26 Nov, 2020 | admin | No Comments
Treatment of wounds / Detailed description of all stages of treatment. Part 1
In the surgical practice of a rural paramedic, wound treatment occupies an important, if not leading, place. For small wounds, the patient is treated at the FAP. The treatment of the most severe wounds or wounds requiring serious surgical treatment goes through certain stages: FAP – hospital – FAP. The paramedic begins and ends the treatment of the wounded, while performing quite complex and critical elements of the treatment process. Clear interaction, continuity of the post-hospital stage of treatment, high professional skill and knowledge of the paramedic provide improved results while reducing the number of days of hospitalization and sick leave.
Classification of wounds
Wound – damage with violation of the integrity of the skin or mucous membranes in their entire thickness, with access for contamination of deeper tissues by microorganisms contained in the air or on objects in contact with the surface of the wound.
Wounds are mainly caused by mechanical injuries, but they can also occur when exposed to thermal, electrical and chemical factors. Combined lesions are also possible.
Depending on the circumstances of their occurrence, wounds are divided into surgical, that is, inflicted specifically during operations, and accidental, resulting from trauma.
Surgical wounds, in turn, are divided into clean incisions during clean (aseptic) operations and purulent ones that have arisen after surgery for abscesses of a different nature.
Accidental wounds are divided according to the anatomical principle, depending on the degree of tissue damage, into stab, cut, torn, chopped, bruised, crushed, patchwork, scalped and tears of limb segments.
Puncture and cut wounds are similar in nature – they are inflicted with a sharp object (nail, awl, knife, glass, etc.). The edges of the wound are smooth. The difference between puncture wounds and cut wounds lies in their depth. With the latter, the width of the wound is much greater than the depth.
Lacerated wounds often occur when falling, the victim clings to an object with his skin, wounds of this type have an irregular shape.
Chopped and contused wounds have much in common in the mechanism of damage. If the former arise from a blow, for example, with an ax, then bruised wounds are due to a blow with a blunt object or a blunt object. In both cases, in addition to the wound, there is a contusion of the surrounding tissues of one length or another.
Broken wounds occur with a significant impact force that exceeds the mechanical strength of not only the skin, but also the underlying tissues. There is extensive necrosis of bruised tissues, as a result of which there is a high probability of developing a severe wound infection.
Patchwork and scalped wounds are characterized by significant detachment of the skin from the underlying tissues, in most cases they require special surgical techniques for successful healing.
Thanks to the success of modern microsurgery, the severed fingers and segments of the limb are successfully engrafted, the victim gets the opportunity to use his limb and does not become disabled.
The division of wounds into single and multiple is of great importance; through, tangent and blind; with and without foreign bodies; penetrating and not penetrating into the body cavity. It is important to take into account the location of the wound (head, chest, abdomen, buttocks, extremities, etc.), the type of damaged tissues and organs (soft tissues, bones, joints, blood vessels, nerves and internal organs).