EngradeWikisTRAUMA › Chapter 19 Soft tissue Injury

Chapter 19 Soft tissue Injury

Incidence, Mortality and Morbidity

A. Soft Tissues
1. can be injured through a variety of mechanisms
a. blunt injury
b. penetrating injury
c. barotrauma injury
d. burns
2. Leading form of injury
3. Death often related to hemorrhage or infection

Structure and Function of the Skin

A. Overview
1. Integument
a. complex organ
b. crucial role in maintaining homeostasis
c. protects underlying tissue
d. aids in temperature regulation
e. acts as a watertight seal
f. serves as a sense organ
B. Epidermis
1. Outermost layer
C. Dermis
1. Tough, highly elastic layer of connective tissue
2. composed chiefly of collagen fibers, elastic fibers and a mucopolysaccharide gel
3. Fibroblasts
4. Papillary dermis
5. Reticular layer
6. Macrophages and lymphocytes
7. specialized structures
D. Subcutaneous Tissue
1. layer of tissue beneath the dermis
2. superficial fascia
E. Deep Fascia
1. Dense layer of fibrous tissue
F. Skin Tension lines
1. Tautness varies by body regions
2. occurs in patterns
3. static tension
4. dynamic tension

Wound Healing

A. Pathophysiology of Wound Healing
1. Natural process
2. hemostasis
3. Inflammation
4. Epithelialization
5. Neovascularization
6. Collagen synthesis

B. Alterations of Wound Healing
1. Anatomic factors
2. High-risk wounds
3. Abnormal scar formation
4. Pressure injuries
5. Wounds requiring closure
6. Infection
7. Gangrene
8. Tetanus
9. Necrotizing fascitis

Closed Versus Open Wounds

A. Closed Wounds
1. Soft tissue beneath the skin surface are damaged, but there is no break in the epidermis
2. Contusion
Open Wounds
1. Characterized by a disruption in the skin
2. See Table 19-1 Conditions that require transport
3. Abrasions
4. Lacerations
5. Puncture Wounds
6. Avulsions
7. Amputations