What Are Open and Closed Wounds? Differences, Examples, and Management
The largest organ in the body that covers the entire external surface of the body is called the skin. It is made up of three layers that are, epidermis, endodermis, and hypodermis. According to pathology, a wound is referred to as a sharp injury that damages the epidermal skin. In this condition, the skin immediately gets cut or torn. It can be defined as the breaking of continuity of any tissue present in the body due to an external situation such as violent acts or accidents. It can be healed by taking proper care, to give proper treatment one should know the type of the cut, how deep the cut is, the reason for the wound, and the way to treat it. If the wound is not provided with medical treatment, it may lead to complications. Let us understand the different types, how to treat it, and how the wound has to be dressed.
Types of Wounds
Based on the level of contamination, the wound can be classified as,
Clean Wound:
In this case, the chances of getting the wound healed are very high, as there are no organisms present around it.
Contaminated Wound:
It occurs due to an accidental injury, and the pathogenic organisms are found around it.
Infected Wound:
It is caused by the pathogenic organisms, which multiply evenly leading to a clinical sign called infection.
Colonized Wound:
It is a chronic situation, where the chances of healing the wound are difficult.
Open Wound
The injury that involves the breakage of tissue externally or internally is called open wounds. Most of the open wounds can be treated at home.
The different Types of Open Wounds are as follows:
Abrasion:
When the skin is rubbed or scraped to a rough surface abrasion occurs. There is not a lot of bleeding in this case of the wound, but it has to be cleaned in order to avoid getting infected.
Laceration:
The tearing of the skin or deep cut is referred to as laceration. The accidents that occurred due to machinery or tools or knives cause a laceration. If the laceration is deep then the bleeding can be excessive.
Puncture:
The small hole that is caused by a nail or needle is called a puncture. The bleeding might not be that severe but it can damage the internal organs if the hole is deep enough.
Avulsion:
The complete or partial tearing of the skin and the beneath the tissue is called avulsion. It will occur in the incidents such as gunshots or explosions or body-crushing accidents. The bleeding is heavy in case of avulsion.
Closed Wound
The injury happens under the outer epidermis and it is not exposed to the outer environment.
Types of the Closed Wounds involve:
Contusions:
It is known to be a common type of sports injury. It can damage small blood vessels, muscles, capillaries, tissues, internal organs, and sometimes bones as well. The colour changes from reddish to bluish in the injured area of the skin.
Hematomas:
The injury that damages the blood capillaries and vessels, resulting in the flow of blood in a limited space. It will be present as a spongy, rubbery, and lump-like lesion, which is more painful. It can either be small or large and can present under the skin or inside the body.
Crush injuries:
It is caused due to the squeezing of a part of a body in between the two surfaces due to the high-pressure forces.
Wound Dressing
The wound treatment is different and dependent on several factors. Age and skin type are the major ones that require the way of treating a wound and making it less prone to infection. Along with avoiding the infection, proper care is to be taken to cure the wound, and hence dressing is important. The dressing is done depending on the factors such as the type of the wound, its location, how big and severe the wound is. To heal and to prevent the further complications that might happen to the wound, we use a method with direct contact to help it heal, called wound dressing.
Different Types of Wound Dressing include:
Cloth:
The most commonly found and helpful one is cloth dressing. It is used to protect the open wounds that occur due to injuries in the sensitive area or too broken skin or scraped knee or uncomfortable cut. As the first layer of protection medical practitioners uses cloth dressing.
Foam:
These are good for the wounds that exhibit a foul smell. It helps to heal the wound and maintain the moisture. These are soft and absorbent depending on the brand used. It absorbs the excess fluids present in the wounds by keeping them moist.
Transparent:
To monitor the wound healing doctors use a transparent type of dressing. These are used mostly on burns, surgical incision sites, and ulcers. These are more flexible and due to their thin-film, these are more comfortable.
Hydrocolloid:
These are non-breathable and self-adhesive dressings. They help in fast healing by creating moist conditions. The surface of these dressings is coated with a substance that has polysaccharides and other polymers. Thus these gels help to heal the wound fastly as they are in direct contact with it. These are mostly used on burns, necrotic wounds, pressure ulcers, and under compression wraps.
Hydrogel:
For the wounds that are dry and just need a little help to heal, hydrogels are used. These help to keep the wound moisten by reducing the pain and it is comfortable as well. These are used on large wounds for a strong recovery. As it contains excess liquid that promotes cellular growth, these are used on second-degree burns as well.
Collagen:
These types are commonly used for chronic wounds. These act as a temporary second skin. It is a good alternative to the traditional type of dressing. It helps to remove dead cells, tighten the edges, and encourages the formation of blood vessels.
Wound Healing
The healing of the skin that begins immediately after an injury and that might take years is called wound healing. It is found on the epidermal layer. It is done in three phases such as inflammation, proliferation, and remodeling disruption in any of these phases leads to abnormal healing of the wound.
There are Two Types of Wound Healing:
Primary Healing:
The non-infected, well-approximated wound is healed in an uncomplicated way that includes surgical wounds.
Secondary healing:
If there is an interruption in the course of healing due to infection, hypoxia, or dysfunction of the immune system then this stage begins. They are prone to poor healing and infections.
Conclusion
The wound is most common that happens to living beings in everyday life. Thus, proper care is required to heal the wound to avoid further complications. When we treat the wound correctly it can help to heal the wound fastly by keeping our body protected from infections. There are different factors that help to heal the wound and if neglected, the severity can increase.
FAQs on Understanding Wounds: Types, Healing, and Care
1. What is a wound in biology?
In a biological context, a wound is any injury that results in a break in the skin or other body tissues, disrupting their normal structure and function. Wounds can be caused by various factors, including physical trauma (like cuts and punctures), chemical exposure, or thermal damage (burns), and they trigger a natural healing response from the body.
2. What are the major types of open wounds?
Open wounds are those where the skin is broken, exposing the underlying tissue. The main types are classified based on their cause and appearance:
Abrasion: A superficial wound where the top layer of skin is scraped off, often called a graze.
Laceration: A deep cut or tear in the skin, typically with irregular, jagged edges.
Incision: A clean, straight-edged cut, usually caused by a sharp object like a knife or surgical scalpel.
Puncture: A deep, narrow wound caused by a pointed object, such as a nail or needle.
Avulsion: A severe injury where a flap of skin and the tissue beneath it are torn away from the body.
3. How does the body heal a wound? Explain the four main stages.
The body heals wounds through a complex process that occurs in four overlapping stages:
1. Haemostasis: This is the first stage, where the body works to stop bleeding. Blood vessels constrict, and platelets gather at the injury site to form a clot.
2. Inflammation: Once bleeding is controlled, the body initiates an inflammatory response. White blood cells enter the wound to fight bacteria and remove dead tissue, which causes redness, swelling, and pain.
3. Proliferation: In this stage, the wound begins to rebuild itself. New tissue, called granulation tissue, is formed from collagen, and new blood vessels develop to supply nutrients to the healing area.
4. Maturation (Remodelling): The final stage involves the strengthening of the new tissue. The collagen is reorganised to increase the tensile strength of the skin, and the wound fully closes, which can sometimes result in a scar.
4. What is the difference between healing by primary intention and secondary intention?
The key difference lies in the nature of the wound and how it closes:
Healing by Primary Intention: This occurs in clean, straight-edged wounds with minimal tissue loss, like a surgical incision. The edges of the wound are brought close together (approximated) and secured with stitches or staples. This leads to rapid healing with minimal scarring.
Healing by Secondary Intention: This happens in large, open wounds with significant tissue loss or in wounds that are infected. The wound edges are far apart and cannot be brought together. The body heals it from the bottom up by filling the space with granulation tissue. This process is slower and results in a more prominent scar.
5. Why do some wounds leave scars while others do not?
Scar formation depends on the depth of the injury. Scars form when the dermis, the deeper layer of the skin, is damaged. When only the outermost layer (epidermis) is injured, like in a mild scrape, it can regenerate without scarring. However, when the dermis is damaged, the body produces collagen fibres to repair the site. This new collagen has a different texture and alignment than the original skin tissue, creating a visible scar. The extent of scarring is influenced by the wound's size, depth, and factors like infection or poor healing.
6. What biological factors can slow down or impair the wound healing process?
Several internal factors can interfere with the body's ability to heal effectively:
Poor Circulation: Inadequate blood flow deprives the wound of essential oxygen and nutrients needed for repair.
Infection: The presence of bacteria prolongs the inflammatory stage and can damage newly forming tissue.
Nutritional Deficiencies: A lack of protein, vitamins (especially C and A), and minerals (like zinc) can hinder cell growth and collagen synthesis.
Chronic Conditions: Diseases like diabetes can impair immune function and circulation, significantly delaying the healing process.
Age: The healing process naturally slows down with age due to a decrease in the rate of cell regeneration and collagen production.
7. Can you explain the difference between a simple and a complicated wound?
The distinction between a simple and a complicated wound is based on the extent of tissue damage and involvement of other structures:
A simple wound is one that only affects the skin and the tissue directly beneath it. It typically heals without any significant issues through the normal healing stages.
A complicated wound is more severe and involves damage to deeper structures like nerves, tendons, blood vessels, or bones. It may also be considered complicated if there is a foreign object in the wound, significant tissue loss, or a severe infection, often requiring specialised medical treatment.
