Tuesday, September 20, 2016

Cuts and Closures

Cuts and scrapes are a part of life, as any mother of boys can tell you (just ask my mom; she treated plenty of  them, between my brother and me). However, there are multiple types of cuts, and they all need to be treated a bit differently.

This isn't a comprehensive breakdown by any means, as that can occupy entire chapters of medical textbooks. Instead, it's more of a crash course, if you'll pardon the unintentional pun. So, without further ado, lets close some cuts.

(Author's note: The pictures for this article are hidden behind links, for the benefit of those with softer stomachs. They are quite graphic. Be advised.)

Abrasions are one of the most common types of cuts, and are caused by rough materials rubbing the skin away. Colloquially called "road rash," abrasions can be caused by tools, falls, recreational accidents, or any other incident where moving skin hits a stationary surface (or vice versa).

These wounds look ugly, but usually don't bleed much and are fairly shallow. They do need particular attention when being cleaned, however, as debris often ends up in the wound.

Some abrasions can be quite severe, though. If large areas of skin are removed, or the wound bleeds heavily, professional medical attention is required. In addition, due to the amount of skin removed, abrasions need to be kept clean to prevent infections and speed healing.

Bandaging abrasions is usually quite simple, requiring only adhesive bandages or gauze pads. 
  1. Rinse the wound with clean water
  2. Dry it gently
  3. Apply the needed bandage. 
A laceration is what most people think of when they think of a cutting injury, and occur when a sharp object breaks the skin. They may bleed very little, or they may bleed heavily, depending on the depth of the wound and the location. Lacerations that bleed heavily, or won't stop bleeding with direct pressure, should be seen by a doctor. In addition, a wound deep enough or wide enough that you can see into it needs professional attention, typically sutures. Some folks are bold enough to do that at home, but I lack formal training in the subject, and so would rather leave that job to the professionals.

Bandaging a minor laceration is so basic that most folks do it without thinking.
  1. Flush the wound with clean water
  2. Dry it
  3. Apply an adhesive bandage, or something larger if needed. 
  4. Antiseptic ointment can also be used, if desired.
Temporary bandaging can also be used while transporting to, or waiting for, professional medical treatment. Wounds too large to bandage at home often benefit from a compression bandage until better treatment can be applied.

Puncture wounds are deep, narrow, and generally difficult for a layman to treat. If possible, do not remove whatever caused the puncture, as it often helps "plug the hole" and removing it can make things dramatically worse.
  1. Bandage any areas that are bleeding
  2. Immobilize or otherwise support the object to keep it from moving
  3. Summon professional help.

Illustration: Laceration vs Puncture

Avulsions are ugly, nasty wounds. The definition of an avulsion is when something is "torn away" from its natural place. These injuries are often caused in a manner similar to abrasions, but they are far more severe. In short, if things are only partially attached, it's an avulsion. 

Much like a puncture, there isn't anything that can be done in the field beyond keeping the patient still and calm, controlling bleeding, and calling the professionals.

Blood makes folks understandably upset. With a bit of forethought and awareness, you can help calm that storm and lead the way to the E.R. and, hopefully, a shorter recuperation period.


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