As a result of accidents, injuries at work and intentional actions, various damages to the skin, soft tissues and bones can occur. Crushed wounds do not appear very often, but they are still likely to occur in some cases. What are these wounds? Causes, symptoms, first aid and subsequent treatment.
Characteristic
A crushed wound is an injury that has arisen as a result of mechanical compression. Most often, limbs, especially fingers, are susceptible to these types of injuries. Wounds are difficult to treat, as the area of injury is extensive, and their edges have an uneven surface.
What are bruised and crushed wounds characterized by? They have a pronounced pain syndrome, which often leads to pain shock and loss of consciousness. In this case, the arteries are rarely affected, so the bleeding is moderate. With mechanical compression of the torso or head, a person receives torn-crushed wounds that are incompatible withlife.
Causes of occurrence
Such injuries are one of the most dangerous, since bone fragments inevitably get inside the wound, which can be crushed; dust and dirt that mixes with the flowing blood. The integrity of not only the skin, but also soft tissues is violated, ruptures of blood vessels are observed. There are several ways to get this kind of injury:
- Traffic accidents, as a result of which the lower limbs can be crushed by the engine, which, in a head-on collision, goes inside the passenger compartment, exerting strong pressure on the legs along the way. Also, in an accident, people can get crushed wounds of the skull and torso, which are incompatible with life. In this case, a person dies almost instantly. A complicating factor is that it can sometimes be difficult to get a victim out of a wrecked vehicle.
- Failure to comply with safety regulations when working at a construction site or any other hazardous industry. Injuries can also be caused by a malfunction of the heavy equipment used or carelessness.
- Games and visits to unfinished houses, roofs, which can result in a fall from a height or injury due to broken beams, ceilings and other structural elements.
- In everyday life, crushed, bruised wounds can often be obtained with a strong blow with a hammer on the fingers.
Different causes of wounds lead to injuries of different hazards, all of which require immediate first aidmedical care and subsequent appropriate treatment.
Symptoms
A crushed wound of a finger or other part of a limb is notable for its complexity of flow, but it can be seen with the naked eye. Depending on the degree of complexity of the damage, as well as the presence of complications, such wounds may have the following manifestations:
- Superficial wounds can be distinguished by crushed skin and soft tissues. The bone remains intact.
- Deep crushed wounds affect bone tissue, as well as internal organs when squeezing the torso.
- Purulent discharge may occur when an infection is connected. This complication often manifests itself in the absence of the necessary first aid, as well as late access to doctors.
- Bleeding occurs as a result of rupture of small capillaries, veins, and in rare cases, arteries, which can be mild, moderate or severe. Large bleeding leads to severe blood loss, as a result of which a person can lose consciousness and even die.
- A patient with an injury experiences a state of shock, which manifests itself in clouding of consciousness, confusion of thoughts, disorientation in space and time, cold clammy sweat, lack of reactions to external stimuli.
- When a crushed wound causes very severe pain, which is difficult to stop with traditional analgesics.
Paleness of the skin, drop in blood pressure and increased heart rate are also observed.
First Aid
The characteristics of crushed wounds are disappointing, so the first thing to do is to provide medical assistance to the victim. It should be provided by the one who is with the victim until the ambulance arrives. First aid for a crushed wound is as follows:
When a patient is found under rubble or trapped in a car during a car accident, it is not recommended to try to pull the person out on their own, as this is fraught with life-threatening problems. In this case, the only adequate help is to call the medical team and wait for them
- A person with injuries that involve a small amount of soft tissue should be placed in a horizontal position. In this case, it is desirable that the affected limb be above the level of the heart.
- You can try to apply a tourniquet above the wound, be sure to remember and tell the doctors the time of its application.
In addition, it is recommended to give the victim painkillers in tablets. The likelihood that it will work with pain shock is extremely small, however, with a small area of damage, tablet preparations can help.
First Aid
The photo of crushed wounds shows the severity and danger of the situation (but will not be presented for aesthetic reasons), so a very important point in first aid is to call the doctors. They, in turn, must perform a number of the following activities:
- Release a person from the rubble or from the press. Do it alsocan employees of the Ministry of Emergency Situations in the presence of doctors.
- To suppress pain shock or prevent it, the patient is given narcotic painkillers such as Morphine, Fentanyl, Tramadol, Omnopon. For minor wounds, the use of ordinary analgesics is allowed.
- Medics must apply a tourniquet so that the victim does not die from blood loss.
- If the heart rhythm is abnormal, resuscitation should be performed, such as chest compressions and artificial respiration.
- The injured limb must be immobilized.
These activities can be carried out both at the scene of the incident with subsequent delivery to a medical facility, and in an ambulance on the way to it.
Diagnosis
Determining the presence of a crushed wound is not difficult, since it has a rather specific appearance. Diagnostic measures include a medical examination of the injured limb, as well as clarification of the circumstances under which the injury was received. Also, in some cases, X-ray diagnostics is recommended to determine the integrity of the bone.
Surgical Care
With bruised lacerations and crushed wounds, surgery is required in almost all cases. An experienced surgeon performs the following steps:
- Damaged, and not subject to subsequent recovery, soft tissues are excised.
- After this, the edges of the wound open up. This is necessary in order to thoroughly rinse it from associated contaminants. For this, cotton and gauze swabs are used, as well as a large amount of saline, chlorhexidine or hydrogen peroxide.
- Drainage is installed in the wound cavity to ensure the outflow of excess fluid, including pus.
- After that, a sterile dressing is applied, which should be changed daily until the wound is completely healed.
The operation is performed under general anesthesia, as a person is not able to survive it without being put into deep sleep. Also, in cases of severe damage, the surgeon decides to amputate the limb.
Drug therapy
Crushed wounds are characterized by a long healing period, therefore, to accelerate it, as well as to avoid serious consequences, treatment with drugs is used:
- To accelerate the recovery of soft tissues, the patient is recommended to use ointments such as Levomekol, Betadine, Tetraktsylinovaya.
- Anti-inflammatory drugs - Solcoseryl, Actovegin, Traumeel.
- For the relief of pain, narcotic drugs such as "Tramadol", "Morphine" are used. In later stages of healing. when the intensity of pain decreases, the victim is offered drugs such as "Ketanov", "Analgin".
- Forto prevent connecting the infection, it is required to take broad-spectrum antibiotics for 10-14 days. The most commonly prescribed drugs are Augmentin, Levomycetin, Levofloxacin, Tetracycline.
- In case of large blood loss, the patient is prescribed droppers with saline and glucose, as well as a blood transfusion.
The wound may start to fester, in which case washing it with antiseptic agents is also connected to daily dressings.
Treatment of weeping wounds
In some photos of crushed wounds, you can see that they may have a weeping character. This means that there is always a liquid discharge from the wound, which significantly impairs the healing process. For the treatment of weeping wounds, the following methods are used:
- Daily treatment with antiseptics, for example, Miramistin.
- To reduce the amount of discharge, dressings with 10% sodium chloride solution are used. These dressings are recommended to be changed every 4-5 hours.
- Powders can be used as a drying agent - "Xeroform", "Baneocin".
- Especially effective are such ointments - "Streptocid", "Mafenide", "Fudizin".
Wound treatment should take place under the supervision of surgeons, so such a patient is shown to be in the hospital.
Healing period
Wounds may take longer to fully healfor a long time, especially if the damage is extensive. On average, the period of complete healing can be delayed for several months or several years. The patient should spend the first 2-3 months in the hospital to monitor his condition, especially if the injury was severe. After that, treatment is carried out at home. It is also noted that these injuries heal faster on the hands, since blood circulation is better organized than on the lower extremities.
Possible consequences
Crushed wounds cannot heal without complications. This is especially true for those that have a large affected area. The most common consequences are:
- A large amount of scarring in the affected area, which can tighten the skin, causing discomfort.
- Partial loss of sensation that occurs due to the excision of a large amount of skin, as well as the formation of keloid scars.
- Paresis or paralysis.
- Loss of limb function due to extensive damage to ligaments and soft tissues.
The most serious consequence is the loss of a limb due to amputation. This happens in the case of extensive damage to soft and bone tissues, the restoration of which is considered impossible.
Bandaging at home
Often, after the patient is discharged from the hospital, he will need daily wound dressings. If necessary, you can call a nurse from the nearest clinic, but you can learn how to do them yourself. This is usually done by the next of kin. Dressing is done according tofollowing algorithm:
- First you need to remove the old bandages. If some of them have dried to the wound, then it must be gently soaked with an antiseptic solution.
- After that, you need to treat the entire surface of the wound. Most often, "Chlorhexidine" or "Miramistin" is chosen for these purposes, since they have a mild effect and do not cause discomfort to the victim.
- The surface of the wound must be covered with a sterile napkin and its edges fixed with adhesive tape.
- After that, you can proceed directly to the dressing with a bandage.
It is recommended to carry out such manipulations daily. This will ventilate the wound, which is necessary to prevent rotting.
Conclusion
Crushed wounds are a rather difficult injury for both the victim and the attending surgeon. In this case, success depends not only on the professionalism of the doctors, but also on the timeliness of the assistance they provide, so an ambulance for the victim must be called immediately. Before arrival, if the patient is not clamped, you can give him first aid.
