wound
(woond 
)
Injury or damage to body structures caused by violence, trauma, or surgery. In treating a wound that was not made surgically, prophylaxis against tetanus must be considered. The patient, if not previously immunized, should be given tetanus immune globulin.
Patient Care: Successful wound assessment includes the location of the wound, its size, depth, undermining, drainage, edges, base, and surrounding tissues. An assessment should be made for any redness, swelling, tenderness, and gangrene/necrosis. The assessment includes the patient's vital signs and measures taken to improve the healing. There are many diagnostic tools (such as radiography) to determine the extent of the injury.
abdominal w.A wound that may be superficial or extend to intraperitoneal or extraperitoneal organs or tissues. In cases of abdominal trauma, a careful examination (often including peritoneal lavage, ultrasonography, or computed tomographic scanning of the abdomen) is necessary to determine the precise nature of the injury and the proper course of treatment. Superficial injuries may require no more than ordinary local care; immediate laparotomy may be needed, when major bleeding or organ damage has occurred. Intravenous fluids, blood components, antibiotics, and tetanus prophylaxis are given when necessary. Major abdominal trauma may be overlooked in comatose or otherwise critically injured patients when there is no obvious abdominal injury.
SEE: abdomen.
bullet w.A penetrating wound caused by a bullet discharged from a firearm. The extent of injury depends on the wound site and the speed and character of the bullet.
SEE: gunshot wound.
Tetanus booster injection or tetanus immune globulin and antibiotics, if indicated, should be given. An appropriate band age should be applied. Emergency surgery may be necessary. Complications, including hemorrhage and shock, should be treated.
Removed bullets or bullet fragments become police property because they have forensic value and may be used in criminal prosecution.
chronic w.A wound with abnormally delayed healing; a refractory wound.
clean w.A wound that has been debrided to remove dead tissue, debris, pus, and potentially infectious materials.
closed w.A wound whose surface has been covered by an epithelial tissue layer.
contused w.A wound in which the skin is not broken; a bruise. It may be caused by a blunt instrument. Injury of the tissues under the skin, leaving the skin unbroken, traumatizes the soft tissue. Ruptured blood vessels underneath the skin cause discoloration. If extravasated blood becomes encapsulated, it is a hematoma; if diffuse, an ecchymosis.
SEE: ecchymosis; hematoma.
Cold compresses, pressure, and rest, and elevation of the injured area will help prevent or reduce swelling. When the acute stage is over (within 24 to 48 hr), continued rest, heat, and elevation are prescribed. Aseptic drainage may be indicated.
Variant: crush wound
Crush injury.entry w.A wound made by a penetrating object (e.g., a bullet) entering the body.
exit w.A wound made when a penetrating object leaves the body.
fishhook w.A wound caused by a fishhook becoming embedded in soft tissue. Deeply embedded fishhooks are difficult to remove. One should push the hook through, then cut off the barb with an instrument, and pull the remainder of the fishhook out by the route of entry. Antitetanus treatment should be given as indicated. Because these injuries often become infected, prophylactic use of a broad-spectrum antibiotic is indicated.
ABBR: GSW
A penetrating injury from a bullet shot from a gun. At very close range, the wound may have gunpowder deposits and the skin burn marks. GSWs can crush, penetrate, stretch, cavitate, or fracture body structures. The severity of the wound may depend on the structures damaged, the velocity and caliber of the bullet, and the underlying health of the victim.SEE: bullet wound.
junctional w.A wound at the branch point where the limbs emerge from the trunk of the body. Bleeding from such wounds can be difficult to control with stand ard tourniquets.
knuckle w.A wound to the metacarpal bones, esp. one that results from a fist fight. These wounds commonly include fractures and penetrating injuries contaminated with oral or periodontal bacteria. SYN: knuckle tooth wound.
knuckle tooth w.Knuckle wound.
nonpenetrating w.Blunt trauma.
open w.A contusion in which the skin is also broken (as by a gunshot), incised, or lacerated wound.
SEE: illus.
penetrating w.A wound in which the skin is broken and the agent causing the wound enters subcutaneous tissue or a deeply lying structure or cavity.
perforating w.Any wound that has breached the body wall or internal organs. The perforation may be partial or complete.
puncture w.A wound made by a sharp-pointed instrument such as a dagger, ice pick, or needle. A puncture wound usually is collapsed, which provides ideal conditions for infection. The placement of a drain, antitetanus therapy or prophylaxis, and gas gangrene prophylaxis may be required. This will depend on the nature of the instrument that caused the injury.
subcutaneous w.A wound, such as contusion, that is unaccompanied by a break in the skin.
sucking chest w.A wound that penetrates the thorax and draws air into the pleural cavity, usually resulting in an expand ing pneumothorax.
tunnel w.A wound having a small entrance and exit of uniform diameter.