Transcript Skin Wounds Classification

Objective 2: Identify soft tissue injuries
and skin conditions
o
o
o
o
Trauma that happens to the skin is visually exposed
Categorized as a skin wound
Defined as a break in the continuity of the soft
parts of body structures caused by a trauma to
these tissues
Mechanical forces include:
o
Friction, scraping, compression, tearing, cutting,
penetrating
o
o
o
Skin scraped against a
rough surface
Several layers of skin
are torn loose or totally
removed
Usually more painful
than a deeper cut b/c
scraping of skin exposes
millions of nerve
endings
o
Wash wound to remove all dirt and debris
o
o
o
o
o
Soap and water or hydrogen peroxide
Scrub wound if particles of dirt, rocks, or tar embedded
Leave open to air, unless oozing of fluid or blood
Apply antibiotic ointment to inhibit infections
Scrapes scab over quickly
o
o
o
o
Loose skin flaps form natural dressing; if flap dirty
remove with clean nail clippers
Check on date of last tetanus immunization
Watch for signs of infection
Seek medical attention if any of following:
o
o
o
o
Pain increases after several days
Redness/red streaks appear beyond edges of wound
Swelling
Drainage




Flesh irregularly torn; cut or tear in the skin
Minimal bleeding, minimal pain, & no numbness
or tingling
Cuts ≤ 0.25” (6mm) deep and 0.5” (1.3cm) long &
have smooth, edges can be treated at home
Deeper lacerations should be treated by physician
(stitches)
o
o
o
o
Cleaned with soap and water
Irrigate with clean water to remove debris
Do NOT use alcohol, iodine, or peroxide as it may
cause further damage and slow healing process
Stop bleeding
o
o
Cover wound with sterile gauze
Apply direct & constant pressure (15min+)
o
o
o
Once wound cleaned,
antibiotic ointment may
be applied to reduce risk
of infection & aid healing
Change sterile dressing
daily as needed
Bruising and swelling are
normal
o
o
Apply ice to site
Elevate area above level
of heart
o
Contact a physician if:
o
o
o
o
o
Laceration more than
0.25” (6mm) deep and
0.5” (1.3cm) long
The wound is in area
where wound by be
opened by simple
movement of body part
Wound on face, eyelids,
or lips
Deep cuts on palm,
finger, elbow or knee
Loss of sensation or ROM
of body part as result of
cut
STITCHES
STERI-STRIPS®
o
o
o
Layers of skin torn off completely or only flap of
skin remains
Same mechanism as laceration, but to extent that
tissue is completely ripped from it’s source
May be considerable bleeding
o
o
o
o
Clean wound with soap and water
If flap of skin remains connected replace skin
in its original position
If deep avulsion, seek medical attention for
stitches
If large piece of skin torn off place in plastic
bag and put on ice
o
o
Skin should not get frozen or soaked in water
Take skin in plastic bag to doctor; may be able to
save and replace torn-off piece
o
o
o
o
A blow compresses or crushes the skin surface and
produces bleeding under the skin
Does not break skin
Bruising due to injury to blood vessels
Most mild and respond well to RICE
o
o
o
Swelling
Pain to touch
Redness
o
Ecchymosis
o
o
o
o
accumulation of blood
in skin & subcutaneous
tissue more than one
cm in diameter
General term=bruising
Result of bleeding;
clotting or bleeding
disorders
Bluish lesion at earliest
stages of onset
o
o
o
o
o
o
Careful monitoring
Anti-inflammatory oral medications
Compressive dressing
Ice
Modalities to ↓ ecchymosis, ↓ swelling, ↑ ROM
Myositis ossificans: calcification that forms within
muscle
o
Requires surgical intervention
o
Continuous rubbing over the
surface of the skin causes a
collection of fluid below or within
the epidermal layer
o
o
Wash area thoroughly
Donut padding or
moleskin covering
o
Prevention:
o
o
o
o
Wear work gloves
Break in new shoes
Petroleum jelly/skin
lube
Adhesive bandage
o
o
Skin has been sharply cut
Surgical cut made in skin or flesh
o
o
Remove bandage day after surgery; replace daily or
as needed
Normal for edges of healing incision to be slightly
red
o
Call physician if:
o redness increases/spreads more than half an inch
o pus in incision
o more than mildly tender or painful
o
o
o
o
Keep incision clean & dry for several days after
surgery
Non-absorbable sutures or staples must be kept dry
until doctor removes
Steri-strips® should be kept dry 4-5 days
On face, hands, arms: take showers or tub baths
along as affected area stays dry




Wash with soap and water
Cover with sterile dressing
Apply antibiotic ointment
Apply Ice

Never apply ice with snakebites
 Stimulates the spread of the venom

Complications

Poisonous
 Minimize movement
 Seek medical attention

Infection
 Seek medical attention

Treatment


Look for stinger
If stinger present scrape away from skin with finger
nail or edge of a plastic card
 Never use tweezers to remove stinger- squeezing the
stinger will release venom into body
Wash area with soap water
 Cover with sterile dressing
 Apply Ice
 Watch for allergic reaction







Caused by insect stings, food,
other allergens
Known as Anaphylactic shock
Cause serious life-threatening
breathing emergencies
Air passages swell and restrict
breathing
S/S= rash, tightness in chest,
swelling of face and tongue,
dizzy, confused
Use of Epi-pen is necessary
treatment

HITCH
o
o
o
Skin always has some amount of bacteria, fungus,
and viruses living on it
Skin infections occur when there are breaks in the
skin and the organisms have uncontrolled growth
It is more important to understand the potential for
infection rather than placing a name on the skin
problem
o
Bacteria—can be cured
o
Staphlococcus
o Including MRSA & Impetigo
o
o
Fungal—can be cured
o
o
Streptococcus
Ringworm
Viral—cannot be cured, but can be treated
o
o
Warts
Eczema
o
o
o
o
o
Lesions with an irregular
border
Raised skin lesions
“wet” or “moist” lesions
Lesions that have different
colors within the lesion
Bright red colored lesions
are more of a problem
compared to faded lesions
o
o
o
o
Lesions that are warmer
compared to other skin
Inflammation & irritation
around skin lesion
Prior history of infectious
skin lesion
Skin abrasions
o
Deeper or more
traumatic break in skin,
higher risk for
subsequent infection
o
o
o
The right antibiotic is required to cure a specific
bacterial skin infection
Antibiotics for bacteria will not improve fungal or
viral infections
Bacterial infections can be the fastest growing
infections
o
Thus the most easily spread among athletes
o
o
o
Infection caused by
Staphylococcus bacteria
About 25% of people
normally carry staph in
the nose, mouth,
genitals, and anal areas
Infection begins with a
little cut gets infected
with bacteria
o
o
Range from a simple
boil to antibioticresistant infections to
flesh-eating infections
Difference is:
the strength of the
infection
o How deep it goes
o How fast it spreads
o How treatable it is with
antibiotics
o
o
o
Methicillin resistant Staphylococcus aureus
Resistant to certain antibiotics most are skin
infections
o
o
Methicillin, oxacillin, penicillin, amoxicillin
More severe or potentially life-threatening occur
most frequently among patients in healthcare
settings
SKIN INFECTIONS
o
o
o
o
o
o
o
Appear as pustules or
boils
Red
Swollen
Painful
Pus or other drainage
First look like spider bites
or bumps
Occur at sites of visible
skin trauma
SEVERE INFECTIONS
o
Potentially life-threatening
o
o
o
o
Blood stream infections
Surgical site infections
Pneumonia
Signs & symptoms vary by
type and stage of infections
o
o
Spread by having
contact with someone’s
skin infection or
personal items they’ve
used
Spread in places where
people are in close
contact
o
o
o
o
o
Close skin-to-skin
contact
Openings in the skin
(cuts or abrasions)
Contaminated items &
surfaces
Crowded living
conditions
Poor hygiene
o
o
o
o
o
Good hygiene
Keep hands clean—wash with soap and water
thoroughly
Keep cuts and scrapes clean & covered with a
bandage
Avoid contact with other’s wounds/bandages
Avoid sharing personal items i.e. towels, razors
o
Practice good personal
hygiene
o
o
o
Do not share items that
come in contact with
your skin
o
o
Towels & razors
Ointments
Take care of your skin
Take precautions with
common surfaces &
equipment
o
o
o
o
Keep hands clean
Shower after exercise
Do not share soap or
towels
Wash uniform & clothing
o
o
Cover abrasions/cuts
Change bandages
regularly
o
Use barrier between skin
& surface (towel,
clothing)
o
o
Antibiotic to drain infection
DO NOT attempt to treat yourself!
o
o
Includes popping, draining, using disinfectants on area
If you think you have an infection:
o
o
o
Cover affected skin
Wash hands
Contact physician
o
o
o
o
Mild itching & soreness
Eruption of small vesicles and/or pustules that
rupture to form honey-colored crusts
Combo of 2 bacteria that spread rapidly when
athletes in close contact with one another
Responds rapidly to proper treatment
o
o
Thorough cleansing of crusted area
Application of topical antibacterial agent
o
o
o
o
o
Caused by streptococcus (strep) or staphylococcus
(staph) bacteria
MRSA becoming common cause
May occur on skin where there is no visible break
Most common in children, particularly unhealthy
living conditions
Infection carried in fluid that oozes from blisters
o
Single or many blisters filled with pus
o
o
o
Itching blister
o
o
o
o
o
Easy to pop
When broken leave a reddish raw-looking base
Filled with yellow or honey-colored fluid
Oozing and crusting over
Rash
Skin lesions on face, lips, arms, or legs
Swollen lymph nodes near infection
o
o
o
o
Skin infection caused by
fungus (not a worm )
Fungi thrive in warm,
moist areas
Often several patches at
once
Contagious
o
Symptoms:
o
o
o
o
Itchy, red, raised scaly
patches that may blister
and ooze
Patches often have
sharply-defined edges
Redder around outside;
normal skin tone in
center
Skin appear unusually
dark or light
o
o
o
o
Body—tinea corporis
Scalp—tinea capitis
Groin—tinea cruris (jock itch)
Feet—tinea pedis (athlete’s foot)

Treatment



Warts



Verruca vulgaris
Small tumors with
dark centers
May appear anywhere
on body
Cryosurgery
Salicylic acid



Develop on sole of foot
Pinpoint black spots
Can be protected with donutshaped pad to relieve pressure


Itchy red rash
Caused by
Allergies
 Stress
 Temperature
 Drug
reaction
 Scratching
 Sun
exposure

Treatment




Corticosteroid
Lotions and
ointments
Antihistamines
Lotions to hydrate
skin