Puncture wounds in children can occur due to accidents. A variety of sharp objects are especially popular among children, including nails, pins, needles, buttons, as well as various pins, swords, skewers and others. Therefore, you need to be extremely careful and attentive to children.

Another reason for getting a puncture wound is a criminal situation.

In case of an accident, it is also possible to receive a puncture wound.

Most of these injuries occur on the extremities of children.

Symptoms

Puncture wound in a child, this is a round-shaped injury with smooth edges, which is characterized by minor bleeding. For the most part, signs of damage depend on how deep the puncture wound is, whether the wound channel is infected, whether the internal organs. In case of infection and in case of serious wound the child may feel:

• severe pain up to painful shock,
• temperature rise,
• chills.

Fainting, increased blood pressure, nausea and vomiting may occur. The child is scared and worried.

Diagnosis of a puncture wound in a child

To diagnose a puncture wound, doctors only need a visual examination. Diagnose the presence internal damage This is possible after determining the extent of the damage and requires a certain amount of time.

It is important to use all diagnostic methods, including x-ray, in order to identify fragments of piercing objects, which often remain deep in the wound. If any are found, they must be removed, as they can act as a source of severe infection.

A general and biochemical analysis blood, if necessary, the blood type is determined, and an x-ray is performed.

Complications

If medical care in case of injury is provided in a timely manner and by a qualified specialist, then severe consequences and complications can be avoided. The further prognosis largely depends on how significant the injury was and whether there was damage to internal organs, tendons and nerves. Most complications arise due to infection or failure to consult a doctor in a timely manner. These include sepsis, for example when a wound becomes infected. Also, a number of complications are associated with the depth of the wound and damage to certain organs.

The best prognosis is for small wounds when internal organs are not damaged.

Treatment

What can you do

If a child receives a puncture wound, first of all, it is necessary to provide him with first aid. This largely determines how quickly the wound will heal; the main thing is to prevent it from becoming infected. To do this, wash the damaged skin with soap and water, and then apply a sterile bandage with an antiseptic to the wound that does not irritate the surface of the wound.

If the penetrating object remains in the organ, under no circumstances should it be removed, as this can lead to infection of the wound and damage to internal organs.

After the first treatment of the wound, you should consult a doctor with your child.

If a prolapse occurs when the abdomen is wounded abdominal viscera, then they need to be wrapped wet bandage, while under no circumstances pushing them into the peritoneum. When transporting an injured child, you need to think about how to protect the injury from possible cooling and drying out. In case of injury to the sternum, a state of open pneumothorax may appear, which can be recognized by severe shortness of breath and a certain sound when air penetrates through a puncture wound. In this case, the wound must be covered with an airtight bandage, in which the dressing fabric is covered on top with oilcloth material, preventing the access of air.

What does a doctor do

Therapy for stab penetration depends on its significance, extent of damage, depth and the presence or absence of damage to internal organs.

If a child has a small puncture wound, then it is treated and thoroughly toileted. skin near the damage. After which antitetanus serum is necessarily administered.

If a puncture injury to the tissues of the distal limb with symptoms affecting tendons, nerves or arteries is obtained, surgical excision with expansion is necessary to identify the damage. Tendons and nerves are sutured, damaged arteries are ligated.

To prevent infection of the wound, it is immobilized. In the case of a puncture wound to the fingers and hand, the doctor will immobilize the limb. A plaster splint is usually applied. After which the immobilized limb must be suspended.

In the presence of puncture wounds of the neck, torso and proximal extremities, patients, even in the case of a satisfactory examination, are taken to the hospital for surgical treatment.

Prevention

Measures to prevent children from getting injured include special caution in their interaction with piercing and cutting objects. The responsibility of parents is to prevent dangerous games between children, as well as to provide good supervision to them not only at home, but also outside.

To protect your child on the road, you must use car seats. You should not leave small children at home alone; you must close the windows to prevent the child from falling out of the window.

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Arm yourself with knowledge and read a useful informative article about puncture wound disease in children. After all, being parents means studying everything that will help maintain the degree of health in the family at around “36.6”.

Find out what can cause the disease and how to recognize it in a timely manner. Find information about the signs that can help you identify illness. And what tests will help identify the disease and make a correct diagnosis.

In the article you will read everything about methods of treating a disease such as puncture wounds in children. Find out what effective first aid should be. How to treat: choose medicines or traditional methods?

You will also learn how untimely treatment of a puncture wound in children can be dangerous, and why it is so important to avoid the consequences. All about how to prevent puncture wounds in children and prevent complications.

And caring parents will find on the pages of the service full information about the symptoms of puncture wound disease in children. How do the signs of the disease in children aged 1, 2 and 3 differ from the manifestations of the disease in children aged 4, 5, 6 and 7? What is the best way to treat puncture wound disease in children?

Take care of the health of your loved ones and stay in good shape!

Stab wounds - injuries associated with damage to the skin, with penetration foreign objects into deep layers. Characteristic Features Such damage is that they are caused mainly by sharp objects (knife, pin, blade, fragments with sharp edges), and are shaped like a corner or a crack with smooth edges.

Identification of stab wounds

By the shape and depth of the wound, you can identify the nature of the damage and approximately determine what kind of object it was caused by. Wounds inflicted by a knife have a decent depth of penetration and a certain shape of the wound - pointed at one edge. A blow from a dagger leaves a wound with sharp edges on both sides. Blades and glass fragments usually cause superficial, sliding wounds with a shallow penetration depth and smooth edges. Penetration of an awl, a nail into soft fabrics(puncture wound) leaves a small, round hole with depth of penetration depending on the length of the object. Injuries can also be caused by ancient weapons, such as a spear or sword. The nature of such wounds is very serious, the wound is often through, with very wide edges.

Features of injury

Puncture wounds are generally considered less dangerous than wounds caused by wide, flat objects with cutting edges. The severity of the wound is determined by its location, depth of penetration, and size of the wound. Moreover, a wound inflicted along the elastic fibers is considered less dangerous than penetration across the fiber, which leads to greater blood loss. Wounds inflicted in the area of ​​the heart muscle, liver, kidneys, and spleen are considered especially severe and often incompatible with life. Penetration into hollow organs (lungs, intestines, stomach) is fraught with serious internal bleeding. But compared to gunshot and shrapnel wounds, stab wounds have the advantage of having no dead tissue around the entry hole. This significantly reduces the risk of wound suppuration, but does not completely eliminate it, for example, in case of intestinal damage, where there is a high probability of pathogenic microflora entering the general bloodstream and its subsequent infection. In some cases, the object itself can be a source of infection.

First aid to the victim

The main task is to correctly assess the condition of the victim, the nature of the injury received, a thorough examination for additional damage and take urgent measures. Assessment of the victim’s condition depends on the amount of blood lost and the degree of pain shock received. TO necessary measures refers to immediate stopping of blood and prevention of possible . Since first aid measures usually have to be provided to people who have little knowledge in this area, it is necessary to treat this matter with all responsibility. But in any case, if the victim’s condition is serious, it is necessary to call emergency help.

In case of a deep wound and heavy bleeding, a tourniquet is applied to the limb above the site of injury. The tourniquet should not be applied for more than an hour and a half; every forty minutes it must be loosened slightly.

After this, you should disinfect the wound by first rinsing it with clean warm water. Hands must be perfectly sterile; it is better to treat them with alcohol or potassium permanganate. Only after these manipulations is the tissue processed. This can be done using hydrogen peroxide, potassium permanganate, medical alcohol or vodka.

In case of a serious wound that causes unbearable pain, it is recommended to intramuscular injection analgin or baralgin.

Treatment of stab wounds

When treating wounds, they are divided into superficial wounds, cutting wounds and deep wounds penetrating deep into the muscle tissue:

1. Superficial incised wounds. Superficial wounds wounds caused by cutting objects are never sutured immediately, as an infection may remain in them, and re-opening of the seam is possible. In this case, temporary sutures are used or the wound is not sutured at all.
2. Puncture wounds. It is mainly necessary to check the wound for the presence of foreign bodies, taking into account that a small particle can be pushed out by the body on its own. But if the wound closes along with it, then suppuration is possible. The puncture must be constantly washed with hydrogen peroxide and treated with antibiotics. If the injury is not serious, then it is quite possible to get by with home treatment. Treatment of an injured foot requires special attention, because pathogenic microorganisms that can cause gangrene enter the puncture from the ground. The skin on the sole is relatively thick, and it is difficult to remove dirt from the wound. Therefore, before treatment, it is advisable to remove the top callous layer of skin.
3. Deep wounds. During the first phase of healing, it is necessary to maintain the sterility of the wound by constantly washing it with hydrogen peroxide. The edges should not be pulled together too quickly; unclean contents should be completely pushed out, otherwise there may be a risk of infection. The bandage should not be too tight or thick, otherwise the fluids will be reabsorbed.

In the second phase, when the risk of suppuration is over and the edges begin to shrink, it is necessary to help the regeneration process. Great fit various ointments on any water-soluble basis. U traditional medicine There are many recipes for similar compositions.

Folk remedies

Very interesting old recipe

You need to take one hundred grams pine resin, lard, beeswax. If the resin is hardened, you must first grind it into powder. Place all ingredients in a small container, melt and boil for 10-15 minutes, skimming off any foam that has formed on top. Cool, put in the refrigerator. Before applying a bandage with this mixture, the wound is washed with water and lime. A tablespoon of lime is slaked in a liter of water and left for several hours, after which it can be used.

The second recipe is no less effective.

Quicklime is poured halfway into the glass, filled to the brim with water, left for 5-6 hours, after which the top liquid is drained, leaving a thick sediment. You need to take an equal amount vegetable oil, heat for ten minutes, remove from heat, cool. Mix with the resulting lime residue and treat the wound with this mixture once a day, dressing the top.

Recipes for initial stage gangrene.

If the tissue around the wound turns black, the pain intensifies, there is fever throughout the body, weakness, this is a sure sign of gangrene. In this case, it is necessary to cover the affected area with moistened warm water cloth. It is necessary to take antibiotics internally, medicinal decoctions, a little alcohol (not in combination with antibiotics) will not hurt. If it is not possible to hospitalize the victim, it is necessary to cauterize the wound.

Powders for external treatment:

1. Coffee.
2. Charcoal.
3. Pounded rhizome of calamus.
4. Any antibiotics (streptocyte, furatsilin, etc.).

Several effective techniques

It is necessary to keep the affected limb very hot every day so that only the leg can tolerate it, strong solution potassium permanganate for at least an hour, after which thoroughly dry the surface and apply a breathable bandage. After two weeks there should be a noticeable improvement.

Old healers advise taking a little rye bread, coarse salt and chew it all thoroughly. Apply the resulting crumb to the gangrene in the form of a compress. It is worth noting that healing effect achieved only in combination with human saliva.

To avoid injuries, both accidental and intentional, it is necessary to take precautions at work and at home and avoid unnecessary conflicts. You should not rely too much on self-medication, because even the most insignificant wound can lead to sad consequences, and there are many such examples. Late request for qualified help may result in disability or even death.

Wounds are tissue damage with disruption of the integrity of the skin and mucous membrane caused by physical impact. Most often in everyday life there are cut wounds, for example, those caused by a knife. But there are also biting, puncture and other wounds.

Dangerous are bite wounds that occur in humans from the bite of a domestic or wild animal (less commonly, a snake). Typically, the damage zone of such damage is small, but they themselves can have significant depth. For such wounds, vaccination of the patient against rabies is indicated. Sometimes they penetrate through damaged skin or mucous membrane toxic substances, for example, when bitten by a poisonous snake. Puncture wounds are less common: a person can be pricked by a needle, twig, or thorn of some plant. Puncture wounds caused by a knife are especially dangerous, since large blood vessels and internal organs are often damaged. All accidental wounds are considered infected (there is a possibility of infection). A wound is uninfected or aseptic only when it is inflicted by a doctor, for example, during an operation or treatment of a patient.

What happens with puncture and incised wounds?

With cut wounds, the damaged area usually hurts and often bleeds. With a minor injury, as a rule, only the smallest blood vessels of the skin - capillaries - are damaged. With a deeper wound, damage to veins and arteries may occur. In such cases, the patient may become bleeding, so his life is at risk. Due to a profusely bleeding wound, acute anemia or shock may develop.

In addition, when a wound occurs, there is always a risk of infection with various diseases, for example, tetanus, which is manifested by periodic general convulsions. This life-threatening disease is caused by clostridium toxins (from the Latin clostridium tetani). When bitten by an animal, you should always expect that an infection may set in.

How to treat?

Treatment of incised wounds is carried out in different ways. It depends on the nature of the damage. Sometimes the consequences of incorrectly provided assistance can be very dire. For minor damage, no special means it is not necessary, for example, by scratching the skin or pricking yourself with a needle; just let the blood flow out, and the wound will quickly heal. Sometimes additional measures need to be taken.

Do not clean or rinse the wound with disinfectants, such as iodine. If a foreign body gets into the wound large sizes, in no case should it be removed, since it serves as a kind of “plug” - the wound should be tied up and try to maintain the position of the foreign body in it.

If the wound is significant, bleeding, or caused by a bite, you should always consult a doctor.

If the wound is deep and gaping, the doctor will first remove it from the wound. foreign bodies(of course, if there are any), he will clean it and connect the edges by applying sutures, and possibly apply fixatives. Puncture wounds are treated in a similar way. If the injuries are serious, the patient should be treated in a hospital. If the wound is deep, or soil or metal particles have entered it, a tetanus vaccination is recommended. When an animal is bitten, a rabies vaccination is given. Depending on the nature of the wound, the doctor may apply a compression bandage. If arteries are damaged, the limb must be elevated to stop pulsating bleeding.

Due to the fact that the skin regenerates well, scratches and damage to the skin of young people usually heal very easily and quickly. When suturing a deeper wound, efforts are made to ensure that the edges are even, so usually no scars are left. A doctor should monitor the healing of the wound. He will remove dead tissue, and if inflammation threatens, he will take preventive measures.

Arterial bleeding

Abundant arterial bleeding from the neck armpits It is life-threatening and must be stopped as soon as possible. For this bleeding blood vessel you need to press it with your finger and hold it in this position until the doctor arrives!

These wounds of the hand constitute the main group of open injuries and are very diverse in severity of damage, course and consequences. More than half of them do not require surgical treatment and heal under an aseptic dressing while maintaining cleanliness and rest of the wound.

Skin abrasions and excoriations

The term “excoriation” combines damage with damage to integrity surface layers skin, and under the abrasion - all layers of skin. IN everyday practice abrasions of the hand occur much more often than are recorded. Excoriations and abrasions on the hand occur during tangential, sliding, tearing movements, more often on the back than on the palm side. It is enough to recognize them short story and inspection.

Most abrasions can be treated without a doctor, so it is necessary to promote prevention and teach proper self-help. Providing surgical care, after appropriate treatment of the skin with one method or another (see page 18), the abrasion can be powdered with a biological antiseptic, covered with MK-6 or BF-6 glue and injected with anti-tetanus serum. Average duration Treatment of victims with hand abrasions - 3-5 days. Complications after abrasions are rare. Several cases have been reported subcutaneous panaritium, paronychia and traumatic arthritis of the proximal interphalangeal joint from an abrasion on the back above the distal interphalangeal joint.

Each industry has its own causes and characteristics of hand injuries, depending on which the severity of tissue damage and the course of the wound process vary different character.

Cut and chopped wounds

The combination of cut and chopped wounds is somewhat arbitrary, since a cut wound is characterized by smooth, uncrushed edges and a bottom, while with a chopped wound these features may be absent. The mechanism of cut and chopped wounds in most cases is associated with contact of the hand with a sharp, rapidly moving hard object or impact with sharp objects.

Rice. 117. Chopped wound distal phalanx Third finger of the left hand.

Cut wounds on the back of the hand often penetrate into the joints: cut wounds are complicated by flaws in the fingertips and damage to the nails. A vocational school student, Ch., while hewing a board, used an ax to cut off a nail on the third finger with adjacent tissues (Fig. 117). An hour later, in the trauma room of the clinic, the wound was treated, a suture was applied to the cut nail bed, the wound was powdered with streptocide and covered with an aseptic bandage. Healing after 12 days. The nail plate grew into a regular shape after 5 weeks. Was incapacitated for 6 days.

It is more advisable to speed up healing and protect the wound of the nail bed from infection, if the nail plate is intact, clean it of soft tissue, treat it with furatsilin, carefully place it under the nail fold and fix it with 1-2 sutures from fishing line or other synthetic thread. Cut and chopped wounds are characterized by burning pain, profuse bleeding, rapid gluing of wound edges. The course of cut and chopped wounds depends on the severity of the wounding object, the infection introduced, the functional significance of the damaged tissue, first aid and subsequent treatment. An incised wound is easier than others to turn into a clean surgical wound and heal by primary intention. With incised wounds, there are conditions for a delayed secondary suture; even infected cut wound often heals without complications. Complications are observed in 0.5-3%. The average duration of treatment is 7-8 days.

Puncture wounds are inflicted with a pointed object (needle, awl, glass) or a blunt object (nail, bone, pencil tip, sliver) with rapid movement of the hand. Puncture wounds are most commonly seen on the fingers, then on the metacarpus, and least often on the wrist. Puncture wounds are characterized by pain, minor bleeding, rapid gluing of the edges and gradually developing infection. With puncture wounds inflicted with an aniline pencil, aseptic tissue inflammation and necrosis develop along the wound canal. The course of puncture wounds varies depending on the infection, the depth of the wound, the presence of a foreign body and the quality of first aid and treatment.

Choice correct method Treatment of puncture wounds presents some difficulties. Is it necessary and in what cases to cut and excise puncture wounds? We adhere to the following principles. Fresh puncture wounds with a foreign body remaining in the wound are excised, the foreign bodies are removed, the wound is turned into an operating room and sutured. Puncture wounds of the hand caused by obviously contaminated objects are dissected and treated like infected wounds. Puncture wounds caused by relatively “clean” objects are treated conservatively (skin and wound treatment, observation). Puncture wounds are more likely to be complicated than others inflammatory processes in surrounding tissues. Outcomes after puncture wounds are worse than after cutting wounds. Complications are observed in 1-4%, the average duration of treatment is 9 days. When, during first aid, after cleaning the skin, the epidermis overhanging the puncture wound is removed and cryotherapy is applied, the number of complications is halved and the duration of treatment is reduced.

Bruised and lacerated wounds

This is the most common species open injuries arising from a blow, compression, jerk, fall, etc. Bruised lacerations often occur on the fingers, less often on the metacarpus and wrist; equally often on the back and on the palm. For the bruised lacerations characterized by uneven, bruised edges, wrinkled, elongated, crushed tissues, skin imperfections, light bleeding, aching dull ache, often a complicated course.

The principles of treatment of bruised and lacerated wounds of the hand are the same as those previously stated, but they are more difficult to convert into clean wounds, therefore, a primary suture is applied less often and a secondary suture is more often applied.

However, in all cases when victims seek help and the surgeon has the appropriate conditions for the operation, primary surgical treatment of bruised wounds is performed as a rule.

A 16-year-old vocational school student pinched her index finger right hand in a vice. At the health center, the circumference of the wound is smeared with iodine and applied aseptic dressing. Half an hour later at the trauma center: cleaning the skin of the hand, conductive anesthesia at the base of the finger, surgical treatment of the wound.

To close the wound, pieces of skin lying loosely in the wound were used (Fig. 118). The wound is powdered with streptocide, a tile-shaped pressure bandage is applied, and the finger is immobilized.

Rice. 118. Bruised laceration wound index finger right hand.
a - type of wound before treatment; b - a developing scar after 2 weeks.

Rice. 119. Extensive bruised and lacerated wound of the right hand.
a - view of the wound from the palm; b - from the side of the thumb.

Dressing on the 8th day - the grafts have taken root; UFO, aseptic dressing. On the 10th day, the victim began work on a professional sick leave certificate.

The second observation concerns 38-year-old washerwoman B., who received a glancing blow to her right palm with a drum blade. Half an hour later delivered to surgical clinic. The victim is very excited, dejected and, although she does not feel acute pain, cannot move his fingers.

There are no symptoms of shock, bone loss or bleeding. The patient was injected with 1.5 ml of a 1% pantopon solution, 1500 AE of antitetanus serum, and given ether anesthesia. After cleaning the skin, it was discovered: a bruised laceration wound begins on the dorsal-ulnar surface V metacarpal bone, its distal edge runs slightly obliquely along the palm at the base of the V-IV-III-II fingers, the proximal edge - at the level of the wrist skin fold from the radial styloid process to the styloid process ulna(Fig. 119).

A flap of skin with subcutaneous tissue, palmar aponeurosis, vessels and nerves are detached to the first finger and are supported by a skin bridge 2 cm wide at the base of the thumb. In the depths of the wound there are bruised, partially torn hypothenar and thenar muscles and fatty tissue. The integrity of the great vessels, nerves and tendons is not damaged. Surgical treatment of the wound was performed; the flap is processed, placed in place and sewn with single, dense horsehair sutures. Pressure aseptic dressing, dorsal plaster splint, scarf. Due to home circumstances, the victim categorically refused hospitalization. The wound healed by primary intention. After 2 weeks the patient could move her fingers. Electric massage and dry air baths were prescribed. The patient left Leningrad after 2 weeks.

Associated infection, the extent and depth of tissue damage require skillful complex treatment bruised and lacerated wounds, since they exhibit general and local complications: necrosis of skin and tendons, retention of discharge, phlegmon, inflammation of tendon sheaths, periosteum, bones and joints.

Complications were observed in approximately 5-8% of victims, adverse consequences- 1.5%. The average duration of treatment is 14.5 days.

Bite wounds

They are most often caused by domestic animals (dog, cat, horse, pig) - in 74.2%; less often by other representatives of fauna (rats, snakes, fish, etc.) - in 13.8%; by humans - 3%, and 9% of victims, the cause was not specified. Of the 10 bite wounds, 9 are localized on the fingers and only 1 on the proximal parts of the hand. These wounds are characterized by small one or two entrance holes and crushed tissue in depth; they are applied with fangs. A different nature of the wounds is observed when not individual teeth, but the jaws of the animal close: the victim strives to free his hand - then they resemble lacerated or scalped wounds. Back surface the brush is often bitten by small insects (mosquitoes, wasps, bees, ants); they are not counted as wounds, but the poison released causes itching and swelling of the dorsum of the hand, for which patients come in. Poisonous snakes bite mainly on the finger, less often on the hand (when picking berries, mushrooms, etc.).

When treating bite wounds, we must not forget about the need for specific therapy against rabies and tetanus; it is more advisable to introduce serum even in the absence absolute readings rather than abstain and expose the victim to the risk of tetanus or rabies.

Treatment of bite wounds is based on the generally accepted view of them as wounds infected with virulent microorganisms. It is necessary to promote the need in every possible way immediate appeal the victim to the doctor.

Bite wounds such as puncture wounds, after disinfection of the skin and anesthesia, are dissected, drainage is ensured, and the wound is prepared for a secondary suture. Bite wounds in the form of lacerations and crushed wounds are treated after disinfection of the skin and anesthesia: non-viable tissue is excised, the outflow of discharge is ensured, the edges of the wound are brought together with an adhesive plaster and bandage. The wound is closed with provisional sutures only if the surgeon is confident in the successful course of the wound process and can observe the patient in order to notice complications in time.

For bite wounds, despite their insignificance, immobilization of the hand is necessary, and in some cases ( severe pain, swelling, inflammatory phenomena) and a hand abduction splint.

The course of bite wounds is often complicated general reaction the body and the development of local infection with leaks of pus, tissue necrosis, inflammatory processes in the joints, tendon sheaths, periosteum and bone. Complications of a trophoneurotic nature are also observed.

Citizen N. was bitten by a cat about three years ago. The wound on the back of the right hand, above the metacarpophalangeal joint of the third finger, festered and healed slowly. The hand remained swollen with bluish spots. Then itching, aching pain and difficulty moving the hand appeared. The patient was periodically treated with physiotherapeutic and homeopathic remedies, but the improvement did not come for long. We performed paravertebral intradermal blockade with novocaine (0.5 x 50 ml) three times on N. There was a significant improvement: there was no more itching, swelling and cyanosis decreased, movements became freer. The results of treatment were monitored for six months. Complications from bite wounds were observed in 8-11%, adverse consequences - in 4%. The average duration of treatment is 15 days.

E.V.Usoltseva, K.I.Mashkara
Surgery for diseases and injuries of the hand

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A puncture wound is a damage to the skin with a violation of its integrity, caused by a nail, sharpening, an awl, or a knitting needle, in which the depth of the wound is significantly greater than its surface. The entrance of the wound opening is small, with neat clear boundaries, round in shape.

It seems that the wound poses no danger to the victim, but this is not the case. The damaging weapon often penetrates internal cavities, touches important organs, and damages blood vessels, which leads to serious consequences and complications.

Types of puncture wounds

A single stab wound occurs in rare situations. In accidents, motor vehicle accidents, industrial or man-made disasters, these wounds occur together with fractures, traumatic brain injuries, lesions of the chest, pelvic organs, and so on.

According to the depth of damage, wounds inflicted by a long sharp object are divided into: through and blind. Often, especially in rural areas, there is a puncture wound of the foot resulting from accidentally stepping on a nail.

Puncture injuries also occur:

• With penetration into the organ cavity;
• Without penetration into internal organs.

According to the presence of complications, puncture wounds are:

• Complicated by severe blood loss;
• Complicated by organ prolapse.

The specificity of the injury will depend on where the piercing object occurred. Despite the fact that the victim’s condition remains satisfactory, and the entrance hole small size, such injuries should be treated with high vigilance.

Particular attention should be paid to:

• When striking with a sharpening, the depth of damage can be 20 cm or more;
• A blow with an awl leaves a wound channel of 10-12 cm;
• The metal pin penetrates through the cavities.

It is also necessary to take into account the angle and direction of the impact. For example, if an injection with a weapon is applied to the stomach from below in an upward direction, not only the liver, stomach, spleen, but also the organs lying in the stomach are damaged. chest. A wound entrance located similarly, but applied at a different angle, can damage the kidneys and bladder.

Symptoms of puncture wounds

The entrance to the puncture wound is round in shape with clear boundaries. When the traumatic instrument remains in the wound, its edges are directed inward. Stab wounds leave a hole in the form of a slit or a triangle, bleeding is insignificant.

Other symptoms depend on location and what type of anatomical structures affected.

Signs of a puncture wound:

• Weakness, chills, anxiety;
• Tachycardia, decreased blood pressure;
• Nausea, dizziness.

Fainting and weakness indicate internal cavities. Increasing shortness of breath indicates that the lungs are damaged, hemo- and/or pneumothorax is possible.

With strong pain develops pain shock . In the first phase of this state, excitement occurs, the pulse quickens, and cold sweat, breathing quickens, pupils dilate, while the victim screams loudly and makes sudden movements.

This phase passes after about 15 minutes and the inhibition stage begins. In this case, the victim loses consciousness, turns pale, his lips and nails turn blue, muscle tone, temperature, breathing, and blood pressure decrease. The victim requires emergency assistance.

First aid for puncture wounds

For a stab wound, first aid is provided in stages. First, you should then disinfect the wound entrance to prevent infection.

The first step in providing assistance is to isolate the wounded surface using a bandage. If this is a through wound, then both holes need to be treated and bandaged: both the entrance and the exit.

In case of external bleeding, one of the ways to stop it is used: either twisting, pressure bandage or perform tamponade of the wound cavity.

When the victim shows signs internal bleeding, apply an ice pack or a container of ice water to the wound.

If a traumatic instrument remains inside the wound, it must not be removed so as not to increase bleeding. The object should be fixed on the surface.

Related articles

Fixing an item

Rules for fixing a traumatic weapon:

If the lung is damaged and pneumothorax is suspected, the victim should apply a sealing bandage in order to eliminate the message pleural cavity with the surrounding air.

Occlusive dressing

Algorithm of actions when applying an occlusive dressing for a puncture wound:

• Any airtight material can be used - rubber, oilcloth, polyethylene, adhesive plaster, wax paper;
• A sterile napkin is applied to the wound, then a sealing layer;
• The material should be applied while the victim is inhaling;
• To better adhere the product to the skin, lubricate the area around the lesion with Vaseline;
• Tape the rubberized fabric tightly to the surface.

All actions must be performed quickly, before the victim gasps for air..

While applying the bandage, the person should sit half-sitting, put support under his back, and the person should remain in this position until the ambulance arrives.

Treatment after first aid

Victims with puncture wounds without affecting internal organs are hospitalized in the trauma department. At various violations the person is referred to the appropriate specialized departments: thoracic surgery, cardiology, urology, neurosurgery, thoracic department. Surgeons provide treatment.

An uncomplicated wound is subject to primary surgical treatment, which the doctor does under local anesthesia.

The wound is washed with a 3% solution of hydrogen peroxide and furatsilin. The wound canal is examined with a special probe, contaminated lesions are excised, and then the tissue is sutured. For better outflow, drainage must be installed. The drainage can be removed 1-2 days after surgery, and the sutures are removed after a week or 10 days.

For minor injuries, treatment of puncture wounds after surgery can be outpatient. Patients are prescribed antibiotics and physiotherapeutic procedures. Conservative treatment also includes pain relief, vitamin therapy, and the use of immunomodulators. The patient comes to the hospital only for bandaging once every 2-3 days.

When internal organs are affected by a puncture wound, appropriate abdominal surgery. If the patient develops painful shock, surgical treatment contraindicated until the person is brought out of this state.

After stabilization general well-being carried out symptomatic treatment and surgical surface treatment.

The dangers and complications of puncture wounds

Complications after a puncture attack are early and late:

• Early– bleeding, damage to organs in cavities, traumatic, painful, hemorrhagic shock.
• Late- this is secondary bleeding, the accumulation of fluid in internal cavities, in which there is a danger of suppuration. In such conditions, it is imperative to ensure the evacuation of wound exudate from the cavity.

Among serious consequences As a result of receiving a puncture wound, the following can be noted: