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Chapter 7. WOUNDS AND WOUND INFECTION

7.1. Types ofwounds

A wound is an injury to the skin or mucous membrane of any area and depth with violation of the integrity of the main barriers of the body - mechanical and biological, which separate it from the environment. This prompts disorders of vital activity; these disorders can be divided into local (tissue changes in around the wound), regional (reflex reactions, vascular and neurologic disorders within the injured segment) and general disorders (shock, endotoxicosis).

Classification of wounds. Wounds are classified by a number of signs:

► according to the cause: surgical, accidental (traumatic), and combat related (gunshot, mine blast injury);

► accoding to their quantity (single, multiple);

► according to anatomic localization (head, neck, chest, abdomen, pelvis, limbs);

► type of injured tissues (soft tissue wounds, cerebral trauma with injury to the brain substance, osseous imjury with open fractures, wounds with injury to blood vessels, nerves, tendons);

► nature of the wound canal (blunt, perforating, tangent, penetrating and not penetrating a body cavity);

► structural features - stab wound (usually with a deep canal), cut wound (with smooth edges), degloving wound (superficial wound with separation of skin and subcutaneous tissue), chopped (significant traumatization of skin edges), bruised (torn, crushed), bite wound (contaminated with specific microflora or poison), and mixed (for example, chopped and cut, torn and degloving).

Gunshot wounds are a separate category characterized by severity of injuries due to the impact on the tissue of significant kinetic energy of the projectile and the shock wave.

Features of gunshot wounds. Wounds are formed as a result of a firearm shot (from improvised, hunting or combat weapon), as well as exploding mines and ammunition.

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