A wound occurs when the integrity of any tissue is compromised, for example, when skin breaks, muscle tears, burns, or bone fractures. A wound may be caused by an act, such as a gunshot, fall, or surgical procedure; by an infectious disease; or by an underlying condition.
Types and causes of wounds are wide ranging, and health care professionals have several different ways of classifying them. They may be chronic, such as the skin ulcers caused by diabetes mellitus, or acute, such as a gunshot wound or animal bite. Wounds may also be referred to as open, in which the skin has been compromised and underlying tissues are exposed, or closed, in which the skin has not been compromised, but trauma to underlying structures has occurred, such as a bruised rib or cerebral contusion. Emergency personnel and first-aid workers generally place acute wounds in one of eight categories:
Abrasions. Also called scrapes, they occur when the skin is rubbed away by friction against another rough surface (e.g. rope burns and skinned knees).
Avulsions. These occur when an entire structure or part of it is forcibly pulled away, such as the loss of a permanent tooth or an ear lobe. Explosions, gunshots, and animal bites may cause avulsions.
Contusions. Also called bruises, these result from forceful trauma that injures an internal structure without breaking the skin. Blows to the chest, abdomen, or head with a blunt instrument (e.g. a football or a fist) can cause contusions.
Crush wounds occur when a heavy object falls onto a person, splitting the skin and shattering or tearing underlying structures.
Cuts are slicing wounds made with a sharp instrument, leaving even edges. They may be as minimal as a paper cut or as significant as a surgical incision.
Lacerations. Also called tears, these are separating wounds that produce ragged edges. They are produced by a tremendous force against the body, either from an internal source as in childbirth, or from an external source like a punch.
Missile wounds. Also called velocity wounds, they are caused by an object entering the body at a high speed, typically a bullet.
Punctures are deep, narrow wounds produced by sharp objects such as nails, knives, and broken glass.
Kathleen Wright, Teresa G. Odle, The Gale Group Inc., Gale, Detroit,