Open wounds can be both external or internal. Internal tissues are left exposed to the external environment either by injury or a surgical procedure. Low level acute open wounds can sometimes be treated at home, but if an injury is bleeding significantly or there are broken bones involved, immediate medical attention should be sought.
Wounds can be categorized into two categories which are open or closed. A bruise is considered a closed wound because the damage to the tissue and the bleeding take place beneath the surface of the skin.
Open wounds occur when the skin breaks and internal tissue is open to the air. These wounds can come from trauma such as a car accident, falling, or surgery.
Types of Open Wounds
Some examples of open wounds include the following:
Abrasion
when the skin is rubbed or slid against a rough surface, an abrasion occurs. Scarring a knee in a bicycle wreck or getting road rash are examples of abrasions.
These injuries don’t bleed much but it’s very important to use a sanitizer on the wound and use tweezers to remove any debris that may be in it. This will prevent infections from occurring.
Laceration
Laceration is deep tear in the skin that results in an opening often referred to as a gash is a laceration. These wounds usually stem from a vehicle accident or injuries from sharp tools such as knives and saws. There can be substantial blood loss with lacerations.
Avulsion
Avulsions occur when the skin is torn away from the tissue beneath it, and possibly portions of the tissue as well. These types of wounds are often seen in explosions, incidents involving violence against a person, attacks from animals, and severe car accidents.
Puncture
Punctures are wounds that are small holes that occur in the soft tissue such as your upper arm, belly, or thigh. Splinters from wood and needles are causes of puncture wounds.
These types of punctures only have an adverse effect on the outer layer of tissue. If the puncture is as a result of a gunshot or a knife wound deep muscle penetration is possible as well as damage to internal organs. These wounds often result in significant blood loss.
Incision
Incisions are straight cuts in the skin that are clean. Many surgeries are done via an incision. This is not the only cause for this type of wound, though.
Incisions can occur during accidents that involve sharp objects such as razor blades or broken glass. There is usually an onslaught of heavy bleeding that comes quickly.
If an incision is deep, muscle and nerve damage can occur and stitches or staples are needed to close the wound.
Types of Wound Treatments
Dressing wounds with bandages can help with the healing process. Minor open wounds may not need to be treated by a medical professional. If there is significant bleeding involved or the bleeding will not stop, medical attention should be sought immediately.
Open Wound Care Steps
- Stop the wound from bleeding. It takes gentle pressure applied directly to the wound to initiate the clotting of the blood. This should be done with a bandage or any other clean material that is readily available. If the bleeding will not stop, seek medical attention
- Cleanse the wound thoroughly: Using the saline solution and clean water, wash away any debris that may be in the wound, especially if it’s an abrasion.You will be flushing any bacteria out as well. When the wound is clean to the eye, use a dry clean cloth to pat the wound dry. If the wound has dead tissue, fragments of glass, bullets, or any other debris that cannot be removed without causing more damage, a doctor needs to be consulted. A wound care specialist can intervene if needed.
- Treat the wound with antibiotic ointment: Once the wound has been thoroughly cleansed, rub a thin layer of antibiotic ointment across the top of the wound to prevent infection.
- Bandage the wound: It is important to close the wound once it is clean so that it will heal quicker. For minor wounds, gauze and waterproof bandages are appropriate. Deep, open wounds will likely need either stitches or staples. If the wound is infected already, a wound care specialist will more than likely advise that it be kept open until the infection has cleared up completely.
- Change the dressing on a regular basis: Old bandages should be removed and the wound should be checked for any symptoms of infection every 24 hours. Do not do it more often, as exposure to the environment puts the wound at risk. When the old bandages are taken off, disinfect the wound and dry it thoroughly before you reapply new dressing.
Open Wound Medications
Over-the-counter medications can be taken for the reduction of swelling and to ease the pain. Aspirin can thin the blood, so it should not be taken during the healing process.
The attending physician may prescribe stronger pain medication if the patient has a more severe wound or a wound that has become infected. Topical antibiotic ointments can be used if the wound is a minor cut or scrape.
If a wound care physician or a surgeon is attending to the patient, oral antibiotics may be prescribed if there is a belief that the risk of contracting an infection while healing is possible.
Risks
If a wound gets infected, fever can set in and the pain may worsen greatly. There are many different bacteria that can colonize on the skin’s surface, therefore open wounds need specific care and appropriate sanitation to calm the risk of infection.
Signs and Symptoms of Infection
There are signs and symptoms of infection that can warn you that you need to let your doctor know there may be a problem such as:
- Warm and swollen skin around the wound that may begin to flush
- Intensification of the pain in the wound
- Any fluids collecting in the wound (either clear fluid or pus)
- Sores or blistering of the area around or in the wound
- Running a fever
- Swelling of the lymph nodes.
Types of Infections
There are different types of infections that can set into an open wound that include:
Staph Infection
Staphylococcus is a group of bacteria that are always present on the skin and inside every human’s nose. They usually don’t cause disease but if they enter the body via an open wound a contagious condition called staph infection can result.
The staph infection can stay in the skin and have an adverse effect on the sweat and oil glands in the body. In severe cases, the staph infection can spread through the entire body and affect many vital organs.
Professional medical assistance will need to be administered for the infection. The provider will likely give the patient antibiotics to ward off the staph infection.
However, if the staphylococcus strain is methicillin-resistant Staphylococcus aureus (MRSA), treatment becomes very challenging for the attending physician who will likely be a wound care specialist.
Tetanus (Lockjaw)
Clostridium tetani (C. tetani) can enter the body through any open wounds on the body and will cause an infection that is called tetanus.
Once this bacteria is inside the body, incredibly painful muscle spasms in the neck and the jaw. The bacteria is found on metal objects, in soil, and in the dust.
If a person’s skin is pierced or punctured by a metal object, medical attention should be sought immediately, especially if the person has not had a tetanus shot. The tetanus booster should be given every ten years.
Necrotizing Fasciitis
Necrotizing fasciitis is a very rare bacterial infection. It kills off the soft tissue that is infected. Group A Streptococcus usually is the cause of the infection and it develops abruptly and the spread is rapid.
The severe condition requires immediate medical administration. Toxic shock syndrome and organ failure can set in. Additionally, the patient can become septic and could even die.
Symptoms are similar to the flu and include extreme pain at the wound site, fever and chills, aching body, nausea and vomiting, diarrhea, sore throat, and a stomach ache.
Chronic Wounds and Wound Care Specialists
Chronic wounds take longer than usual to heal and may reopen repeatedly. Bacterial infections can be a common cause of chronic wounds.
If the person with the wound has weakened immunity or underlying illnesses such as diabetes or cancer, the risk of their wound becoming chronic is heightened.
Chronic wounds are expertly handled by professional wound care physicians that have retained extensive knowledge on wounds and how to treat them.
If you have a wound and it has not cleared up or you are questioning if it may be infected, you should seek medical attention. The only bad question is the question that never gets asked.
- What to know about open wound care ( Reviewed May 23, 2019) https://www.medicalnewstoday.com/articles/325260.php
- Signs of Wound Infection (October 19, 2016) https://www.woundsource.com/blog/8-signs-wound-infection
- Elizabeth K, Renuga, Clostridium Tetani George: Dec 10, 2019) https://www.ncbi.nlm.nih.gov/books/NBK482484/
