Soft Tissue Injuries:

The Skin:

• Best be described as the skin and subcutaneous layers.

• Largest organ of the body.• Epidermis - outermost layer consists of

dead cells constantly being rubbed off & replaced.

• Dermis - second layer containing sweat glands, sebaceous glands, hair follicles, Blood vessels, and nerve endings.

• Subcutaneous Tissue - innermost layer composed of fat that serves as a body insulator and shock absorber.

Functions of the Skin:

• Water balance.

• Temperature regulation.

• Excretion.

• Shock absorption.

Closed Soft Tissue Injuries:

• Characterized as a wound beneath the unbroken skin.– Contusion.– Hematoma.– Crush injury.

Contusion:

• Bruise

• Epidermis remains in tact.

• Injury to cells and blood vessels in the dermis.

• Localized pain & swelling at the site.

• Blood accumulation in surrounding tissue causes discoloration. (Ecchymosis).

Hematoma:

• Similar to contusion.

• Involves damage to larger blood vessels.

• Larger amount of tissue damage.

• Shock can result due to blood loss.

Crush Injuries:

• Crushing forces applied to body.

• Can cause internal organ rupture.

• Internal bleeding may be severe resulting in hypoperfusion.

Emergency Medical Care:

• BSI.

• Assure airway and Oxygenation.

• Treat for shock.

• Splint painful, swollen, deformed extremities.

• Transport.

Open Soft Tissue Injuries:

• The skin has been opened exposing the tissue beneath.

• Risks.– Possible contamination.– Infection.– Indicator of more serious injury/fracture.

Types of Open Soft Tissue Injuries:

• Abrasions

• Lacerations

• Avulsions

• Punctures/Penetrations

• Amputations

• Crush injuries

Abrasions:• Epidermis is damaged by

scraping, rubbing, or shearing forces.

• Considered superficial injury.• Painful due to exposed nerve

endings.• Blood will ooze from wound

(capillary bleeding).• Road rash.• Infection, contamination, &

potential for underlying injury.

Lacerations:

• Break in the skin of varying depth.

• May be linear, smooth edges.

• May be stellate or jagged edges.

• Caused by forceful impact with sharp object.

• Bleeding may be severe.

Avulsions:

• Flaps of skin or tissue are torn loose or pulled completely off.

• Replace flap carefully in place and apply large bulky dressing and bandage in place.

Amputations:

• Involves the extremities and other body parts.

• Bleed may be massive but in most cases, very little bleeding occurs.

Penetrations/Punctures:

• Caused by sharp pointed object.

• May be no external bleeding.

• Internal bleeding may be severe.

• Exit wound may be present.

• EXAMPLES– Gunshot wound.– Stab wound.

Crush Injuries:

• Damage to soft tissue and internal organs.• May cause painful, swollen, deformed

extremity.• External bleeding may be minimal or

absent.• Internal bleeding may be severe.