Wound Care

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Wound Care

• Chapter 8
• Pages 219-224

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Caring for Skin Wounds

• Skin wounds are extremely common in sports
• Soft pliable nature of skin makes it susceptible
  to injury
• Numerous mechanical forces can result in trauma
• Friction, scrapping, pressure, tearing, cutting
  and penetration

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Types of wounds

• Abrasions
• Skin scraped against rough surface
• Top layer of skin wears away exposing numerous
  capillaries
• Often involves exposure to dirt and foreign
  materials increased risk for infection

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Abrasions
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Types of wounds

• Laceration
• Sharp or pointed object tears tissues results
  in wound with jagged edges
• May also result in tissue avulsion

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Laceration
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Laceration
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Laceration
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Types of wounds

• Incision
• Wounds with smooth edges

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Incisions
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Types of wounds

• Puncture wounds
• Can easily occur during activity and can be fatal
• Penetration of tissue can result in introduction
  of tetanus bacillus to bloodstream
• All severe lacerations and puncture wounds should
  be referred to a physician

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Puncture Wounds
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Types of wounds

• Avulsion wounds
• Skin is torn from body major bleeding
• Place avulsed tissue in moist gauze (saline),
  plastic bag and immerse in cold water
• Take to hospital for reattachment

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Avulsion
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Immediate Care

• Should be cared for immediately
• All wounds should be treated as though they have
  been contaminated with microorganisms
• To minimize infection, clean wound with copious
  amounts of soap, water, and sterile solution
• Avoid hydrogen peroxide and bacterial solutions
  initially

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Immediate Care

• Dressing
• Sterile dressing should be applied to keep wound
  clean
• Occlusive dressings are extremely effective in
  minimizing scarring
• Antibacterial ointments are effective in limiting
  bacterial growth and preventing wound from
  sticking to dressing
• Utilization of hydrogen peroxide can occur
  several times daily before reapplication of
  ointment

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Immediate Care

• Sutures may be necessary
• Deep lacerations, incisions, and occasionally
  punctures will require some form of manual
  closure
• Decision should be made by a physician
• Sutures should be used within 12 hours
• Area of injury and limitations of blood supply
  for healing will determine materials used for
  closure
• Physician may decide wound does not require
  sutures and utilize steri-strips or butterfly
  bandages

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Use of Sutures
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Signs of Wound Infection

• Same as those for inflammation
• Pain
• Heat
• Redness
• Swelling
• Disordered function
• Pus may form due to accumulation of WBCs
• Fever may develop as immune system fights
  bacterial infection

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Tetanus

• Bacterial infection that may cause fever and
  convulsions and possibly tonic skeletal muscle
  spasm for non-immunized athletes
• Tetanus bacillus enters wound as spore and acts
  on motor end plate of CNS
• Following childhood vaccination, boosters should
  be supplied once ever 10 years
• If not immunized, athlete should receive tetanus
  immune globulin (Heper-Tet) immediately following
  skin wound

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