From this topic you willl be able to cover Laceration and A short study on VRANA according to ayurveda Very helpful for BAMS student Hope you like and share it

1. LACERATION
INJURY
Presented by : AbhinayKureel
(BAMSSTUDENT)

2. CONTENT:
 DEFINITION
 CAUSESOFLACERATION
 MECHANISM
 TYPES
 SIGNSANDSYMPTOMS
 STAGEOFLACERATION
 COMPLICATION
 TREATMENTANDPREVENTION
 ANTI-MORTEMAPPEARANCE
 POST-MORTEMAPPEARANCE
 MEDICO-LEGALASPECT
 VRANAA/CTOAYURVEDA

3. DEFINITION :
LACERATIONS ARE TEARS OR SPLITS OF SKIN MUCOUS
MEMBRANE MUSCLE OR INTERNAL ORGANS PRODUCED BY
APPLICATION OF BLUNT FORCE TO BROAD AREA OF THE
BODY, WHICH CRUSHED OR STRETCHED TISSUES BEYOND
THE LIMITS OF THEIR ELASTICITY .
THEY ARE ALSO CALLED AS TEARS OR RUPTURES.

4. CAUSES OF LACERATION :
They are caused by blows from blunt objects, by falls on
hard surface ,by machinery ,traffic accidents , etc.
SOURCES :
1. Sharp Objects : Includes knives, Broken glass, scissors or any object with sharp
edge
2. Sports Injuries : Without wearing proper protective gear can lead to laceration e.g
cuts from sports equipment , collision or falls
3. Animal bites or scratches : Particularly dogs or cats scratches from them may
require medical attention
4. Accidental Cuts : Whille handling broken glassware or sharp objects can lead to
unexpected laceration if caution is not exercised
5. Accidental Fall : A fall can result in laceration when someone stumbles onto sharp
or jagged surface such as the edge of furniture of abroken object.

5. MECHANISM :
When the skin or other structures are subjected to blunt
forces, the tissue gets crushed or stretched beyond the limits
of their elasticity leading to tearing of the skin or other tissue
thus producing laceration. Laceration differs from the incised
wounds because in laceration, the continuity of the tissues
is disrupted by tearing rather than clean slicing.

6. TYPES OF LACERATION :
1. Split laceration
2. Stretch laceration
3. Tear laceration
4. Avulsion laceration

7. SPLIT LACERATION :
Splitting occur by crushing of the skin between two
objects.
o Also called as incised looking laceration
o These types of laceration are found usually in body parts
with underlying bones without much tissue in between
o Due to splitting of skin the laceration appear like incised
wound

8. STRETCH LACERATION :
• Over stretching of the fixed skin till its ruptures.
• In such type of lacerated wound there is localized pressure with pull
that causes tearing of the skin .
• Thus a pulling force cause stretch laceration.
• These laceration are superficial and multiple mostly located at groins.
• They are present in Road accident victim when body part (Usually
thigh or abdomen is run over )
• The crushing weight of vehicle”s Wheel provides the pulling and
stretch of skin

9. AVULSION LACERATION
• Also called as flaying injury or grind laceration
• Avulsion laceration occur due to grinding compression of the tissue to
such an extent that the skin gets detached from the deeper tissues thus
resulting in de-gloving of skin ,
• Such as lorry wheel passing over a limb may produce separation of skin
from underlying tissue (avulsion) over a relatively large area this is called
“Flaying”
• Avulsion of scalp is also caused by traction from hair being trapped in
machinery

10. TEAR LACERATION :
• It is common form of laceration.
• Tearing of the skin and tissues can occur
from impact by or against irregular or semi
sharp objects such as door handle of a car
or fall over a rough projected object
• A tear is deeper at the starting point than
at termination

11. CUT LACERATION:
o Produced by a heavy relatively sharp –
edged instrument such as axe.
o In an impact over the scalp external
laceration may not occur due to the hair
but inner layer of scalp may be laceratic

12. SIGNS AND SYMPTOMS :
 VISIBLE CUT OR TEAR IN THE SKIN .
 BLEEDING – SEVERITY OF BLEEDING CAN VARY DEPENDING ON DEPTH AND SIZE OF LACERATION.
 PAIN – PAINFUL ESPECIALLY IF THEY ARE DEEP OR INVOLVE NERVE ENDINGS
 SWELLING AND INFLAMMATION : SURROUNDING AREA MAY BECOME SWOLLEN,RED & WARM TO TOUCH.
 TENDERNESS
 LOSS OF FUNCTION OR LIMITED RANGE OF MOTION : IF THE LACERATION AFFECTS UNDERLYING STRUCTURES
LIKE TENDONS , MUSCLES , NERVES IT MAY RESULT IN LOSS OF FUNCTION OR RESTRICTED MOVEMENT IN
AFFECTED AREA .
 NUMBNESS AND TINGLING SENSATION.
 DEFORMITY :ESPECIALLY THOSE THAT EFFECT BONES OR JOINTS.

13. STAGEOF LACERATION:
TIME CHANGES
Intially Bleeding
After 12-24Hr clotting
After 18-36 Hr Pus formation
After 1-2 Week Granulation Tissue
After 4-8 Week Healing of fractures

14. COMPLICATION
 LACERATION OF AN INTERNAL ORGAN MAY CAUSE SEVERE OR EVEN
FATAL BLEEDING. MULTIPLE LACERATION , INVOLVING THE SKIN &
SUBCUTANEOUS TISSUE EACH CAUSING SOME HAEMORHAAGE
 INFECTION – ACT AS PORTAL OF ENTRY FOR BACTERIA
 IF IT IS LOCATED WHERE SKIN STRETCHES OR WRINKLED, BLOOD
MAY CAUSE IRRITATION AND PAIN

15. TREATMENT AND PREVENTION
Immediate First aid - Apply direct pressure to the wound using a clean
cloth
Elevate the injured limb , if possible to help reduce blood flow to the area.
Avoid scrubbing the wound vigorously
IF laceration is deep involve vital body parts like the face or significant
blood vessel seek medical help
Clousre and wound case : Cleaning Regularly The wound , applying
antibiotic ointment & changing dressing
Pain – Management : Over the counter pain reliever like acetaminophen or
ibuprofen can help alleviate discomfort associated with laceration

16. PREVENTION OF INFECTION :
Keep wound clean and dry .
Cover the wound with sterile dressings or
bandages to protect from dirt.
Teatanus vaccination : Ensure your
tetanus vaccination is upto date especially
if laceration caused by contaminated
object.

17. ANTI-MORTEM APPEARENCE OF LACERATION
Generally it refers to the physical characterstics and
appearance of laceration that occurred prior to person’s
death .
When a laceration is observed and evulated it is important
to determine it occurred before or after death.

18. FACTORS CONSIDERED :
 Tissue characterstics : Anti – mortem laceration often display characterstics that
indiacate vitality and response to injury such as bleeding,inflammation and
signs of healing.
 Surrounding tissue damage : When laceration occur while alive, it typically
causes additional trauma to the surrounding tissues.
 Blood flow : Anti-mortem laceration generally evidence of blood flow i.e
blood was circulating at the time of injury.
 Cellular & molecular changes : There may be signs of tissues repair, such as
presence of inflammatory cells or cellular response consistent with healing
such as collagen deposition

19. POST MORTEM APPEARENCE
Lack of bleeding : one immediate difference in a post-mortem laceration is
that it will not bleed so there will be no active bleeding once the injury
occur.
Tissue change :. The surrounding tissue may become gradually discolored
, swollen and softened this process may affect the overall appearance of
the laceration
Lack of vital sign : A post mortem laceration will not carry any associated
vital sign that are typically present in living indivisuals , such as heart rate ,
BP or pain response.

20. MEDICOLEGALIMPORTANCE
 Cause of injury can be known
 Type of lacerated wound may be known
 Age of injury can be estimated
 Direction of application of force can be known
 It can be known whether the injury is accidental or sucidal or homicidal
 Foreign bodies present in wound may help in identification of the offending weapon /
place of incident etc.

21. VRANA
A/C TO
AYURVEDA
NIRUKTI
Definition : Always There is a scar after healing of a wound
which remains throughout life is called vrana
Breaking of body into fragments.
There is discolouration of body due to vrana
“Gatra” Means Tissue(Body tissue or part)
“Vichurna” Means Destruction , break, rupture and
discontinuity of body or tissue is called vrana

22. CLASSIFICATION OF VRANA
• On Basis of origin :
• NIJA VRANA
• AGANTUJ VRANA
• On basis of Avastha :
• 1)Dushta Vrana
• 2) Shuddha vrana
• 3)Ruhyaman vrana
• 4) Rudha Vrana
Nija vrana : These appears due to vitation of vata,pitta,kapha,Rakta and saniipataj separate with its
combination
Agantuj vrana: These are all the external factors when may cause injury to the body , here the vrana
appear due to the injury by the above factor (external force) later on dosha involve

23. Vrana vastu (Vrana Adhisthan) : Twacha ,sira,snayu,asthi,sandhi,koshta and
marma where the vrana develops
Stages of vrana : [NIJA VRANA]-(Imbalance of
dosha)
Dushta vrana : All the nija vrana are dushta from
initial but against vrana become dushta later
according to involve dosha.
Suddha vrana : (Healthy Wound)
The vrana which is soft ,smooth,color like tongue
painless,clear margins & without discharge are
called as shudda vrana.

24. Ruhyaman : (Healing wound)
The healing wound have color like pigeon , no discharge
firm and full of granulation tissue , yellowish coloured
wound .
Samyak rudha vrana : (Healed wound)
The healed wound must not have swelling,no
granulation,no sign of inflammation , no pain , the color
similar to surrounding skin & scar is flat no elevation
from body surface.

25. DUSHTA VRANA SUDDHA VRANA
RUHYAMAN VRANA SAMYAK RUDHA VRANA

26. Agantuja vrana : [Sadhyo Vrana] : The sudden injury by any sharp objects
having various shape , blade (Sharp or Blunt) When causing trauma leads to
different types of surgical wounds are considered as sadhyo vrana
CLASSIFICATION OF SADHYO VRANA :
Chinna : The wound occurred by the wide , curved or
straight object causing injury.
Bhinna : The wound created by very sharp object like
tip of sward etc. leading to puncture called as bhinna
injury
Viddha : The small sharp object when give penetrating
injury to the body then it is called as viddha injury

27. Kshata : The wound created by the blunt objects called
as kashata vrana MAY BE CALLED AS LACERATED WOUND
Pichchita : Injury by heavy objects leading to crush that part
with bone & muscles and wound appeared mixed with blood
called as pichhita vrana may be co related as crush injury
Dhrastha : The injury created by strong rubbing force
leading to expose the underline tissue and discharge of
serous called as dhrastha vrana.

28. CHINNA BHINNA Viddha
Kshata PICHCHITA DHRASTHA

29. VISHESH CHIKITA OF AGANTUJ VRANA
CHINNA Vrana sodhana,bandhana
BHINNA Sodhana Ropana , Raktsthambana
VIDDHA Remove retained foreign body after that insert
medicated oil
KSHATA Raktsthambana and bandhana
PICHHITA Seet leepana
DHRASTHA Kashay aushad for pain relief

30. Ayurvedic therapies for vranna management :
Sutika Abhyanga : Gentle masagge with herbal oil around the wound
Pratisarana : Topical application of medicated pastes or oils to clean the
wound
Herbsandmedicinesfor vranahealing:
Neem : Antibacterial , antifungal and wound healing properties
Turmeric : Anti-Inflammatory , Anti microbial and anti-oxidant effects
Aloe Vera : Soothes and promotes healing , Reduces the inflammation
Dietary & Lifestyle consideration :
Nutritious Diet : Rich in vitamin to aid healing
Adequate hydration : Drink Sufficient water to maintain hydrated & support the
regeneration

31. “A Laceration may leave scars,but it reminds us of our
strength to endure and overcome”