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.