Classification of wounds

classification of surgical wounds.

1. Resource Faculty: Dr. Rohit Yadav
Presented by: Ashish Kr. Tripathi

2. A wound is:
A loss of continuity of the skin or mucous
membrane, which may involve soft tissues,
muscle, bone and other anatomical
structures
Collier 1994

3. Wounds
Rank and Wakefield
Classification
 Tidy Wounds
Untidy Wounds
Duration
Acute Wounds
Chronic
Wounds

4. Most useful from practical point of View
Classified as Tidy and Untidy
Tidy Wounds Untidy Wounds
Incised Crushed Or Avulsed
Clean Contaminated
Healthy tissue Devitalized Tissue
Seldom Tissue Loss Often Tissue Loss

5. •Inflicted by Sharp Instruments
•No devitalized Tissue
•Skin wounds will usually be single and clean cut
•Tendons, arteries and nerves will commonly be
injured but repair is usually possible
•Fractures are uncommon
•Eg: surgical Incisions, Glass cuts, Knife wounds

6. Tidy Wound (Picture Source: Bailey and Love)

7. Tidy Wound (Picture Source: Bailey and Love)

8. •Result from Tearing, Crushing, Avulsion, Vascular
Injury or Burns
•Contains devitalized tissue
•Skin wounds will often be multiple and irregular
•Tendons, arteries, Nerves: exposed, might be
injured but usually not divided
•Fractures: common and may be multi-fragmentary

9. Untidy Wound (Picture Source: Bailey and Love)

10. Untidy Wound (Picture Source: Bailey and Love)

11. Acute Wounds:
 Trauma
 Burns
Chronic Wounds
Pressure Sores
Leg Ulcers

12. Bruise and Contusion: Injury caused by blunt force
that damages small blood vessels and causes
interstitial bleeding, usually without the disruption of
the continuity of the tissue.
Hematoma: When the amount of bleeding due to
injury is sufficient enough to create localized
swelling, it is called hematoma.

13. Contusion (Picture source: Robin and Cotran)

14. Puncture Wounds: is an open injury in which foreign
materials and organisms are likely to be carried
deeply into the underlying tissues. Eg: Nails, sharp
objects, needles, bullets.
Bite: Particular type of puncture wounds caused by
animal bites(Eg. dogs, cats, humans etc.) which are
associated with the high incidence of infection
presumably from mouth organism.

15. Gun shot Puncture Injury (Picture Source: Robin and Cotran)
A

16. Dog Bite Injury (Picture Source: Bailey and Love

17. Abrasion: Shearing injury of skin in which the surface is
rubbed off. Most are superficial and will heal by
epithelialization but some may result in skin thickness
loss. Eg: skinned knees and elbow
Friction Burns: Similar to abrasion but there will be an
element of thermal damage as well as the abrasion. Eg:
Rope burns, floor burns

18. Laceration: is an irregular tear in the skin produced by
overstretching. May be linear or stellate depending on
the tearing force. Immediate margins of lacerations are
frequently hemorrhagic and traumatized. Eg: wounds
made by dull knife, bomb fragments.
Incision: cut made by sharp cutting objects such as knife
(scalpel) or piece of glass. Margins are usually clean and
there are no bridging strands of tissue

19. Laceration of Scalp (Picture Source: Robin and Cotran)

20. Avulsion: Open injury where there has been severe
degree of tissue damage. Eg: Hands or limbs trapped in
moving machinery like rollers. May produce a degloving
injury.
Degloving: Is caused by shearing forces that separate
tissue planes rupturing their vascular interconnections
and causing tissue ischaemia.
Most frequently occurs between the subcutaneous fat and deep
fascia.
Can be open/closed, and localised or circumferential.

21. Degloving Injury of Hand (Picture
Source: Bailey and Love)
Degloving Injury of Buttocks (Picture
Source: Bailey and Love)

22. Crush Injury: Variant of blunt injury often
accompanied by degloving and
compartment syndrome.

23. Breach in epithelial continuity
Prolonged Inflammatory Response: overgrowth of
granulation tissue, and scarring- leave a fibrotic margin
Slough: Necrotic tissue often at the Ulcer center

24. Defined as tissue Necrosis with ulceration due to
Prolonged Pressure
Also called bed sores, pressure ulcers and decubitus
ulcer
Higher incidence in paraplegic, elderly and severely ill
patients

25. Bailey and Love’s Short Practice of Surgery : 25
th

Edition.
Robbins and Cotran Pathological Basis of Disease: 7
th

Edition.