The
direction of the shelving of margins of a lacerated wound indicates the
direction of the blow applied to cause the wound as seen in MLC cases.
- Lacerations
are tears or splits of skin, mucous membranes, muscle or internal organs
produced by application of blunt force to a broad area of the body, which
crushes or stretches the tissues beyond the limits of their elasticity.
- Crush
injury from a direct blow may produce an irregular or stellate laceration
with a variable degree of devitalized tissue, abrasion and visible
contamination.
- Do not
close a laceration if there is visible contamination, debris, non–viable
tissue or signs of infection. Wounds may involve vascular areas of the
face and scalp where the risk of infection is low or extremities where
infection becomes a greater risk, along with the possibility of tendon and
nerve damage. The elderly and patients on chronic steroid therapy may
present with "wet tissue paper" skin tears following relatively
minor trauma.
- When
produced by a blunt weapon, such as club, crowbar, stone, brick etc., a
lacerated wound is usually accompanied by a considerable amount of
bruising of the surrounding and underlying tissues, and has inverted and
irregular edges. The direction of the shelving of margins of a lacerated
wound indicates the direction of the blow applied to cause the wound.
- When a
heavy weight such as the wheel of a heavy cart or a truck passes over an
extremity, by its shearing and grinding force, it tears the skin from the
underlying tissue and crushes the muscles and soft part lying beneath it
realizing considerable blood and fat in them.
- Crush
injury syndrome or fat emboli may follow a lacerated wound. The tear,
avulsion, split are types of laceration.
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