Analysis of common classifications of skin and soft tissue injuries

What are the main types of skin and soft tissue injuries?

Soft tissue injuries, simply put, are wounds, a common problem in our lives. But did you know that wounds are not all the same? Doctors systematically classify them based on their cause, depth, and level of contamination. This classification is not simply labeling; it directly determines how to treat the wound, whether it can be sutured, what medication to use, and how to predict the healing time. Understanding these classifications helps us deal with accidental injuries more rationally and cooperate with doctors for effective treatment.

According to the cause of the injury, what are the different categories?

We can categorize these injuries into four main types . The first type is mechanical injury, including familiar abrasions (where the skin's surface is broken by rough objects); lacerations (caused by sharp objects like knives or glass, with clean edges); tears (often caused by blunt force trauma or animal bites, with irregular edges and severe damage); and puncture wounds (such as those caused by nails or sharp objects, small but deep, with high risk). The second type is physical injury, mainly including thermal injuries like burns and scalds, as well as frostbite, electric shock, and radiation damage. The third type is chemical injury, caused by contact with corrosive substances like strong acids and alkalis. The fourth type is biological injury, mainly referring to skin breaks caused by animal bites or specific infections; these wounds, in addition to tissue damage, require special attention to the risks of toxins and specific pathogens.

Why do doctors pay attention to the degree of contamination in wounds?

In the eyes of surgeons, the cleanliness of a wound directly determines the treatment direction. Based on the risk of contamination and infection, wounds are strictly divided into four categories. The first category is clean wounds, mainly referring to surgical incisions performed under sterile conditions, free from bacterial contamination, with the best healing prospect. The second category is clean-contaminated wounds, such as gastrointestinal surgical incisions performed after bowel preparation; although bacteria are present, their numbers are controllable, and with proper treatment, they usually heal smoothly. The third category is contaminated wounds, commonly seen in accidents such as car crashes and falls; these wounds are contaminated with foreign objects such as mud and sand, containing a large number of bacteria, and must be thoroughly cleaned and rinsed. The fourth category is infected wounds, where the wound has shown clear signs of infection such as redness, swelling, pus discharge, and fever; the core treatment is draining the pus and controlling the infection, and suturing is absolutely prohibited.

What is the difference between acute and chronic wounds?

This classification is based on the healing process and time, and the treatment logic for the two is completely different. Acute wounds are those that occur suddenly and heal in an orderly manner according to the normal physiological stages, such as clean surgical incisions, superficial abrasions, or burns. These wounds usually heal within days to weeks if treated properly. Chronic wounds, on the other hand, are those whose healing process is blocked by certain factors and which fail to heal or show a clear healing trend after 4 to 8 weeks. Common chronic wounds include pressure injuries caused by prolonged bed rest, i.e., pressure sores; diabetic foot ulcers caused by diabetes; venous ulcers caused by lower extremity venous circulation problems; and arterial ulcers caused by insufficient arterial blood supply. The focus of treating chronic wounds is to find and eliminate the root cause hindering healing.

How does wound depth affect treatment options?

The depth of a wound directly affects its severity and recovery outcome. Epidermal injuries are the most superficial, such as sunburn or minor abrasions, affecting only the outermost layer of skin; they heal quickly and leave no scars. Dermal injuries are deeper, such as common blistering burns, which damage the dermis and form granulation tissue during healing, potentially leaving scars. Full-thickness skin injuries mean that the entire structure of the skin is destroyed, including the subcutaneous fat layer; examples include severe burns or deep lacerations. These wounds cannot heal on their own and usually require surgery such as skin grafts. The deepest injuries are deep tissue injuries, affecting muscles, tendons, nerves, and even bones. In these cases, in addition to repairing the skin, the key is to address functional reconstruction, making treatment the most complex.

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Editor: kiki Jia