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By: Ikedi Ani-okoye

Types of wound

Even minor wounds can become infected and cause real problems with the casualty's health. However, most bites, grazes cuts heal without too much trouble and can easily be treated at home. It is important that you are aware of the type of wound sustained so that you can carry out the appropriate first aid, described in detail on the following pages. Some wounds, such as puncture wounds, are more likely to cause damage to the underlying tissues and organs, and so they need professional assessment by medical personnel.

There are two main types of wound: closed and open. Closed wounds are usually caused by a blunt object, and vary from a small bruise to serious internal organ damage. A bruise the size of the casualty's fist would cause substantial blood loss. Open wounds range fiom surface abrasions to deep puncture wounds. Identifying the wound type helps first-aiders decide whether damage to underlying structures is likely.

Abrasions

Abrasions tend to be caused by a blunt object applied at an angle, or by falling on to, or sliding along, a hard or rough surface. A knee, ankle or elbow is a common place for an abrasion arising from a fall or slide.

Lacerations

A laceration is a wound with jagged edges. These are often seen in car accidents, and may cause heavy bleeding (although some large lacerations show little bleeding). As the object causing the wound may be very dirty, the risk of subsequent infection is high.

Incisions

These arc clean-edged cuts, such as those caused by a knife or broken glass, and they may be deep. Incision wounds may look relatively harmless, but there can be considerable damage to underlying tendons, nerves, blood vessels and even organs. Deep incisions may be life-threatening especially if the injury is around the chest or abdomen. Bleeding from incisions can take some time to stop. Superficial incisions often heal quickly and well as the edges come together cleanly.

Puncture wounds

Often caused by long, needle-like objects, these can be tricky to assess, as the size of the external wound gives no clue to how deep it goes (and the extent of tissue damage). Professional assessment may be needed.

Bites

All bites carry a high risk of infection, with human bites almost invariably becoming infected - a doctor should see any human bite at all, in case antibiotics are needed.

Bruises

A bruise is discoloration of unbroken skin, caused by blood escaping from a vessel. This may be minor, as from a small area of broken capillaries after a bump, or may indicate internal bleeding. Most look more alarming than they are, and gradually disappear. A new bruise is usually red or purple; older ones are brown, yellow or greenish.

Gritty wounds

Dirty or gritty wounds must be clear in hospital to remove foreign bodies from the wound and prevent infection.

Gunshot wounds

Guns can inflict many types of wound, and bleeding can be extend and internal. Handguns, low-calibre rifles and shotguns fire fairly low-velocity projectiles, which usually stay in the body while high-velocity bullets from military weapons often leave entry and exit wounds. High-velocity bullets create powerful shock waves that can break bones and cause widespread tissue damage.

Amputations

The cutting or tearing off of body parts needs urgent help. Keep the severed part dry and cool and take it straight to hospital along with the casualty, as reattachment may be possible.

Scarring

The extent of scarring after an injury will vary depending on the individual.
Children's skin is usually flawless and so any scarring will show up more clearly than in an adult. However, children also heal much more quickly and more effectively. A childhood scar will often fade completely over time.

Some people are unlucky and their skin forms what are known as keloid scars. Here, cut or wounded skin heals over-enthusiastically, forming huge, often unsightly, scars.