Cuts And Wounds
Posted August 20, 2022 by Anusha ‐ 5 min read
Injuries caused by sharp objects that damage the skin and result in the exposure of underlying soft tissues are known as cuts and puncture wounds. The risk is high in children, elderly population and those who suffer from balance disorders such as Parkinson’s disease, cerebral palsy, ataxia, etc. Also, diabetics and immunocompromised patients need to be extra careful of cuts and wounds as they have higher risk of contracting an infection due to such wounds.
Cuts and puncture wounds are the injuries resulting from trauma caused by sharp objects. Such wounds damage the skin and cause a break in the continuity of the skin. More specifically, these can be described as below:
These are the injuries occurring from clean, sharp-edged objects, such as knives, scissors, etc., or as a result of blunt trauma, such as an injury sustained after falling on a rocky surface, or hitting the edges of furniture, etc. These types of wounds typically have a larger surface area but are mostly superficial.
These refer to the injuries occurring from sharp objects, such as nails or needles. They typically have a smaller surface area but penetrate deeper.
Cuts and puncture wounds can occur in a variety of circumstances where a body part is at risk of sustaining an injury, such as:
Falling and hitting yourself on sharp objects like rocks, furniture, tools, broken glass, etc.
Walking without proper footwear on open roads or grounds where nails or other sharp objects may be lying around
Not wearing protective gear while operating tools or heavy machinery
Self-infliction of injury
Immediate responses can lead to following symptoms
Bleeding: At times, the bleeding can be minimal. In the case of larger cuts or puncture wounds or where soft tissues or blood vessels are also injured, there may be significant blood loss.
Swelling: The area surrounding the wound becomes swollen, inflamed, and tender to touch.
Pain: Depending on the severity of an injury and the structures involved, the intensity of pain ranges from mild to extremely severe.
Difficulty in movement: Due to pain, swelling and bleeding, it becomes difficult to move or bear weight on the area injured.
Delayed responses can lead to following symptoms
Fever: If a wound that has not healed for long becomes infected, the body tries to fight off the infection, resulting in fever.
Pus formation: It is a common occurrence in infected wounds. Pus refers to a collection of dead white blood cells that accumulate in the wound due to an ongoing infection.
Chronic pain: Wounds that do not heal for a long time can cause chronic pain.
Infection: Contaminated wounds, presence of foreign bodies in the wounds, diabetes, reduced immunity, and unclean dressings can lead to a wound being infected.
Arterial and Venous Doppler Both Lower Limb, Arterial and Venous Doppler Both Upper Limb may be performed, depending on the site of injury in the case of puncture wounds with excessive blood loss to determine the blood insufficiency.
X-ray to detect if a concurrent bony injury has occurred. Tests may include X-ray Right Ankle AP View, X-Ray Left Elbow AP View, etc.
Complete Blood Count (CBC), Erythrocyte Sedimentation Rate, Total Leukocyte Count (TLC) and Differential Leukocyte Count (DLC) in cases of suspected wound infection.
Glucose - Random Blood, Glucose - Fasting Blood to check for sugar control in diabetic patients.
Culture sensitivity testing refers to identification of disease-causing microorganism, and to determine which antibiotics are sensitive to (effective against) the identified microorganism. It is usually recommended in case of severe infection.
First-aid for cuts and puncture wounds
The pointers given below should be followed when you administer basic first aid:
Inspect the wound thoroughly and look for the presence of any foreign body, such as dirt, tin, stones, pieces of glass, etc.
Carefully remove the foreign body if it is superficial, ensuring it does not increase the bleeding. If the foreign body is deeply embedded in the wound, do not try to remove it. Seek medical help.
Assess the amount of bleeding and if the bleeding is excessive, immediately call for help.
Try to stop the bleeding by applying pressure to the area and holding the area in an elevated position if possible.
Once the bleeding is under control, gently but thoroughly clean the wound with an antiseptic liquid or sterile water.
Apply a topical antiseptic cream and cover the area with a sterile bandage dressing.
Inspect the dressing regularly to see if it gets soiled or wet, and change it as required.
Monitor for signs of infection, such as fever, discharge from the wound, increased pain, etc.
Emergency treatment of cuts and puncture wounds
Emergency treatment consists of:
Stopping the bleeding - If the patient has lost excessive blood, intravenous transfusions with normal saline infusion or blood transfusion may be required.
Surgical debridement and cleaning the wound in the case of heavily contaminated wounds, with extensive damage to surrounding soft tissues.
Suturing the wound.
Use topical antiseptic ointments while covering the wound with proper dressing
Appropriate additional treatment for concomitant injuries.
Tetanus toxoid TF injection is given if the patient has not taken a dose in the last 5 years.
Painkillers, antibiotics and anti-inflammatory medicines are recommended to relieve pain, prevent infection and inflammation respectively.
Treatment for complicated cuts and puncture wounds
If the wounds become infected, additional treatment to control the infection and promote healing is required.
Paracetamol for relief from pain and fever.
Antibiotics like amoxicillin, cotrimoxazole, ampicillin, azithromycin, and doxycycline can be given to prevent bacterial infection
Antibacterial ointments like soframycin, mupirocin, neosporin, etc are used along with dressing to cover infected wounds
Vitamin C and zinc supplements to promote rapid wound healing.