Laceration. Injuries and wounds of the soft tissues of the head, symptoms and treatment Lacerated wound of the forehead

Most common reason appeals to pediatric surgeon are acute surgical diseases and injuries in children. Any emergency, especially if it requires the intervention of a surgeon, is a legitimate concern for parents. It is very important for a number of diseases or injuries to consult a pediatric surgeon in a timely manner so that qualified surgical care is provided as soon as possible.

One of the most common such injuries is bruised and cut wounds in children. What is it and how parents should act in such cases - says the doctor of medical sciences, head of the department of pediatric surgery at EMC Viktor Rachkov.

Bruised wounds

Children aged 2 to 5 years actively comprehend the world around them and the limits of their bodies. Unfortunately, the child's coordination of movements does not always correspond to this activity. Therefore, very often children fall and get bruised. Bruising against hard objects may cause injury (shearing) skin and underlying tissues and the appearance of bruised wounds. The reasons for the fall of the child can be different: stairs, ice slide, bicycle, scooter, roller skates, household items, etc. The most common area for bruised wounds is the head: hairy part heads, forehead and chin. Bruised wounds can be accompanied by severe bleeding. Depending on the place where the wound was received and the method of obtaining it, such wounds can be of different degrees of contamination: more "clean" at home and "contaminated" on the street. Of course, wounds vary in size and depth of injury, from superficial to deep, as determined by the force of the impact. It is important to understand that the force of impact can be such that it will damage the underlying bone structures, and with a head impact - to a traumatic brain injury (for example, concussion, brain contusion, etc.). Therefore, in order to make a diagnosis, it is very important for the doctor to assess the child's condition immediately after the injury: did the child lose consciousness, did he scream immediately or with a delay, does he remember the circumstances of the injury, was there dizziness, nausea or vomiting? Parents should pay attention to such details. If you have any of these symptoms when you hit your head, you should immediately seek medical attention.

Cut wounds

Cut wounds are less common in children. However, given a different mechanism of damage, they can be deeper. With cut wounds, damage to the underlying tissue is more common. For example, cut wounds in the hand or foot may show tendon damage that can lead to dysfunction of the fingers. It is very rare in children to have penetrating wounds to the chest and abdomen, which can lead to damage to vital organs and serious internal bleeding... This must be remembered with a cut wound on the chest or abdominal wall, received with a sharp object. In addition, with cut wounds, damage to large blood vessels, arteries and veins, accompanied by severe bleeding.

Treatment of bruised and cut wounds in children

What should parents do when a child gets a similar injury? Of course, immediately contact the emergency room or a pediatric surgeon. If the bleeding is heavy or the child is unconscious, induce ambulance... If possible, close the wound with a clean bandage, but never use cotton wool. Bleeding can be stopped with a pressure bandage. Severe bleeding from the great vessels (this is extremely rare in children) requires a tourniquet. But it is better not to use a tourniquet if the parents do not know how to do it.

The task of the surgeon is to assess the condition of the child and exclude associated injuries (for example, the bones of the skull and brain with a bruised head wound, internal organs with suspicion of penetrating wounds). This may require additional studies: X-ray, ultrasound, CT.

The amount of surgical care required depends on the severity of the injury. Any wounds are washed with antiseptic solutions to cleanse any possible contamination. Small linear wounds can be closed with adhesive sutures or special medical glue. More serious wounds and wounds with severe bleeding or contamination require surgical intervention or the so-called primary surgical debridement ( PHO wounds). Typically, PHO wounds include washing with antiseptic solutions, stopping bleeding, excision of damaged tissue and wound closure. For execution final stage - closure of the wound, the surgeon has about a day from the moment of injury. If more time has passed after the wound was applied, then the wound is considered conditionally infected, and the imposition of primary sutures is impossible in most cases. Therefore, it is better for parents not to delay the consultation of a child with similar wounds with a surgeon.

PCO wounds can be performed both under general (anesthesia) and local anesthesia. In many ways, the choice of anesthesia is determined by the volume of surgery, the location of the wound, and the age and character of the child. Small wounds in adult children or calm children preschool age can be closed under local anesthesia. For this, local anesthetics, similar to those used in dental treatment, are injected into the edges of the wound. At the same time, the child practically does not feel anything. But, of course, the very environment, the sight of the surgeon and the operating room can cause anxiety in the child. Therefore, young children, as well as in cases of more serious injuries, should be carried out under general anesthesia in a full operating room. This usually requires hospitalization. In the EMC Children's Clinic, such hospitalization for an uncomplicated wound is carried out for only a few hours. Usually, an uncomplicated, uncontaminated bruised wound does not require antibiotics in the postoperative period.

It is important to be aware of the risk of developing tetanus, especially with contaminated wounds. Therefore, doctors always discuss with parents which vaccinations were previously performed, and carry out anti-tetanus vaccination (AC-toxoid), if it was not performed on time. With a head injury, in many cases, it is advisable to consult a neurologist to exclude a concussion. In the postoperative period, inflammation may develop in the area of \u200b\u200bthe stitches - in this case, antibiotics are additionally prescribed. Healing of a bruised wound may be worse than with a cut wound. This means that the cosmetic effect may be worse. This is due to the mechanism of damage - soft tissue injury leads to damage to the edges of the wound. Therefore, it is not worth expecting that the cosmetic result will always be perfect after healing (as before the injury).

European Children's Clinic medical center renders surgical care children around the clock.

Often they are multiple, localized on the chest, abdominal walls, limbs, head and are the result of the impact of so-called secondary shells and metal structures, parts of mechanisms, metal fences, in traffic accidents, falls from a height, earthquakes, explosions and collapses of buildings.

When falling from heights the victim's body is pushed onto metal structures, like a spit, and the patients are delivered to the operating room with reinforcement cut off on both sides. The separation of the part of the reinforcement fixed in the victim's body from the rest of the metal structure is carried out by a team of rescuers from the Ministry of Emergencies.

Patient N., 34 years old, in a state of alcoholic intoxication, fell at a construction site from the height of the 4th floor. At about the height of the 3rd floor, he came across a vertically located metal structure (corner) and hung on it. The metal structure was cut off by the Emergencies Ministry's team and the patient was delivered to the operating room 3 hours after the injury.

When admission serious condition. Consciousness - 11 points on the Glasgow Coma Scale. NPV 28 per minute. With auscultation on the left, breathing is carried out well, on the right is not heard. Heart sounds are muffled, rhythmic, no noise. HR NO per minute, BP 110/70 mm Hg. Art. On the right, on the chest wall, an entrance laceration wound of an irregular oval shape, 25 x 15 cm, located between the posterior and anterior axillary lines at the level of the VII-IX ribs, with a metal corner and clothing embedded in it. The exit wound of an irregularly oval shape 15 x 15 cm is also located on the right on the chest wall between the parasternal and anterior axillary lines at the level from the clavicle to the third rib. A metal corner and clothes come out through the wound.

Across 20 minutes from the moment of admission under combined endotrachtal anesthesia in the position of the patient on the back with a roller under the right half of the chest, a right-sided anterolateral thoracotomy was performed in the fifth intercostal space. Metal corner for the most part located intrapleurally, scraps of clothing soaked in blood. There is a fracture of the clavicle in the middle third with displacement and ruptures of the V-IX intercostal vessels.

As scraps clothes played the role of tampons, after their removal, severe bleeding began, which was not there before. Pericosteal sutures with vicryl were applied on an atraumatic needle. The bleeding has stopped. After removal of nonviable fragments of the lung, his wound was sutured in layers with Vicryl on an atraumatic needle. Pleural cavity washed with antiseptic solutions and drained in the second and eighth intercostal spaces. The thoracotomy wound was sutured in layers. Traumatologists performed osteosynthesis of the right clavicle with wires and wires.
Completed primary surgical treatment entrance and exit wounds of the chest wall, leaving drainage. Flow postoperative period without serious complications.

In the past often featured woundsapplied by "fishing hooks and hooks for hanging meat". Some of these items, extracted from the tissues of the victims, are shown in the figure. These are scraps of construction fittings, a tip from a metal fence, parts of machine tools, parts of door handles and even a bicycle handlebar that has penetrated abdominal cavity in case of an unsuccessful fall of the cyclist.

Typically it is heavily contaminated wounds with necrosis of the edges, with multiple pockets in which blood clots and scraps of dead tissue accumulate. The overwhelming number of them is of a non-penetrating nature, and the severity of the condition of the victims is determined mainly by severe closed damage of a combined nature, which determine the relevance of emergency diagnostic and therapeutic measures.

The presence in such neck wounds, chest or abdominal wall contaminated foreign bodies increases the risk of tetanus.

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These wounds of the hand constitute the main group of open injuries; they are very diverse in the severity of damage, course and consequences. More than half of them do not require surgical treatment and heal under an aseptic dressing, while maintaining the cleanliness and rest of the wound.

Abrasions and excoriations of the skin

Under the term "excoriation" damage is combined with a violation of the integrity of the surface layers of the skin, and under the abrasion - all layers of the skin. In everyday practice, abrasions to the hand are much more frequent than they are recorded. Excoriation and abrasions on the hand occur with tangential, sliding, abrasive movements, more often on the back than on the palmar side. A short story and inspection is enough to recognize them.

Most abrasions can be healed without a doctor, so prevention should be promoted and educated in proper self-help. When providing surgical assistance, after the appropriate treatment of the skin with one method or another (see page 18), the abrasion can be powdered with a biological antiseptic, covered with MK-6 or BF-6 glue and injected with tetanus serum. The average duration of treatment for victims with abrasions of the hand is 3-5 days. Complications after abrasions are rare. Several cases of subcutaneous panaritium, paronychia, and traumatic arthritis of the proximal interphalangeal joint from abrasions on the rear over the distal interphalangeal joint were noted.

Each industry has its own causes and characteristics of hand injuries, depending on which the severity of tissue damage and the course wound process are of a different nature.

Cut and chopped wounds

The combination of cut and chopped wounds is somewhat arbitrary, since a cut wound is characterized by smooth, uncrushed edges and a bottom, and with a chopped wound these features may be absent. The mechanism of cut and chopped wounds in most cases is associated with the contact of the hand with a sharp, rapidly moving ^ hard object or hitting sharp objects.


Figure: 117. Chopped wound of the distal phalanx of the third finger of the left hand.


Cut wounds on the back of the hand often penetrate the joints: chopped wounds are complicated by flawed fingertips and damaged nails. Vocational school student Ch., Chipping a board, chopped off a nail with adjacent tissues on the third finger with an ax (Fig. 117). An hour later, in the traumatology office of the polyclinic, the wound was treated, a suture was applied to the severed nail bed, the wound was powdered with streptocide and closed with an aseptic bandage. Healing after 12 days. The correct shape of the nail plate grew after 5 weeks. Was incapacitated for 6 days.

It is more expedient to accelerate healing and protect the wound of the nail bed from infection, if the nail plate is intact, clean it of soft tissues, treat it with furacilin, carefully lay it under the nail roller and fix it with 1-2 stitches from a fishing line or other synthetic thread. Cut and chopped wounds are characterized by burning pain, profuse bleeding, and rapid adhesion of the edges of the wound. The course of cut and chopped wounds depends on the sharpness of the wounding object, the infection, the functional significance of the damaged tissues, first aid and subsequent treatment. An incised wound is easier than others to turn into a clean operating wound and heal by primary intention. With cut wounds, there are conditions for a delayed secondary suture; even an infected cut wound often heals without complication. Complications are observed in 0.5-3%. The average duration of treatment is 7-8 days.

Puncture wounds are applied with a pointed (needle, awl, glass) or more blunt object (nail, bone, pencil tip, sliver) with a quick brush movement. Puncture wounds are more common on the fingers, then on the metacarpus, and less commonly on the wrist. Puncture wounds are characterized by pain, minor bleeding, rapid adhesion of the edges, and progressive infection. With puncture wounds inflicted with an aniline pencil, aseptic tissue inflammation and necrosis develop along the wound channel. The course of puncture wounds varies depending on the infection, the depth of the wound, the presence of a foreign body and the quality of first aid and treatment.

Choosing the right method for treating puncture wounds presents some difficulties. Is it necessary and in what cases to dissect and excise puncture wounds? We adhere to the following principles. Fresh puncture wounds with a foreign body remaining in the wound are excised, foreign bodies removed, the wound turns into an operating room and sutured. Puncture wounds of the hand, inflicted by objects that are known to be contaminated, are dissected and treated like infected wounds. Puncture wounds caused by relatively “clean” objects are treated conservatively (skin and wound treatment, observation). Puncture wounds are more often than others complicated by inflammatory processes in the surrounding tissues. Outcomes after puncture wounds are worse than after cut wounds. Complications are observed in 1-4%, the average duration of treatment is 9 days. When, with first aid, after cleaning the skin, the epidermis hanging over the puncture wound is removed and cryotherapy is applied, the number of complications is halved and the duration of treatment is reduced.

Bruised and lacerated wounds

This is the most common type of open injuries arising from impact, compression, jerking, falling, etc. Bruised lacerated wounds are more often on the fingers, less often on the metacarpus and wrist; equally often on the back and on the palm. Bruised lacerated wounds are characterized by uneven, bruised edges, crumpled, elongated, crushed tissues, skin flaws, minor bleeding, aching dull pain, and often a complicated course.

The principles of treating bruised lacerated wounds of the hand are the same as those previously outlined, but it is more difficult to translate them into clean ones, therefore, the primary and more often the secondary wound suture is applied less often.

However, in all cases, when the victims seek help and the surgeon has the proper conditions for the operation, the primary surgical treatment of bruised lacerated wounds is usually performed.

A 16-year-old vocational school student trapped the index finger of her right hand in a vice. At the health center, the circumference of the wound was smeared with iodine, and an aseptic bandage was applied. Half an hour later, at the trauma center: cleaning the skin of the hand, conduction anesthesia at the base of the finger, surgical treatment of the wound.

To close the wound, pieces of skin freely lying in the wound were used (Fig. 118). The wound was powdered with streptocide, a tiled pressure bandage was applied, and a finger was immobilized.


Figure: 118. Bruised lacerated wound of the index finger of the right hand.
a - type of wound before treatment; b - forming scar after 2 weeks.



Figure: 119. Extensive bruised laceration of the right hand.
a - view of the wound from the palm; b - from the side thumb.

Bandaging on the 8th day - the grafts engrafted; UFO, aseptic dressing. On the 10th day, the victim started to work on the occupational health certificate.

The second observation concerns the 38-year-old washerwoman B., who received a sliding blow with a drum blade on her right palm. In half an hour, she was delivered to the surgical clinic. The victim is very agitated, depressed and, although she does not feel acute pain, cannot move fingers.

There are no symptoms of shock, bone loss or bleeding. The patient was injected with 1.5 ml of 1% Pantopon solution, 1500 AU tetanus toxoid serum, ether anesthesia was given. After cleaning the skin, it was found: a bruised wound begins on the dorsal-ulnar surface of the V metacarpal bone, its distal edge passes slightly obliquely along the palm at the base of the V-IV-III-II fingers, the proximal one - at the level of the carpal skin fold from the styloid process of the radial to the styloid process ulna (Fig. 119).

A skin flap with subcutaneous tissue, palmar aponeurosis, vessels and nerves is detached to the 1st finger and is held on a skin bridge 2 cm wide at the base of the thumb. In the depths of the wound, there are bruised, partially torn hypothenar and thenar muscles and adipose tissue. The integrity of the great vessels, nerves and tendons is not broken. Surgical treatment of the wound was performed; the flap is processed, put in place and sewn with single, frequent horsehair sutures. Aseptic pressure bandage, back plaster splint, kerchief. Due to domestic circumstances, the victim categorically refused hospitalization. The wound healed by primary intention. After 2 weeks, the patient could move her fingers. Prescribed electric massage, dry air baths. The patient left Leningrad after 2 weeks.

The associated infection, the extent and depth of tissue damage require skillful complex treatment bruised and lacerated wounds, since they have general and local complications: necrosis of the skin and tendons, delayed discharge, phlegmon, inflammation of the tendon sheaths, periosteum, bones and joints.

Complications were observed in about 5-8% of victims, adverse consequences - in 1.5%. The average duration of treatment is 14.5 days.

Bitten wounds

They are most often applied by pets (dog, cat, horse, pig) - in 74.2%; less often by other representatives of the fauna (rats, snakes, fish, etc.) - in 13.8%; human - in3%, and in 9% of victims, the reason is not specified. Of the 10 bitten wounds, 9 are localized on the fingers and only 1 on the proximal parts of the hand. These wounds are characterized by small one or two entrances and crushed tissue in depth; they are applied with fangs. Another nature of the wounds is observed when not separate teeth, but the jaws of the animal close: the victim seeks to free his hand - then they resemble lacerated or scalped wounds. The back of the hand is often bitten by small insects (mosquitoes, wasps, bees, ants); they are not counted as wounds, but the venom released causes itching and swelling of the dorsum of the hand, for which patients refer. Poisonous snakes bite mainly on the finger, less often on the brush (when picking berries, mushrooms, etc.).

When treating bitten wounds, one should not forget about the need for specific therapy against rabies and tetanus; it is more advisable to introduce serum even in the absence absolute readingsrather than abstain and expose the victim to the risk of tetanus or rabies.

The treatment of bitten wounds is based on the generally accepted view of them as wounds infected with virulent microorganisms. It is necessary in every possible way to promote the need for an immediate appeal of the victim to a doctor.

After disinfection of the skin and anesthesia, bitten wounds of the stab type are dissected, drainage is ensured, and the wound is prepared for a secondary suture. Bitten wounds in the form of torn and crushed after disinfection of the skin and anesthesia are treated: non-viable tissues are excised, drainage of the discharge is ensured, the edges of the wound are brought together with a sticky plaster and a bandage. The wound is closed with provisional sutures only if the surgeon is confident in the successful course of the wound process and can observe the patient in order to notice complications in time.

With bitten wounds, despite their insignificance, immobilization of the hand is necessary, and in some cases ( strong pain, edema, inflammation) and an abduction splint for the arm.

The course of bitten wounds is often complicated general reaction the body and the development of local infection with leaks of pus, tissue necrosis, inflammatory processes in the joints, tendon sheaths, periosteum and bone. Complications of a trophoneurotic nature are also observed.

Citizen N. was bitten by a cat about three years ago. The wound on the back of the right hand, above the metacarpophalangeal joint of the third finger, festered and healed slowly. The hand remained swollen with cyanotic spots. Then there was itching, aching pains and difficulty in hand movements. The patient was periodically treated with physiotherapy and homeopathic remediesbut the improvement did not last long. We performed N. three times paravertebral intradermal blockade with novocaine (0.5 x 50 ml). There was a significant improvement: there was no itching, swelling and cyanosis decreased, movements became freer. The treatment result was tracked for six months. Complications from bitten wounds were observed in 8-11%, adverse consequences - in 4%. The average duration of treatment is 15 days.

E. V. Usoltseva, K. I. Mashkara
Surgery for diseases and injuries of the hand

Wounds are called mechanical damage the integument of the body, penetrating deep into the dermis of the skin or into the subcutaneous (submucous) tissue.

Depending on the damaging blunt object and the mechanism of injury, bruised, bruised-lacerated, lacerated, patchwork, scalped, and bitten wounds are distinguished.

Features of wounds are associated with the mechanism of action of the traumatic factor. Contacting the body at the moment of impact, a blunt object squeezes and displaces the tissues, causing them to stretch, and then crushing, leading to rupture of the integument with the formation of a wound. This nature of the action of a blunt object determines characteristic signs and the properties of a bruised wound from the action of a blunt object:

The settling of the edges of the wound occurs in the place of direct action of the object or its edges and is expressed more or less evenly. Where the skin is not so much crushed by the object itself as it is torn by tension, the edges of the tears may not be sealed.

Since a blunt object, when crushing the skin and deeper layers, kneads the tissue, the edges of the wound in the depths are uneven. The tissues are not torn deep into the entire length, as a result of which tissue bridges remain, connecting the edges of the wound. Hemorrhages in the wound and surrounding tissues occur as a result of rupture of blood vessels in the place of their compression. Where the soft integuments are thin and there is bone under them, there is a uniform exfoliation of the skin from the underlying bone.

When struck with a blunt object at an angle, the wound takes on the character of a bruised-lacerated one. It differs from a contused wound by uneven sedimentation of the edges and detachment of soft tissues. The edges of such a wound are precipitated mainly from the side from which the object acts, and the detachment of the skin from the underlying layers is more pronounced on the opposite side. Detachment of the skin in the area of \u200b\u200ba bruised lacerated wound is presented in the form of a pocket directed towards the action of the traumatic force.

When struck at an angle to the surface of the body, followed by displacement and tearing of the skin in the form of a flap, a flap wound is formed. Its type - a scalped wound - occurs when the skin is torn off the underlying layers for a considerable extent.

From the action of the teeth, bitten and lacerated-bitten wounds arise, with special importance attached to wounds from bites with human teeth. Bitten wounds are located in the form of one or, more often, two arcs and consist of separate injuries, to one degree or another reflecting the shape of the active surface of the teeth. The general curvature of the arcs, the size and shape of individual damage elements, the distance between them, traces of defects or the absence of a particular tooth and other features, being quite well expressed in some cases, can be used for identification. Such damage must be photographed as soon as possible using a scale bar already at the crime scene.

Forensic medical significance of wounds.

Bruised, bruised-lacerated wounds and their varieties, which have a combination of certain signs (such as unevenness, soreness, bruising of the edges, tissue bridges, etc.), are an indicator of the action of a blunt object.

Indicate the place of application of the blunt object.

When a blunt object acts at an angle, the properties of the wounds make it possible to establish the direction of the traumatic force (the maximum sedimentation of the edges is from the side of the impact, the predominant detachment of the skin from the underlying bone is in the direction of the acting force).

The degree of wound healing and the condition of the scars appearing in their place makes it possible to speak about the duration of the damage.

Features of wounds (shape, size, nature of sedimentation, etc.) sometimes make it possible to judge the configuration and size of a blunt object or part of it, to speak about attributing it to a certain group, the possibility of causing a wound by an object submitted for examination. However, it should be borne in mind that the expert's conclusion in such cases is tentative.

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Every person encounters cut wounds throughout his life and this happens more than once. The point here is not only in various criminal situations and everyday “clarification of relations”, people most often receive such injuries of various depths and sizes in everyday life, when doing everyday activities, for example, during cooking, when washing dishes.

Causes of injuries

A cut wound always occurs when the skin and tissue layers are damaged by cutting objects, for example, a knife, a sharp edge of any metal surface or plastic, glass shards, a razor, or a medical scalpel. Such injuries accompany a person throughout life from childhood.

Children often get various cuts while playing on the street or in the house, picking up sharp objects, actively learning about the world around them.

Adults are faced with such wounds in everyday life, when doing housework, when preparing food, careless handling of sharp objects, and not observing safety precautions in various industries.

Often, cut wounds appear due to various criminal incidents. Moreover, if ordinary household wounds, as a rule, are single, then criminal wounds in most cases have multiple character.

Signs of a cut wound

Since the wound occurs under the sliding action of a sharp cutting object, the injuries are directed in straight lines, while the wounds acquire a fusiform shape.

As a rule, in cut wounds, the length of the injury prevails over the width of the wound and its depth, but in some cases the situation may be reversed.

A distinctive characteristic of a cut wound is that the section of such a wound is wedge-shaped, that is, the depth along its edges is always less than in the central part.

The edges of such wounds are almost always native, smooth, while there is also quite abundant, since the damage simultaneously affects many small vessels. Straightness, or rather, its degree, always depends on the specific shape of the cutting object, as well as on the moment in which it moves in relation to the damaged tissues.

If the cut is located on a part of the body that has a rounding, then its line can be not only linear, but also arched... If the cut is located on skin that has folds or many deep wrinkles, then its edges may be zigzag. The direction of the incision can change, but this usually happens if the cutting object hits the bone in the tissues.

First aid

First aid for a cut first of all includes disinfecting the wound, washing it with running water, and then with hydrogen peroxide or an antiseptic solution, additionally treating the edges of the cut wound with the same solution using a cotton pad.

When providing first aid in the event of a cut wound, special attention should be paid to stopping bleeding, which in most cases is quite abundant, and therefore can lead to tangible blood loss.

If there is a limb in case of injury, when the flowing blood has a bright scarlet color and comes out of the wound in a pulsating stream, it is necessary. To do this, the limb on which the injury is located should be bent at the joint, after which a tourniquet should be applied slightly above the wound site.

If the flowing blood is dark, almost burgundy, then the tourniquet is applied below the cut, if it is located below the level of the heart.

If the cut injuries are located on the trunk or face, the wound must be tamponedby pinching the damaged vessels with your finger. To carry out tamponade, you should use gauze or sterile bandage wipes, as well as dense cotton balls wrapped in several layers of gauze. You can apply ice or some other source of cold to the cut site, this also helps to stop bleeding.

If the cut is small, then the bleeding stops quickly enough in a natural physiological way when applying an ordinary dense bandage or a cotton-gauze napkin tightly attached with a plaster.

In this case, before applying a bandage, the cut wound should be treated by disinfection with hydrogen peroxide or some kind of antiseptic solution.

Additionally, to prevent possible infection, the skin around the cut wound can be treated at home with a solution of brilliant green or iodine.

Since large cut wounds, as well as cuts, small in size, but having a serious depth, must be sutured, after performing first aid procedures, you should immediately contact the clinic.

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Treatment of cut wounds

Small cut wounds, the size of which does not exceed 0.5 cm in width and 1.5 cm in length, can be treated independently by following the correct first aid procedures and further timely treatment and dressing change with the application of ointments. Larger injuries require mandatory medical care and suturing.

To stop bleeding in the clinic, they use a special apparatus called an electrocoagulator, with which the bleeding vessels are stopped.

If the incision is particularly severe and the large vessels are damaged, the doctor may apply ligatures (special sutures) on them.

After cleaning from dirt, treating the cut wound and the surrounding area of \u200b\u200bthe skin with antiseptic solutions or hydrogen peroxide, stopping bleeding, the cut is sutured by suturing. You should not abandon this measure, even if the cut is only slightly more than 2 to 3 cm.

It is important to remember that a stitched cut wound heals much faster than the one that will not be sutured.

On average, if after stitching the wound healing time is about a week, and full recovery takes 2 to 4 weeks, depending on the depth of the cut, its size and the occurrence of complications, then the unsecured cut will take several months.

In this case, the wound can periodically open, bleeding will begin again, and this will significantly increase the healing time of the injury.

If the duration of the injury at the time of contacting the doctor is more than a day, then it will no longer be sewn up. In this case, the resulting injury must be cleaned, inspected, rinsed, and in some cases the drainage tube must be installed, after which it is stretched and secured with a bandage. Such wounds are treated only by re-tensioning with regular washing and treatments.

A patient with a stale trauma is also prescribed a mandatory course of taking antibiotics and pain relievers of the analgesic class. In this case, the time of treatment until the moment of complete recovery will depend not only on the size and depth of the cut, but also on other features of the injury, as well as on the severity of the existing purulent inflammatory process, which is an indispensable companion of such injuries.

In some cases, in particular, when especially complex injuries are received, in which damage to blood vessels, nerves or tendons occurs, a planned operation is prescribed to restore such damage, but it is usually performed after the resulting wound is completely healed.

If, when receiving a cut wound, any internal organs, then an urgent operation is performed to preserve organs, while the amount of intervention by surgeons will depend on the degree of damage and destruction. In some cases, in addition to suturing the damaged organ, partial resection is also performed, if necessary.

After suturing, wound treatment consists of changing dressings regularly, carrying out the treatment of damage and the surrounding skin, as well as the imposition of special ointments, which not only accelerate the regeneration processes, but also have a local anti-inflammatory, antibacterial and analgesic effect.

The choice of the drugs used in most cases is carried out by the doctor, taking into account the peculiarities of the state of the cut and the patient himself.

Most often, in hospitals, Vishnevsky ointment is used to accelerate the processes of cleansing wounds from pus and their healing, which, when applied, helps to activate the inflammatory process and the formation of pus, due to which the wound is quickly cleansed and healed. But other effective remedies can also be prescribed.

Preparations and ointments for healing cuts

The purpose of using ointments and other means for healing wounds is not only to reduce the recovery period of damaged tissues, but also to provide an antibacterial and anti-inflammatory effect to eliminate (prevent) a purulent process. Therefore, the ointment should solve several problems at once.

Most often, doctors recommend using Solcoseryl to heal cut wounds and cuts.available in two forms. Solcoseryl gel is intended for application to fresh cuts. It is not only able to cope with many types of pathogenic microorganisms of various categories, but also to provide a cooling and analgesic effect, which is also of great importance.

Solcoseryl ointment, as a rule, is used in the second stage of treatment, when a fresh wound has already healed and a crust has formed on top. Applying the ointment stimulates the production of new collagen fibers, which significantly speeds up tissue regeneration and recovery.

Often, doctors prescribe the drug Actovegin, which is an analogue of Solcoseryl, and is also available in the form of a gel and ointment. The essence of the application of this remedy, as its action, is similar to Solcoseryl.

Another fairly well-known ointment is Levomekol,it is often used to treat a variety of wounds with an active purulent process, as well as boils, burns of varying degrees and all kinds of cuts, including after surgical operations.

As a rule, this ointment is available in the office of every surgeon and in almost every clinic, as well as Vishnevsky's ointment, since its application allows you to heal wounds and eliminate purulent formations throughout the depth of the existing damage.