Definition and Overview
An injury is a general classification of any type of damage to the body. Possible causes may include accidents, falls, hits, weapons and other physical causes. Injuries may range from minor to life-threatening and can happen anywhere at any time. The most common types of injuries are wounds, bruises, burns, dislocations, fractures, sprain, and strains.
Wounds occur when skin, tissue or muscle is cut or torn open or when an object hits the skin with enough force to cut or tear it open. There are various terms that are commonly used interchangeably with “laceration” simply because they refer to the same type of injury. However, there are minor differences when it comes to severity.
- A cut is generally caused by a clean, sharp-edged object like a knife or glass splinter
- A laceration appears more jagged and is typically caused by blunt trauma.
- A gash is a term used for a wound that appears longer or deeper than a cut or a laceration
- An avulsion is a wound where tissue is not just separated but torn away from the body There are also other types of open-wound injuries that may be classified based on their causes:
- An “abrasion” or a “graze” refers to a wound where the top part of the skin is scraped off, like through friction or scrubbing.
- Puncture wounds are named as such because they cause perforation (or holes) on the skin, like a nail or a needle.
- Penetration wounds are like puncture wound where they cause a hole, but the wound goes deeper and may be jagged or irregularly-shaped, like in stabbing injuries.
- Gunshot wounds are caused by bullets that can enter and exit the body leaving holes on both ends. Sometimes, there’s only an entry wound with the bullet getting lodged inside the body.
Cause of Condition
Despite the many types of minor and serious injurious wounds, most lacerations, in general, are caused by the following incidents:
* Blunt trauma – refers mostly to injuries resulting from a physical attack or an impact from an object (big or small). A good example is a physical confrontation where punches were thrown and they land on different parts of the body, resulting in cuts and split lips. Blunt trauma can also be caused by a major blow to any part of the body, like being hit by a baseball bat. A collision has the heaviest impact and is another blunt trauma that causes lacerations.
* Childbirth – A perineal tear is an unintended laceration of the skin in the perineum, the region where the vagina and the anus are found. This laceration occurs in vaginal childbirth and could be mild or severe.
* Fall – There are two ways where a fall can cause lacerations. One, it can result from a fall when the person gets cut on the way down, like when he’s falling from a tree and he hits several branches before he reaches the ground. Two, a person may get a laceration when he hits the ground, like in the case of falling from a bike and he scrapes his knees or legs or palms.
* Sharp-edged objects – Sharp-edged objects are the most common causes of lacerations because it’s easy to get cut from them, especially knives, scissors and glass.
Lacerations are easy to diagnose and recognize because they happen often and most of the time, they’re minor injuries that they’re also easy to treat. Most lacerations have these key symptoms in common:
* Skin pain, bruising and swelling – It’s common to feel pain and see a bit of bruising and swelling in the lacerated area. The skin is abraded, cut, or torn off and it’s normal to feel pain. Bruising results from the area getting hit which means the tissues and blood vessels are broken as a result of the trauma. The skin also becomes inflamed from either the friction or blunt trauma, leading to swelling.
* Bleeding – Most laceration wounds end up bleeding because of the tear in the skin. Bleeding can be minimal when it’s just a surface wound or minor laceration and it usually stops with gentle pressure. Profuse bleeding can also happen when it’s a serious cut or when it involves the face, mouth or head, as these areas contain several blood vessels.
* Numbness and tingling – Another symptom of lacerations include the abnormal feeling or loss of sensation in the injured area. This may be due to the injury to the nerves or it’s the body’s way of shutting down feeling to the injured area to enable it to cope with the pain.
* Loss of function – In the case of more severe lacerations, the injured area may lose the ability to move or may display loss of function.
Who to See and Types of Treatments Available
The treatment of lacerations ideally starts with the evaluation of the type, cause and depth of the wound. The doctor has to determine if there are other injuries, if the wound needs to be cleaned first and if blood supply is impaired (in extreme cases). The doctor then needs to prioritize which condition has to be treated first. But generally, most lacerations are treated by following these steps:
* The wound is cleaned first – Any cut, scrape or puncture wound is best cleaned with cool, running water. Soap and a washcloth may be used to clean the area around the wound but not the wound itself. Tweezers (cleaned with rubbing alcohol) may be used to remove any debris in the wound. Deeper wounds may need to be anesthetized for a more thorough cleaning.
* The bleeding must be stopped - Bleeding from minor lacerations is easily stopped by putting direct pressure on the affected area. If necessary, a gauze bandage may be used to absorb the blood.
* The wound must be closed – Some minor cuts can be closed with the use of special adhesive tapes or tissue glue. Some may be managed with dressings if they’re not gaping wounds while deeper lacerations may require sutures/stitches.
References: * James D. Skin stapling. In: Pfenninger JL, Fowler GC. Procedures for Primary Care. 3rd ed. Philadelphia, PA: Elsevier Mosby; 2011:chap 34. * Usatine RP, Coates WC. Laceration and incision repair. In: Pfenninger JL, Fowler GC. Procedures for Primary Care. 3rd ed. Philadelphia, PA: Elsevier Mosby; 2011:chap 22.