Wound treatment rules

The term “wound” in medicine refers to a violation of the integrity of body tissues: skin, internal organs, bones, blood vessels, and other constituent “elements” of the human body. Such a violation appears as a result of external influence. Wounds can be of a diverse nature, of different area and depth, so they require different measures for neutralization and treatment. Some wounds can be dealt with on their own, while others require medical attention. However, in any case, each person should know the basic rules and master the skills of first aid and the treatment of different types of wounds – such knowledge can come in handy at any time.

The main classification of wound lesions in medicine

The type of injury directly affects how it needs to be treated – after all, for example, a gunshot penetrating wound requires a slightly different “treatment” than stab wounds or wounds after an animal attack, and superficial wounds are treated differently from deep penetrating injuries.

One of the most common classifications of wounds – depending on the nature of the injuries received. So, there are chopped, lacerated and stab wounds bitten, for example, after a dog attack. Also, wounds can be cut or gunshot if they are received from cold or firearms, razors or knives.

Chopped wounds are quite rare, and they are considered one of the most dangerous types of wounds. Usually, in addition to damage to the skin and soft tissues, chopped wounds are accompanied by a violation of the integrity of bone structures. Such a lesion is accompanied by bleeding, often severe, and has jagged edges that heal for a long time and are painful for the patient. The most characteristic type of slash wound remains after being struck with an axe. Also, a person can get a similar injury in case of accidents on various modes of transport. Chopped wounds, of course, require some initial treatment, which others can provide to the victim, and then the victim must be taken to the doctor, and often for suturing.

Lacerations are the result of severe bruises or falls. Such lesions often have a large area, they heal poorly and are dangerous with a high probability of developing an infectious lesion. Characterized by significant crushing of tissues and skin.

Stab wounds are one of the most common types of injuries that can easily be obtained even in everyday life, for example, by pricking with a needle while sewing, or stepping on a nail. They are characterized by a small area, but a deep and penetrating damaged area, due to which internal suppurations can develop in them.

Injuries after attacks by animals, such as dogs, are called bite wounds. Such wounds can be superficial or deep, affecting blood vessels, soft tissues and even bones. Their distinctive feature is that, regardless of the area and depth, it is imperative to see a doctor with them in order to prevent the development of rabies in a bitten person.

Incised wounds are another type of injury that is often found in everyday life. Careless handling of a knife, razor or broken glass can cause a cut wound, and it is household wounds that are generally shallow and do not pose a danger to humans, requiring only minimal treatment. If the incised wound is characterized by a large penetration depth, profuse bleeding may develop against its background.

Gunshot wounds are injuries sustained from body contact with a bullet or shot fired from a firearm. They can be:

• through, when the bullet passes through the body, and exits through the hole in the skin;
• blind if the bullet remains in the body.

Such wounds are often accompanied by major bleeding, and require medical intervention.

Types of injuries differentiated by other criteria

If we consider tissue damage according to the degree of their penetration, we can distinguish the following types of wounds:

• superficial;
• tangents;
• deep;
• through;
• blind.

Superficial wounds affect only the skin or mucous membranes, without violating the integrity of the soft tissues underneath – for example, these are abrasions or light scratches.

Tangential wounds pass by vital organs or bones without touching them, but can be quite deep, and are accompanied by bleeding.

Deep wounds are injuries in which the integrity of bones, organs and internal tissues of the body is violated.

Through wounds always have two holes – the place of entry and exit of the injuring object, for example, a bullet or a dagger.

As for blind wounds, they always require the intervention of doctors, since in this case a part of the object that hit the person remains in the body, and it must be removed from tissues or organs.

General rules for providing assistance in the presence of wound injuries

Medical care for wounds can be of two types:

• primary;
• prescribed by the doctor after examination.

Some types of injuries are generally successfully treated at home, without going to the doctor.

Assistance to the victim begins with an assessment of the degree and nature of the lesion. First of all, wounds with bleeding require medical intervention, while manipulations should be aimed at stopping bleeding and preventing large blood loss, which can cost a person life. The basic rules for helping with any type of injury look like this:

• the affected area of ​​the body must be immobilized and isolated from the effects of environmental factors;
• before starting the implementation of any activities, hands and improvised tools must be rid of dirt and thoroughly disinfected;
• if possible, sterile medical gloves should be used;
• after treatment, the damaged area should be covered with a sterile material to prevent infection from entering the wound;
• if the primary treatment of the wound is performed, it is better not to apply any ointments or powders to it, so as not to aggravate the healing process in the future;
• alcohol preparations, iodine or brilliant green for disinfection should not be poured into a deep open wound, as this can cause pain shock in the victim;
• if any organs or bones protrude from the wound, for example, the brain, intestines or bone fragment, it is forbidden to set them inside – they must be covered with sterile material, and the patient should be immobilized and taken to a medical facility;
• removal of foreign bodies from the wound should be carried out only by a doctor;
• Qualified medical assistance to the victim must be provided in the first 6 hours after being injured.

If the affected person needs urgent help, and there are no sterile materials nearby, minimal decontamination can be carried out improvised materialsironed on both sides. Such material can cover the wound.

Primary treatment of wounds has several goals, the main of which is to prevent hit any infection into damaged tissues, as well as to prevent blood loss. If the bleeding threatens with large blood losses, it must be stopped, even if the requirements of the sterility of the objects and materials used in the process have to be neglected.

Before applying a bandage, the edges of the wound should be treated with an antiseptic, and movements should be carried out in the direction from the wound. If the damaged area needs to be bandaged, this is done from left to right, in a circular motion of the bandage. Under the bandage, sterile gauze pads are applied to the wound site.

It should be understood that in severe cases, when it comes to car accidents or natural disasters, it is possible to provide assistance to victims only if there is at least a basic level of medical training obtained, for example, in first aid courses, otherwise you can cause irreparable harm to the victim, wrong by applying a tourniquet or trying to set the internal organs if they fell out of the wound of the abdominal cavity.

How to stop bleeding: the main tricks

First of all, it is necessary to assess the intensity of bleeding – it can be weak, when the blood oozes slightly, medium, or strong, if the blood flows profusely or gushing out of the injury.

Hands must be washed and treated with disinfectants. The skin around the wound also needs to be disinfected.

If the bleeding is profuse, and the outflowing blood spurts and has a bright scarlet color, then the arteries are damaged, but if the blood flows out calmly and has a darker, cherry hue, then the bleeding is venous. Such bleeding requires immediate measures to stop it – if it is impossible to ensure complete sterility, in this case you can even neglect the rule of asepsis, since if more than 35% of the total blood volume is lost, a person is threatened with death.

To stop external bleeding, the following techniques are used:

• finger pressure;
• pressure bandage;
• tight tamponade;
• tourniquet;
• flexion of the limb at the joint.

Finger pressure is the easiest way to stop arterial bleeding of moderate profusion – the artery is pressed against the bone between it and the wound, due to which the blood stops flowing into the damaged vessel.

A pressure bandage is relevant if bleeding of low or moderate intensity is localized on the head or on the limbs. The bandage does not just cover the wound – it is applied with pressure, with effort. If the wound with bleeding is located on the neck, a pressure bandage with a tourniquet may be applied to it.

Tight tamponade is used for arterial bleeding on the extremities, if other options for stopping blood loss cannot be used, for example, for deep wounds.

A tourniquet is required when bleeding from large artery wounds, such as the hip or shoulder, if medical attention is delayed.

If the bleeding is not too profuse, the method of flexing the limb at the joint can be used if the wound is localized above it.

How to properly apply a tourniquet

A tourniquet is an extreme measure to stop bleeding, which can only be used for blood loss from the brachial or femoral artery. It is applied at a distance of 5 centimeters from the wound towards the heart. It is forbidden to apply a tourniquet on the lower third of the thigh or the middle third of the shoulder. The duration of the tourniquet is no more than 45 minutes in summer and 30 minutes in winter.

Under the tourniquet, it is necessary to attach a gauze or fabric bandage to the body. Further, the limb with a tourniquet must be thermally insulated and immobilized until the arrival of doctors.

How to treat abrasions and small wounds

The first and basic rule in this case is not to wash the wound with running water, as it contains various microorganisms that, once in damaged tissues, can cause suppuration. It is also better not to use cotton wool – only sterile bandages or sterile cotton pads.

The wound should be washed with an aseptic solution, such as chlorhexidine or hydrogen peroxide. Cauterizing preparations such as iodine or “brilliant green” should not be applied to the open wound itself if it has a great depth, but they can be used to treat the edges of the wound. In extreme cases, vodka or moonshine is suitable if there are no medicines at hand, however, it should be remembered that their disinfecting ability is somewhat less strong than that of specialized medical products.

After the initial treatment, when all foreign objects are removed from the wound, it is covered with a sterile material and a not too tight bandage is applied over it. An abrasion, if it is heavily contaminated, should be washed well with a solution of peroxide or boiled water before treatment.

Stab and bite wounds: what to do

When inflicting a stab wound, it is first necessary to remove all foreign objects from it: a nail, a needle, a splinter, glass fragments. If foreign bodies are at a depth of more than 2 centimeters, and the wound is more than 5 millimeters in diameter, it is better to consult a doctor to remove them. A doctor’s consultation is also required if, after treatment, signs of an inflammatory process appear around the wound, or if the wound was caused by a rusty metal object.

Wounds that appear after animal bites are always the basis for a mandatory visit to the doctor. If blood flows from the wound, the patient must be given first aid to stop the bleeding, treat the edges of the wound with a disinfectant, cover it with sterile material, and urgently deliver the victim to a medical facility.

In what cases you need to see a doctor

In addition to the obvious cases when the wounded person has moderate or severe bleeding, fractures, damage to internal organs, a person needs to seek medical help in cases where, after treating the wound, signs of inflammation appear in the area of ​​damage (reddening of the skin, swelling, pain on palpation), if pus or a yellowish liquid oozes from the wound, and the wound has a noticeably elevated temperature.

If a person was bitten by an animal, if fragments of a wounding object could remain in the wound, or if the damage was caused by rusty metal objects, it is imperative to consult a doctor immediately after the initial treatment of the wound and stop the bleeding.

The basic and general rules for treating wounds are aimed at maximum disinfection of the affected area, if necessary, to stop bleeding. In order to correctly apply the existing first aid skills, it is necessary to know the main types of injuries and their differences from each other, as well as to understand which wounds require the mandatory intervention of doctors, and which ones can be dealt with at home by decontaminating and bandaging.