Transcript Document 7110348

Wound Care
Jennifer L. Doherty, MS, LAT, ATC, CIE
Florida International University
Dept. of Health, Physical Education, and
Recreation
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
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
Types of wounds
Laceration
 Sharp or pointed object tears tissues –
results in wound with jagged edges
 May also result in tissue avulsion
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
Types of wounds
Incision
 Wounds with smooth edges
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

Immediate Care
Should be cared for immediately
 All wounds should be treated as though
they have been contaminated with
microorganisms

Immediate Care: Step 1

To minimize infection,
clean wound with
copious amounts of
soap, water, and
sterile solution
– Avoid hydrogen
peroxide and bacterial
solutions initially
Immediate Care: Step 2
Control bleeding
 Universal precautions
must be taken to
reduce exposure risk
of bloodborne
pathogens

Controlling Bleeding
Abnormal discharge of blood
 Arterial, venous, or capillary bleeding

– Venous - dark red with continuous flow
– Capillary - exudes from tissue and is reddish
– Arterial - flows in spurts and is bright red

Internal or External hemorrhaging
Internal Hemorrhage

Invisible
– May be detected through body opening, X-ray,
or other diagnostic techniques

May occur…
– Beneath skin
– Intramuscularly
– Within a joint
Internal Hemorrhage
Bleeding within body cavity could result in
life and death situation
 Difficult to detect and must be hospitalized
for treatment
 Could lead to shock if not treated
accordingly

External Hemorrhage

Stems from skin wounds, abrasions,
incisions, lacerations, punctures or
avulsions
External Hemorrhage

Direct pressure
– Firm pressure (hand and sterile gauze) placed directly
over site of injury against the bone

Elevation
– Reduces hydrostatic pressure and facilitates venous
and lymphatic drainage - slows bleeding

Pressure Points
– Eleven points on either side of body where direct
pressure is applied to slow bleeding
Immediate Care: Step 3

Antibacterial
ointments are
effective in limiting
bacterial growth and
preventing wound
from sticking to
dressing
Immediate Care: Step 4
Sterile dressing
should be applied to
keep wound clean
 Occlusive dressings
are extremely
effective in minimizing
scarring

Are Sutures Necessary?

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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
– Utilize steri-strips or butterfly bandages
Wound Infection

Signs and symptoms
are the same as those
for inflammation
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Pain
Heat
Redness
Swelling
Disordered function
Pus may form due to
the accumulation of
WBC’s
 Fever may develop as
the immune system
fights bacterial
infection

Tetanus

Bacterial infection that may cause…
– Fever
– Convulsions
– Possibly tonic skeletal muscle spasm

Tetanus bacillus enters wound as spore
and acts on motor end plate of CNS
Tetanus
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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