Description, Causes and Risk Factors:
Alternative Name: Laceration.
A cut, also called a laceration, is a break or opening in the skin. The cut may be deep, smooth, or jagged. It may be near the surface of the skin, or affect deep tissues, such as tendons, muscles, ligaments, nerves, blood vessels, or bone.
Skin provides the outer covering for our bodies and protects us from heat, light, injury and infection. Most of the time, when someone gets a cut, it's not a big problem. But that's not always the case. Cuts can become infected. Cuts also may not heal the way they're supposed to. Because of this, it's important to be able to recognize the signs of potential problems and get the right medical care when it's needed.
When you get a wound, the surface of the skin has been compromised in some way. It opens the body up to infection. Your body and your immune system immediately go to work to try to close the gap and heal the wound. Most wounds heal easily on their own with just a little care, but if a wound does not heal, it is important to seek medical care. Poorly healing wounds can be the sign there is another problem.
Some of the reasons that a wound doesn't heal are:
Complications from diabetes.
Wounds that are the result of pressure ulcers are also frequently slow to heal. People who have suppressed immune systems often have trouble with wounds.
Tetanus: A serious concern with wounds is tetanus, also called lockjaw. It's caused by a toxin made by a certain bacteria. Tetanus bacteria can enter any wound but prefer deep puncture type wounds. The bacteria can be found in dirt, dust or other organic material.
The signs of tetanus include:
Muscle stiffness in the jaw.
Stiffness of the neck.
Tetanus is extremely rare in the United States but people that get the infection can become seriously ill.
There are vaccines for tetanus. Most American children get their first tetanus shot in the combined DTaP (diphtheria-tetanus-pertussis) vaccine. According to the National Institute on Aging (NIA), most adults need a tetanus booster shot every ten years to be protected. If someone has a severe cut or burn and has not had a booster shot in the past 5-10 years, NIA also recommends a booster shot as soon as possible.
Wounds can get infected with a number of other bacteria, including Staphylococcus aureus or "staph". Some staph infections are drug resistant. So-called MRSA infections, usually occur after surgery, hospitalizations or other medical treatment. However, there is growing concern about MRSA infections that are developing outside of healthcare facilities. The American Academy of Family Physicians (AAFP) recommends that you contact a healthcare provider if a wound appears to develop an infection and becomes tender or inflamed.
If the cut begins to drain yellow or greenish fluid (pus), or if the skin around the wound becomes red, warm, swollen, or increasingly painful; a wound infection may be present and medical care should be sought. Any red streaking of the skin around the wound may indicate an infection in the system that drains fluid from the tissues, called the lymph system. This infection (lymphangitis) can be serious, especially if it is accompanied by a fever. Prompt medical care should be sought if streaking redness from a wound is noticed.
Symptoms may include:
Problems with function or feeling below the wound site.
Infection may occur with some cuts and puncture wounds. The following types are more likely to become infected:
Wounds on the feet.
Wounds that are not promptly treated.
Diagnosis may include history and physical exam:
The history should include information on how much time elapsed between receiving the wound and getting medical attention and the date of the most recent tetanus injection. It is also very important to obtain a history of any medical conditions the individual may have, since diabetes, vascular disease, malnutrition, a history of cancer, and many other medical problems, as well as medication use and smoking, can all influence wound healing. A history of keloid formation can influence wound care strategies.
Physical examination should begin with an assessment of the entire body. Sometimes, serious injuries that are distant from the cut can be overlooked in the initial evaluation. It is helpful to record the size, depth, and type of cut. The cut may need to be explored to evaluate possible involvement of tendons, ligaments, and nerves. Profuse bleeding that does not stop with pressure or bleeding that spurts from the cut (suggesting injury to an artery) may indicate involvement of major blood vessels. Large amounts of blood loss may lead to early signs of shock such as decreased level of consciousness, rapid pulse (tachycardia), and low blood pressure (hypotension). The area around the wound may be tender to the touch and swollen. Redness (erythema) and warmth suggest infection.
Obvious deformity of an extremity (hand, foot, or lower leg) suggests a fracture of underlying bone; in some circumstances, bone may be observed protruding through the skin (open fracture). Damage to the nerves and/or tendons may cause changes in sensation or weakness in an extremity.
Tests: Blood tests (complete blood count) may be needed to monitor signs of blood loss and infection. X-rays help to detect fractures or the presence of foreign bodies. X-rays of the blood vessels (arteriograms) are done if vascular injury requiring surgical repair is suspected. Nerve conduction studies or evoked potentials are usually done several days to several weeks after the incident and may reveal associated nerve injury.
Here are suggestions from the AMA (American Medical Association) for a minor cut:
Wash with a mild soap and rinse again
Cover with a sterile bandage or gauze.
Examine the cut and surrounding area daily for signs of potential problems including redness, swelling, tenderness, warmth, or drainage.
Rinse the cut thoroughly with water.
A more serious cut may require the attention of a doctor. The AAFP (American Academy of Family Physicians) says contact a doctor if the wound is jagged, has dirt in it that won't come out or if the edges gape open. They also suggest getting medical attention if any of the following happens:
The area around the wound feels numb.
You can't move comfortably.
Red streaks form near the wound.
The cut becomes tender or inflamed.
The cut drains a thick, creamy, grayish fluid.
The wound is the result of an animal bite.
You should also get medical attention for any puncture wound or deep cut if you haven't had a tetanus booster in the last 5 years. In general, if there are any questions as to the danger of a cut, it's better to contact a doctor.
You start to run a temperature over 100 degrees.
For cuts or wounds that don't heal, doctors have special bandaging techniques and ointments that can help a wound heal faster and reduce the risk of permanent damage. Wound care centers can often provide a specialized approach, with a team of internists, vascular surgeons, podiatrists, reconstructive surgeons, nurses and other specialists. Treatment options can include:
Synthetic skin grafts, to promote skin growth during healing.
Outer wraps that provide extra compression to promote healing.
Debridement, which involves cleaning out unhealthy tissue, can also help to promote healing.
Hyperbaric oxygen therapy, using a special chamber filled with pure oxygen special dressings, which may contain healing medications or fibers within the dressing itself.
The important thing is to monitor any cuts carefully and seek medical help if the cuts aren't healing as they should.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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