Soft Tissue Injuries:

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Soft Tissue Injuries
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The Skin

• Best be described as the skin and subcutaneous
  layers.
• Largest organ of the body.
• Epidermis - outermost layer consists of dead
  cells constantly being rubbed off replaced.
• Dermis - second layer containing sweat glands,
  sebaceous glands, hair follicles, Blood vessels,
  and nerve endings.
• Subcutaneous Tissue - innermost layer composed of
  fat that serves as a body insulator and shock
  absorber.

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Functions of the Skin

• Water balance.
• Temperature regulation.
• Excretion.
• Shock absorption.

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Closed Soft Tissue Injuries

• Characterized as a wound beneath the unbroken
  skin.
• Contusion.
• Hematoma.
• Crush injury.

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Contusion

• Bruise
• Epidermis remains in tact.
• Injury to cells and blood vessels in the dermis.
• Localized pain swelling at the site.
• Blood accumulation in surrounding tissue causes
  discoloration. (Ecchymosis).

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Hematoma

• Similar to contusion.
• Involves damage to larger blood vessels.
• Larger amount of tissue damage.
• Shock can result due to blood loss.

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Crush Injuries

• Crushing forces applied to body.
• Can cause internal organ rupture.
• Internal bleeding may be severe resulting in
  hypoperfusion.

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Emergency Medical Care

• BSI.
• Assure airway and Oxygenation.
• Treat for shock.
• Splint painful, swollen, deformed extremities.
• Transport.

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Open Soft Tissue Injuries

• The skin has been opened exposing the tissue
  beneath.
• Risks.
• Possible contamination.
• Infection.
• Indicator of more serious injury/fracture.

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Types of Open Soft Tissue Injuries

• Abrasions
• Lacerations
• Avulsions
• Punctures/Penetrations
• Amputations
• Crush injuries

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Abrasions

• Epidermis is damaged by scraping, rubbing, or
  shearing forces.
• Considered superficial injury.
• Painful due to exposed nerve endings.
• Blood will ooze from wound (capillary bleeding).
• Road rash.
• Infection, contamination, potential for
  underlying injury.

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Lacerations

• Break in the skin of varying depth.
• May be linear, smooth edges.
• May be stellate or jagged edges.
• Caused by forceful impact with sharp object.
• Bleeding may be severe.

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Avulsions

• Flaps of skin or tissue are torn loose or pulled
  completely off.
• Replace flap carefully in place and apply large
  bulky dressing and bandage in place.

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Amputations

• Involves the extremities and other body parts.
• Bleed may be massive but in most cases, very
  little bleeding occurs.

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Penetrations/Punctures

• Caused by sharp pointed object.
• May be no external bleeding.
• Internal bleeding may be severe.
• Exit wound may be present.
• EXAMPLES
• Gunshot wound.
• Stab wound.

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Crush Injuries

• Damage to soft tissue and internal organs.
• May cause painful, swollen, deformed extremity.
• External bleeding may be minimal or absent.
• Internal bleeding may be severe.