Thursday, July 26, 2012

Wound Managment Part 1

Democracy, the Facebook way.



By popular demand, I shall do a blog entry about wounds. And since bruises are categorized under "wounds", I will include it in this segment. I know burns are as well, but I will leave that in a separate entry. 

I am going to split this into two parts: 

  • Part one covers the circulatory system and the different types of wounds, ranging from common to the not-so-common ones.
  •  Part two covers the different types of dressings, bandages and anti-bacterial products and I will teach you how to use them to treat wounds.

Before we talk about damaged tissues, let's look at the human circulatory system.


Complex network of major arteries and veins connecting to the heart.




See how elegant that system is? It's our circulatory system. It's inside of you and inside of me. Of course that picture does not represent the entire system, it's just the thorax region that is depicted. Believe it or not, if you lay the entire system out and place them in a straight line, it's able to circle the Earth twice.

At the center of it all is the heart. A pump that never requests for a day off (if it does, you will be seriously short-handed). Every beat it makes drives the blood into all our tissues. Close your hand and make it into a fist, that's roughly the size of your heart.

Flanking from the left and the right of the heart, are the lungs. It's not in the illustration above, but they do play a vital role in our circulatory system. Our tissues and organs need oxygen for chemical reactions and regenerations, and that's where the blood draws oxygen from.   

Take a good look at the picture above again. Do remember that the blue-coloured network represents the veins, while the red-coloured network represents the arteries. De-oxygenated blood flows through the veins, oxygenated blood flows through the arteries.

Here's how it works, it starts from you taking a mouthful of air. The air travels to your lungs through the Trachea (windpipe), and into microscopic air sacs in the lungs known as Alveolus. Wrapping around these air sacs are the pulmonary capillaries (little tiny blood vessels). That is where the stock-exchange begins. The de-oxygenated blood carries a waste product called carbon-dioxide through the pulmonary artery, then through the pulmonary capillaries, then finally to these air sacs, ready to be transferred and expelled by the lungs through exhalation. At the same time, the blood is also taking in fresh oxygen from the air sacs, making it oxygenated again. It then moves from the lungs and into the heart, ready to be pumped out into the tissues. Sounds confusing? I know... 

Here's a video for you to have a better understanding of what I said.

    

   
You may also want to know that our blood has to two different shades of red. De-oxygenated blood is dark-red in colour, and oxygenated blood is bright-red in colour. If you happen to be a blood donor or if you have ever gone for a blood-test, you will notice the blood that they draw from you is always dark-red in colour, that's venous blood (blood from the veins). It is never taken from the arteries where oxygen-rich blood is, because your tissues need it to function normally.

Bright-red oxygenated blood on the left, and dark-red de-oxygenated blood on the right.



Before we venture deeper into the world of hurt, let us take a look at how a normal skin tissue looks like.

Every bit as complicated as the circulatory system.
Our skin is the largest organ of the human body (I know some men are going to disagree with that). It has two primary functions - 1) Regulate heat through perspiration. 2) Protect us from infections.

Nature is rarely unintentional. Nearly every part of the body has an intended purpose. Even the hairs on our skin are there to retain body heat when it gets cold, although they don't work as well as a sweater does.   

When you mess around with your skin, on purpose or otherwise, the nerves' endings are there to send electrical impulses to your brains, then your brains warn you to stop doing what you are doing through the sensation of pain. At the same time, it releases a chemical called adrenaline to temporarily cope with the pain so that you have enough time to get out from a dangerous situation. See? Many things come with reason.

Now, let us see what are the types of damage that can possibly befall on your birthday suit. 

Here is the list:

  1. Contusions (bruises)
  2. Abrasions  (grazes)
  3. Incised wound
  4. Lacerations
  5. Avulsions
  6. Puncture/Penetrating wounds
  7. Amputations   
  
Severe contusion (bruising) of the left ankle.
A superficial wound most of the time. Blood vessels are ruptured and severed under the skin. A bruise is formed when blood pools underneath the skin tissue. The pressure exerted by the pooling blood onto the nerves causes the pain. However, the skin is not broken, therefore, this kind of injury has the least possibility of you suffering from an infection. 

Abrasion (grazing) of the left elbow.
Another superficial wound, this type of injury is frequently a result from falling and fraction burns. The epidermis is grazed. Dirt and debris are often embedded on and the around the injury site. If those are not cleared away, infection may occur.

Incised wound.
A common clean-cut, linear-patterned injury from sharp objects such as knives, scissors, blades ect. Depending on the length, depth, and area of the cut, it ranges from superficial to severe. Infection will occur if wound is not cleaned properly.

Lacerations.
Tearing in the skin from sharp objects that are irregular in shape or edges such as a barbed wire. This type of injury often carries a real risk of infection.

Avulsion
Often caused by dangerous machinery or explosives, this wound has got skin and tissues torn off and left dangling. It may result in severe bleeding. High risk of infection.

Finger punctured by a nail.

Punctured wounds are often very deep wounds caused by a pointed tip object. These wounds have complications if the object is a rusty metal. Serious risk of infections are expected. 

Amputation of the lower left arm.
A part that is totally torn off from the body. Massive bleeding will occur, and the amputee will go into shock due to the blood loss. Infections are to be expected. This is one injury that rushes for time. 

We are done with looking at the circulatory system and the types of wounds. In the next part, I will go through the types of dressings, bandages, and anti-infection products, as well as teach you how to use them to treat wounds. Stay tune for part two!

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