LACERATION INJURY | PPT

From this topic you willl be able to cover Laceration and A short study on VRANA according to ayurveda
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1. LACERATION INJURY Presented by : Abhinay Kureel (BAMS STUDENT)

2. CONTENT : DEFINITION CAUSES OF LACERATION MECHANISM TYPES SIGNS AND SYMPTOMS STAGE OF LACERATION COMPLICATION TREATMENT AND PREVENTION ANTI-MORTEM APPEARANCE POST-MORTEM APPEARANCE MEDICO-LEGAL ASPECT VRANA A/C TO AYURVEDA

3. Definition : Lacerations are tears or splits of skin mucous membrane Muscle or internal organs produced by application of blunt force to broad area of the body, which crushed or stretched tissues beyond the limits of their elasticity . They are also called as tears or ruptures.

4. Causes of laceration : They are caused by blows from blunt objects, by falls on hard surface ,by machinery ,traffic accidents , etc. SOURCES : Sharp Objects : Includes knives, Broken glass, scissors or any object with sharp edge Sports Injuries : Without wearing proper protective gear can lead to laceration e.g cuts from sports equipment , collision or falls Animal bites or scratches : Particularly dogs or cats scratches from them may require medical attention Accidental Cuts : Whille handling broken glassware or sharp objects can lead to unexpected laceration if caution is not exercised Accidental Fall : A fall can result in laceration when someone stumbles onto sharp or jagged surface such as the edge of furniture of abroken object.

5. Mechanism : When the skin or other structures are subjected to blunt forces, the tissue gets crushed or stretched beyond the limits of their elasticity leading to tearing of the skin or other tissue thus producing laceration. Laceration differs from the incised wounds because in laceration, the continuity of the tissues is disrupted by tearing rather than clean slicing.

6. Types of laceration : 1. Split laceration 2. Stretch laceration 3. Tear laceration 4. Avulsion laceration

7. Split Laceration : Splitting occur by crushing of the skin between two objects. Also called as incised looking laceration These types of laceration are found usually in body parts with underlying bones without much tissue in between Due to splitting of skin the laceration appear like incised wound

8. STRetch LACERATION : Over stretching of the fixed skin till its ruptures. In such type of lacerated wound there is localized pressure with pull that causes tearing of the skin . Thus a pulling force cause stretch laceration. These laceration are superficial and multiple mostly located at groins. They are present in Road accident victim when body part (Usually thigh or abdomen is run over ) The crushing weight of vehicle”s Wheel provides the pulling and stretch of skin

9. AVULSION LACERATION Also called as flaying injury or grind laceration Avulsion laceration occur due to grinding compression of the tissue to such an extent that the skin gets detached from the deeper tissues thus resulting in de-gloving of skin , Such as lorry wheel passing over a limb may produce separation of skin from underlying tissue (avulsion) over a relatively large area this is called “Flaying” Avulsion of scalp is also caused by traction from hair being trapped in machinery

10. TEAR LACERATION : It is common form of laceration. Tearing of the skin and tissues can occur from impact by or against irregular or semi sharp objects such as door handle of a car or fall over a rough projected object A tear is deeper at the starting point than at termination This is another form of overstretching

11. CUT LACERATION : Produced by a heavy relatively sharp – edged instrument such as axe. In an impact over the scalp external laceration may not occur due to the hair but inner layer of scalp may be laceratic

12. SIGNS AND SYMPTOMS : Visible cut or tear in the skin . Bleeding – Severity of bleeding can vary depending on depth and size of laceration. Pain – painful especially if they are deep or involve nerve endings Swelling and inflammation : surrounding area may become swollen,red & warm to touch. Tenderness Loss of function or limited range of motion : if the laceration affects underlying structures like tendons , muscles , nerves it may result in loss of function or restricted movement in affected area . Numbness and tingling sensation. Deformity : especially those that effect bones or joints.

13. Stage of laceration : TIME CHANGES Intially Bleeding After 12-24Hr clotting After 18-36 Hr Pus formation After 1-2 Week Granulation Tissue After 4-8 Week Healing of fractures

14. COMPLICATION Laceration of an internal organ may cause severe or even fatal bleeding. Multiple laceration , involving the skin & subcutaneous tissue each causing some haemorhaage Infection – act as portal of entry for bacteria If it is located where skin stretches or wrinkled, blood may cause irritation and pain

15. Treatment and prevention Immediate First aid - Apply direct pressure to the wound using a clean cloth Elevate the injured limb , if possible to help reduce blood flow to the area. Avoid scrubbing the wound vigorously IF laceration is deep involve vital body parts like the face or significant blood vessel seek medical help Clousre and wound case : Cleaning Regularly The wound , applying antibiotic ointment & changing dressing Pain – Management : Over the counter pain reliever like acetaminophen or ibuprofen can help alleviate discomfort associated with laceration

16. PREVENTION OF INFECTION : Keep wound clean and dry . Cover the wound with sterile dressings or bandages to protect from dirt. Teatanus vaccination : Ensure your tetanus vaccination is upto date especially if laceration caused by contaminated object.

17. ANTI-MORTEM APpeARENCE OF LACERATION Generally it refers to the physical characterstics and appearance of laceration that occurred prior to person’s death . When a laceration is observed and evulated it is important to determine it occurred before or after death.

18. Factors considered : Tissue characterstics : Anti – mortem laceration often display characterstics that indiacate vitality and response to injury such as bleeding,inflammation and signs of healing. Surrounding tissue damage : When laceration occur while alive, it typically causes additional trauma to the surrounding tissues. Blood flow : Anti-mortem laceration generally evidence of blood flow i.e blood was circulating at the time of injury. Cellular & molecular changes : There may be signs of tissues repair, such as presence of inflammatory cells or cellular response consistent with healing such as collagen deposition

19. POST MORTEM APPEARENCE Lack of bleeding : one immediate difference in a post-mortem laceration is that it will not bleed so there will be no active bleeding once the injury occur. Tissue change : . The surrounding tissue may become gradually discolored , swollen and softened this process may affect the overall appearance of the laceration Lack of vital sign : A post mortem laceration will not carry any associated vital sign that are typically present in living indivisuals , such as heart rate , BP or pain response .

20. MEDICO LEGAL IMPORTANCE Cause of injury can be known Type of lacerated wound may be known Age of injury can be estimated Direction of application of force can be known It can be known whether the injury is accidental or sucidal or homicidal Foreign bodies present in wound may help in identification of the offending weapon / place of incident etc.

21. VRANA A/C TO AYURVEDA NIRUKTI Definition : Always There is a scar after healing of a wound which remains throughout life is called vrana Breaking of body into fragments. There is discolouration of body due to vrana “ Gatra ” Means Tissue(Body tissue or part) “ Vichurna ” Means Destruction , break, rupture and discontinuity of body or tissue is called vrana

22. CLASSIFICATION OF VRANA Nija vrana : These appears due to vitation of vata,pitta,kapha,Rakta and saniipataj separate with its combination Agantuj vrana : These are all the external factors when may cause injury to the body , here the vrana appear due to the injury by the above factor (external force) later on dosha involve

23. Vrana vastu ( Vrana Adhisthan ) : Twacha , sira,snayu,asthi,sandhi,koshta and marma where the vrana develops Stages of vrana : [NIJA VRANA]-(Imbalance of dosha) Dushta vrana : All the nija vrana are dushta from initial but against vrana become dushta later according to involve dosha. Suddha vrana : (Healthy Wound ) The vrana which is soft , smooth,color like tongue painless,clear margins & without discharge are called as shudda vrana .

24. Ruhyaman : ( Healing wound ) The healing wound have color like pigeon , no discharge firm and full of granulation tissue , yellowish coloured wound . Samyak rudha vrana : ( Healed wound ) The healed wound must not have swelling,no granulation,no sign of inflammation , no pain , the color similar to surrounding skin & scar is flat no elevation from body surface .

25. DUSHTA VRANA SUDDHA VRANA RUHYAMAN VRANA SAMYAK RUDHA VRANA

26. Agantuja vrana : [ Sadhyo Vrana ] : The sudden injury by any sharp objects having various shape , blade (Sharp or Blunt) When causing trauma leads to different types of surgical wounds are considered as sadhyo vrana CLASSIFICATION OF SADHYO VRANA : Chinna : The wound occurred by the wide , curved or straight object causing injury. Bhinna : The wound created by very sharp object like tip of sward etc. leading to puncture called as bhinna injury Viddha : The small sharp object when give penetrating injury to the body then it is called as viddha injury

27. Kshata : The wound created by the blunt objects called as kashata vrana MAY BE CALLED AS LACERATED WOUND Pichchita : Injury by heavy objects leading to crush that part with bone & muscles and wound appeared mixed with blood called as pichhita vrana may be co related as crush injury Dhrastha : The injury created by strong rubbing force leading to expose the underline tissue and discharge of serous called as dhrastha vrana .

28. CHINNA BHINNA Viddha Kshata PICHCHITA DHRASTHA

29. VISHESH CHIKITA OF AGANTUJ VRANA CHINNA Vrana sodhana,bandhana BHINNA Sodhana Ropana , Raktsthambana VIDDHA Remove retained foreign body after that insert medicated oil KSHATA Raktsthambana and bandhana PICHHITA Seet leepana DHRASTHA Kashay aushad for pain relief

30. Ayurvedic therapies for vranna management : Sutika Abhyanga : Gentle masagge with herbal oil around the wound Pratisarana : Topical application of medicated pastes or oils to clean the wound Herbs and medicines for vrana healing : Neem : Antibacterial , antifungal and wound healing properties Turmeric : Anti-Inflammatory , Anti microbial and anti-oxidant effects Aloe Vera : Soothes and promotes healing , Reduces the inflammation Dietary & Lifestyle consideration : Nutritious Diet : Rich in vitamin to aid healing Adequate hydration : Drink Sufficient water to maintain hydrated & support the regeneration

31. “ A Laceration may leave scars,but it reminds us of our strength to endure and overcome”

32. THANK YOU