Wound Assessment

The following should be considered when undertaking an assessment of a wound:

1) Wound classification:

• Laceration
• Contused wound
• Puncture wounds
• Bites
• Degloving injuries
• Abrasions

2) Type of wound:

• Linear (regular)
• Stellate (irregular)

3) Depth:

• Wounds not fully penetrating the skin are superficial
• Explore all deep wounds under anaesthesia if any doubt exists to whether there may be damage to underlying structures

4) Site of wound:

• Infection rate: legs & feet > arms & hands >head & neck.
• Cosmetic implications
• Wounds over joints

5) Damage to underlying structures:

• Key to assessment includes understanding the mechanism of injury
• Always assess distal neurovascular status
• Always assess for underlying tendon damage

6) Is the wound dirty?

• All sporting wounds are potentially dirty
• Injuries more than 4 hours old
• Location
• Contamination with devitalised tissue, foreign material, saliva, or mud
• Blunt (crush) mechanism
• High velocity missile injuries