A wound is a break in the continuity of the skin, the break caused by violence or
trauma to the tissue. Types of wounds include abrasions, punctures, perforations, and
lacerations. A laceration, which is our concern here, is a torn, jagged cut that has gone
through the skin tissues and the blood vessels. Such a wound may have been made by
a blunt instrument such as the fragments of a shell. A laceration may be very dirty and
require cleaning. If only the epidermis layer of skin is involved, there will be no
bleeding. If the dermis layer of skin is involved, there will be bleeding. A laceration may
require wound closure and suturing. Look at the four major types of lacerations.
a. Sheer Laceration. This type of laceration is caused by a sharp object such
as a knife blade or the edge of glass.
b. Tension Laceration. In a tension laceration, the skin strikes a flat surface,
thus ripping because of the tissue stress caused by the impact. There is no bone
directly below the region of the skin that is struck. Instead, there is contusion (bruising)
of neighboring soft tissues. A tension laceration heals with more scarring than a
c. Compression Laceration. A compression laceration occurs when the tissue
is caught between a bone and an external hard surface. The skin bursts, often causing
a stellate (star-shaped) patterned wound to occur. There is a marked degree of injury
adjacent to the laceration itself. This type of laceration heals the most poorly and with
the greatest degree of scarring.
d. Combined Laceration. Combined lacerations have the characteristics of
both sheer and compression lacerations. An example of such an injury is the resultant
injury when you walk into the corner of a desk and your hip bone hits that desk corner.
If a laceration occurs, it will probably be a linear wound with wound edges that are
crushed; in other words, a combined laceration.
Wound healing is a continuous process which begins at the time of injury. The
process of normal healing can be divided into three phases: inflammation, repair, and
a. Inflammation. The process of inflammation begins within minutes following a
laceration. An increased blood supply with edema and engorgement of surrounding
vessels accounts for the inflammatory appearance.
b. Repair. A healthy patient with optimal wound care can expect a semblance
of order in the wound to appear on the third day. The cellular and chemical activity
during this phase results in "granulation tissue." Although signs of inflammation subside
successively during this phase, the wound remains red, raised, and often itchy.