Definition

What is an open wound?

In general, wounds can be either be classified as closed (where the skin stays intact) or open. An open wound is an injury involving an external or internal break in body tissue, usually involving the skin. Most open wounds are minor and can be treated at home.

How common is an open wound?

Open wounds are extremely common. Nearly everyone will experience an open wound at some point in their lives. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of an open wound?

The following signs and symptoms often accompany open wounds:

  • Bleeding or oozing of blood
  • Redness
  • Swelling
  • Pain and tenderness
  • Heat
  • Possible fever with infection
  • Not being able to use or move the affected area
  • Oozing pus, foul smell (in infected wounds only)

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

You should contact your doctor if you have any of the following:

  • An open wound is deeper than 1/2 inch
  • The bleeding does not stop with direct pressure
  • The bleeding lasts longer than 20 minutes
  • The bleeding is the result of a serious accident

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes an open wound?

  • Abrasions: These are shallow irregular wounds of the upper layers of skin, due to skin brushing with either a rough surface or a smooth surface at high speed (running); usually present with minor to no bleeding, with some pain that subsides shortly after initial injury.
  • Lacerations: These wounds are tear-like wounds with irregularly torn edges that are usually deeper than abrasions and cause more pain and bleeding. Lacerations are generally caused by trauma or contact with an object; such as hard blows, collusions or accidents.
  • Incisions:These are most likely the result of a surgical procedure or skin cut with a sharp object; like scalpels, knives and scissors. Incisions are mostly linear in shape with sharp, smooth edges. Depending on the depth and site of the wound, an incision can be life threatening, causing serious damage; especially if it involves vital organs, major blood vessels or nerves.
  • Punctures:These are small rounded wounds that result from objects with thin pointed tips; such as needles, nails or other tapered objects, and teeth, in cases of human or animal bites. The wound size, depth, bleeding and pain are directly related to the size and force of the causative object.
  • Penetrating: This type of wound can be caused by any object or force that breaks through the skin to the underlying organs or tissue. It has variable sizes, shapes and presentations; depending on the cause. Penetrating wounds can be life threatening, causing serious injury; especially if involving vital organs, major blood vessels or nerves.
  • Gunshot wounds: These are considered to be penetrating wounds that are exclusively caused by bullets from firearms (guns, rifles, etc.). These wounds at entrance are regular, rounded, and smaller than the bullet size. The entrance wounds may have burn marks or soot on the edges and surrounding tissue, depending on the distance from which the bullet was fired. If the bullet goes all the way through the body, the exit wound will have an irregular shape that is larger than the entrance wound and usually bleeds more. Bullets move in a straight line through the body, except when they hit a bone. If they hit a bone, they can either break or shatter it, or be deflected in another direction. Aside from the risk to vital organs or major blood vessels, the fast, spinning movement of the bullet may cause serious damage to the surrounding tissue it passes through.

Risk factors

What increases my risk for an open wound?

You may be at higher risk for wounds if you have these characteristics:

  • Older people are at higher risk
  • Poor general health
  • Steroid use
  • Radiation and chemotherapy
  • Diabetes
  • Smoking

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is an open wound diagnosed?

History: Individuals may report a history of recent direct trauma to the area in question (i.e., hand, finger, or foot), often with bleeding from the involved site. Some individuals may report exposure of the wound to dirt or other contaminants such as manure, rust, or foreign bodies. The history should include information on how much time elapsed between receiving the wound and getting medical attention and the date of the most recent tetanus injection. It is also very important to obtain a history of any medical conditions the individual may have, since diabetes, vascular disease, malnutrition, a history of cancer, and many other medical problems, as well as medication use and smoking, can all influence wound healing. A history of keloid formation can influence wound care strategies.

Physical exam: Physical examination should begin with an assessment of the entire body. Sometimes, serious injuries that are distant from the wound can be overlooked in the initial evaluation. It is helpful to record the size, depth, and type of wound. The wound may need to be explored to evaluate possible involvement of tendons, ligaments, and nerves. Profuse bleeding that does not stop with pressure or bleeding that spurts from the wound (suggesting injury to an artery) may indicate involvement of major blood vessels. Large amounts of blood loss may lead to early signs of shock such as decreased level of consciousness, rapid pulse (tachycardia), and low blood pressure (hypotension). The area around the wound may be tender to the touch and swollen. Redness (erythema) and warmth suggest infection.

Obvious deformity of an extremity (hand, foot, or lower leg) suggests a fracture of underlying bone; in some circumstances, bone may be observed protruding through the skin (open fracture). Damage to the nerves and/or tendons may cause changes in sensation or weakness in an extremity. Injuries to the hand, finger, foot, or leg may be associated with loss of tissue, loss of parts of fingers or toes, or even complete loss of limbs. The wound edges may be jagged, pale, or almost invisible, appearing as a fine line. The wound may extend into deep tissue and contain pieces of foreign debris, such as glass, wood, or gravel.

Tests: Blood tests (complete blood count) may be needed to monitor signs of blood loss and infection. X-rays help to detect fractures or the presence of foreign bodies. X-rays of the blood vessels (arteriograms) are done if vascular injury requiring surgical repair is suspected. Nerve conduction studies or evoked potentials are usually done several days to several weeks after the incident and may reveal associated nerve injury.

How is an open wound treated?

Your doctor may use different techniques to treat your open wound. After cleaning and possibly numbing the area with anesthetic, your doctor may close the wound using skin glue, sutures, or stitches. You may receive a tetanus booster shot if you have a puncture wound.

Other treatments for an open wound include pain medication and penicillin. Your doctor may also prescribe penicillin or another antibiotic if there’s an infection or high risk for developing an infection. In some cases, surgery might be needed. If a body part is severed, it should be brought to the hospital for possible reattachment. Wrap the body part in moist gauze and pack it in ice.

When you leave the doctor’s office, you might have bandages and dressings. It’s important to always wash your hands and work on a clean surface when changing bandages and dressings. Disinfect and dry the wound thoroughly before dressing it again. Dispose of old dressings and bandages in plastic bags.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage an open wound?

The following lifestyles and home remedies might help you cope with an open wound:

You can use complementary and alternative therapies (CAM) for minor household injuries or after more serious injuries have gotten medical attention. If you have any question about whether your wound is serious, call your doctor before using CAM therapies. Never apply any herb or supplement to any open wound without a doctor’s supervision.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: September 6, 2017 | Last Modified: September 6, 2017

Want to live your best life?
Get the Hello Doktor Daily newsletter for health tips, wellness updates and more.