer of honey to the wound, leave it on for a few minutes, and then cover it with a bandage.

Garlic: Garlic contains allicin, a compound with antimicrobial and anti-inflammatory properties. It helps stop bleeding.

Aloe vera contains glucomannan, a substance that helps regenerate cells and causes the body to produce collagen. This substance is a protein that promotes wound healing. Put a part of the plant or gel on the wound and wrap with gauze.

Aloe vera: It contains glucomannan, a substance that aids in cell regeneration and stimulates the body to produce collagen. Collagen is a protein that promotes wound healing. Apply a portion of the plant or gel to the wound and cover it with gauze.

Coconut oil: It contains monolaurin, a fatty acid with antimicrobial properties.

Turmeric: It contains curcumin, which has antibacterial, antifungal, and anti-inflammatory properties. Mix turmeric with warm water to make a paste. Then apply it to the wound and cover it with a clean dressing.

 

Prevention of wounds

Depending on the cause of the wound, you can take some of these steps:

• Avoid hot water, fire, sharp objects and other dangers
• Observe safety measures at work (wear helmets, gloves, protective suit)
• Arrange furniture and other items in your home so that they do not obstruct you while moving
• Do not touch chemicals without protective gloves
• Be more active, engage in physical movement as it is good for overall health. Similarly, use appropriate equipment during physical activities and avoid uneven terrains that may cause falls.
• Regularly check if you have any scratches or cuts
• Maintain a healthy diet
• Take prescribed medication regularly for any existing conditions.
• Maintain a healthy weight
• Maintain good skin hygiene
• Quit smoking

Prognosis and possible complications

The healing of wounds depends on their cause, size, severity of symptoms, patient’s age, and underlying conditions that can affect recovery.

Superficial wounds heal in a few days, and larger and deeper wounds usually in 4 to 6 weeks. Chronic wounds take even longer to heal. Several factors can contribute to impaired healing, such as hypoxia, bacterial infection, ischemia, altered cellular response, and collagen synthesis defects. Burn injuries often require skin grafting and involve a prolonged recovery period. Most deep wounds leave scars after healing.

An open wound can be superficial and mild, or it can be large, deep, and extremely uncomfortable. However, with the application of medication, dressings, or medical intervention, these injuries can be successfully treated. Often, clean water and bandage are all that is needed for the healing of minor wounds. If you have a large, deep, or serious wound, seek medical help and follow the doctor’s care instructions.

If you suspect that your wound is not healing properly or may be infected, do not hesitate to seek medical attention. People can use turmeric, aloe vera, coconut oil, garlic as natural treatments for minor open wounds. Large open wounds involving significant bleeding require immediate medical assistance.