types of wounds and explanations

what are all the types of wounds

1. VULNUS SCISSUM – cut wound

2. vulnus contusum - bruise/ abrasion

3. vulnus laceratum - tearing

4. vulnus lacero- contusum

5. vulnus punctum - puncture

6. vulnus morsum- bite wound

7. vulnus scloropectum - gunshot wound

cut/surgical wounds

1. VULNUS SCISSUM

Incisions/ scalpel/ knife/ surgical wound

• Regular, straight edges come to a point

• length is greater than the depth- slash not stab

• clean margins, easier surgical closures

• (1°) Primary Healing

• oppose separated edges (suture/strips/glue)

• minimal scarring

• faster recovery

• Can cut through tendons, vessels, nerves

• functio leasa = (loss of function)

• BLEEDING

• Due to clean-cut transection of blood vessels.

what type of bleeding occurs from vein vs artery

• Arterial bleeding: bright red, spurting.

• Venous bleeding: dark red, steady flow.

bruises/abrasions

VULNUS CONTUSUM

• caused by blunt trauma, such as a fall, blow, or impact with a hard object.

• occurs where bone is directly under the skin

• e.g scalp, elbow, shin ect

• Skin and soft tissue are compressed between two hard surfaces (e.g., bone and blunt object like a bat).

• skin splits open due to pressure, not slicing

  associated with:

  • Bruising (Contusion)

  • Swelling (hematoma)

  • Crushing of underlying tissues

Contusion (Bruise) Color Progression:

1. blue/ purple- du to deO2 blood

2. green - Hemoglobin —> biliverdin

3. yellow- biliverdin —> bilirubin

Morphological Features

• Irregular wound edges

• raised, livid (bluish-purple) borders

• Minimal change in anatomy

• Soft tissue injury, bordered by bone

Stupor Reticaris- around wound, lump in middle, hematoma around it,

infection inside.

Stupor Localis- swelling with inflammation, livid edges, maybe some necrosis

Deep contusion and hematomas

• DANGEROUS coz can cause Tetnus/ infections

Management

• Observation and monitoring for swelling or infection

• Cleaning wound to prevent infection

• Excision and drainage if the hematoma is deep or infected

• Tetanus vaccine if needed

Pathophysiology of Bruising:

Capillaries rupture, leaking RBCs into the tissue.

• RBCs are not reabsorbed into circulation.

• They deoxygenate,

• are phagocytosed

• broken down → colour changes.

tearing/ laceration wounds

Vulnus laceratum

• caused by blunt mechanical trauma

• tears or rips the skin and underlying tissues.

• Shearing or stretching force applied to the skin

• Falls

• Being scraped by a rough object (e.g., tree branch, machinery)

• Road traffic accidents

• Irregular/ torn border- ragged, rough edges

• deep or superficial (only epidermis)

• Infection risk due to contamination and irregular shape

Lacerated-Contused Wound

VULNUS LACERO-CONTUSUM

mixed wound caused by blunt trauma

• Laceration (tear) of the skin/tissues

• contusion (bruising/crushing) of surrounding soft tissue

• Frequently occurs on the scalp

• Example: Brick or heavy object falls on head

Morphology

• wound edges are irregular

• injury to the skin, subcutaneous tissue, muscos and even bone

• can cause internal bleeding, hematoma, bone fractures

• surrounding tisssue- heavily contused, maybe necrotic

• Teta = covered wound DANGEROUS —> Traumatic shock and anaerobic/ gas infection

• Aperta = open wound, more visible but easier to clean and manage

Treatment

Treat = skin graft/ microvascular scalp preserving surgery

puncture wound

VULNUS PUNCTUM

• caused by a long, thin, pointed object

• that penetrates deeply into the tissues

• creating a narrow, deep tract.

• Nails, needles, thorns, screwdrivers, knives (in a stabbing motion)

• Small entry point, often misleading

• Deep penetration through skin, subcutis, muscle, and potentially into body cavities

• looks minor, significant trauma

complications

• Anaerobic infections (due to narrow, poorly oxygenated tract)

  • Especially Tetanus, Gas gangrene
    

• Foreign body retention (wood, rust, dirt)

• Sealed wound = high risk if surface heals first, trapping infection

• Organ injury if penetrating:

  • Pneumothorax (chest)

  • Peritonitis (abdomen)

  • Pericarditis or cardiac tamponade (heart)

    Treatment:

  • Do not close immediately

  • Drainage is crucial

  • May require wound exploration, foreign body removal

  • Tetanus prophylaxis

  • Antibiotics (especially against anaerobes)

  Stab wound

• by knife, so wider wound, less trauma,

• more pain and haemorrhage

• less chance of a foreign body

• less chance of infection

bite wound

VULNUS MORSUM

• Animal or bug bite

• tearing, puncturing, or crushing of the skin and soft tissues.

• Swelling/Oedema

• Painfull

• Allergies and complications are DANGEROUS

  • (rabies, poison, malaria, anaphylactic shock...)

• Bacteria in saliva and venom = ↑ infection risk

Dog- Et canicus

• tearing or crushing wound

• Rabies

• Pasteurella, Capnocytophaga infections

Insect- Et insecticidus

• Allergic reactions

• Disease transmission (e.g., malaria, dengue, Lyme)

Snake - Et serpentibus

• 2 puncture points

• venom

• increase in HR

• oedema

gunshot wound

VULNUS SCLOROPECTUM

• penetrating wound caused by a projectile (bullet) from a firearm

• Bullet size (caliber) determines damage done

• Velocity and energy (high-velocity = more destructive)

• Distance from shooter

• Rotation/spin of bullet

• Tissue type and elasticity:

  • Elastic tissues (e.g., muscle, skin) stretch and may recover

  • Non-elastic tissues (e.g., brain, liver, spleen) are damaged severely

• May have small entry + larger exit wound

Tissue Damage – 3 Zones:

1. Zone of destruction

   • necrotic canal

   • irreversible

   • foreign bodies

2. Zone of contusion

   • irregular bruised tissue

   • irreversible

3. Zone of concussion

   • outer area

   • vessel spasm

-Bullet fragments, shattered bones cause more wounding

Treatment:

• irrigate

• debridement

• exploration

• bullet removal

• dressing

• antibiotics