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CLASSIFICATION OF WOUNDS BDS 3rd year .pptx
- 2. Definition of a wound : ANY break in the integrity of the skin or tissues which may be associated with disruption of structure or function
- 4. RANK & WAKEFIELD CLASSIFICATION ■ Tidy Wounds ■ Surgical incisions, ■ wounds by sharp objects, ■ keloid, ■ Untidy Wounds ■ Avulsion ■ Crush injury ■ Devitalised injury
- 5. BASED ON TYPE OF WOUND ■ Bruising & contusion ■ Haematoma ■ Clean Incised Wound ■ Lacerated Wound ■ Abrasion ■ Crush injury ■ Penetrating wounds
- 6. CLASSIFICATION OF SURGICAL WOUNDS ■ Clean Wound ■ Clean Contaminated Wound ■ Contaminated Wound ■ Dirty Infected Wound
- 7. CLEAN WOUND ■ Clean wound is a nontraumatic, uninfected operative wound in which neither the respiratory, alimentary or genitourinary tracts nor the oropharyngeal cavities are entered. ■ Clean wounds are elective, primarily closed, and undrained wounds. ■ Infection rate is <2%
- 8. CLEAN CONTAMINATED WOUND ■ Gastrointestinal, respiratory or genitor- urinary tracts entered without significant spillage or wounds which are mechanically drained. ■ Eg: appendicectomy, gallbladder, biliary, pancreatic surgeries ■ Infection rate <10%
- 9. CONTAMINATED WOUND ■ Operative wound contaminated ■ Fresh traumatic wound from clean source ■ Gross spillage from the gastrointestinal tract ■ When infected urine or bile is present ■ Incision encountering acute non-purulent inflammation. ■ Eg: penetrating abdominal injury, enterotomy ■ INFECTION RATE –15 –30%
- 10. DIRTY WOUND ■ Traumatic wound from dirty source ■ Fecal contamination ■ Foreign body, Retained devitalized tissue ■ Operative wound w/ acute bacterial inflammation or perforated viscus ■ Presence of pus Eg: abscess drainage, pyocoele INFECTION RATE : 40 – 70 %
- 11. 5. Bite wound 6. Shot wound I. Mechanical: 1. Abraded wound 2. Punctured wound 3. Incised wound 4. Crush wound II. Chemical: 1. Acid 2. Base III. Wounds caused by radiation IV. Wounds caused by thermal forces: 1. Burning 2. Freezing V. Special 1. Based on the origin 8
- 12. Mechanical wounds 9 1) Abraded wound •Superficial part of the epidermal layer •Good wound healing
- 13. Mechanical wounds 2) Punctured wound Sharp-pointed object Seems negligible BUT Anaerobic infection Injury of big vessels andnerves 10
- 14. Mechanical wounds 3) Incised wound Sharp object Best healing 11
- 15. Mechanical wounds 5) Crush wound Blunt force Pressure injury Bleeding 12
- 16. Mechanical wound 6) Shot wound Close - burninjury Foreign materials 13
- 17. Mechanical wounds 7) Bite wound Crushed tissue Infection Bone fracture 14
- 19. Wounds caused by radiation Symptoms and severity depend on: Amount of radiation Length of exposure Body part that wasexposed Symptoms may occur immediately, after a few days, or even as long as months. 16
- 20. Wounds caused by thermal forces 17 1.) Burning 1st degree – superficial injury (epidermis) 2nddegree –partial or deep partial thickness (epidermis+superficial or deep dermis) 3rd degree – full thickness (epidermis + entire dermis 4th degree – (skin + subcutaneous tissue + muscle and bone)
- 21. Wounds caused by thermal forces 2.) Freezing - mild, - moderate, - severe (redness, bullas, necrosis) 18
- 22. Special wounds Exotic, poisonous animals Toxins, venom - toxicologist Skin necrosis 19
- 23. Superficial Partial thickness Full thickness Deep wound + bone, opened cavities, organs…etc. 3. Depending on the depth of injury 21