Contusion wounds can have many “faces” and unfortunately occur quite frequently. Most often, they are noticeable by pain and by bluish-red discoloration and swelling of the skin. Under certain circumstances, however, a contusion wound can also be exposed and therefore even bleed, entailing the need for medical attention as soon as possible.
What are contusion wounds?
A contusion wound is basically nothing more than damage to the skin, the underlying tissue and also the surrounding muscles and tendons caused by a contusion. However, depending on the severity of the contusion wound, the bones can also be damaged in a contusion wound. This is because one contusion wound is far from being the same as another. So a contusion wound can be caused just as much by a minor contusion, such as being caught in a door, window or drawer, as by a serious accident. For example, when a part of the body is pinched by a heavy object. Best examples of this can be severe wounds that occur in a car accident.
Causes
Crush wounds are most often caused by external force applied to the affected body part. The overarching causes here can be very diverse and range from a grip that is too tight on the later damaged body part, to mechanical impact from the outside. An unfortunate fall can be enough. Therefore, contusion wounds are predominantly accompanied by other injuries such as cuts, sprains and fractures. Because a contusion primarily affects the skin and tissue, even mild contusion wounds quickly and often show hematomas – technical term for bruising and discoloration. More severe contusion wounds, however, often have exposed wounds, which in turn carries a higher risk of infection.
Symptoms, complaints, and signs
Contusion wounds are characterized by severe damage to the tissue, although this does not consist of superficial injuries. Thus, contusion wounds are primarily characterized by the fact that there has been an injury to numerous small blood vessels in the tissue. This quickly leads to swelling and the formation of a hematoma. The affected area may turn red and dark blue. In most cases, the contusion wound affects the middle and lower layers of the skin and the tissue immediately underneath. However, it can also damage underlying bones or tissue further inside. There is sometimes very severe pain in the affected areas and also restricted movement. Sensory disturbances occur. Sometimes the areas become numb or tingle unpleasantly. The swelling can also lead to a throbbing pain. If the bruise affects a finger or a toe, there is severe discoloration below the nail. The nail bed may detach as it progresses. In severe bruising, necrosis occurs in the area of the wound. These often lead to an even darker discoloration. In severe wounds, the wound edges are usually torn and heavily bloodshot.
Diagnosis and course
A contusion wound is usually already very easy to recognize with the naked eye – even by a medical layman. Because it always shows itself by more or less strong hematomas, swellings and also pain. The latter is mainly manifested by the fact that the directly affected area of the contusion wound is very sensitive to touch. However, a contusion wound often also restricts the freedom of movement. Less drastic contusion wounds usually heal on their own without any problems. However, if the discomfort or even the wound is too severe, a doctor should definitely be consulted. Because with a contusion wound can also be present strong internal bleeding.
Complications
A contusion wound is often associated with a large loss of blood, which can lead to shock. If an open skin injury is also present, there is an increased risk of wound infection. As a result of nerve injury, sensory disturbances or paralysis may occur in the affected region. Pronounced contusion wounds in the region of the forearm or lower leg can lead to the so-called compartment syndrome, in which there is a slow increase in pressure in the affected tissue. This interrupts the blood supply, which can cause permanent damage to the muscles, blood vessels and nerves.In the case of severe injuries, a contusion wound may necessitate amputation of the damaged limb. Apart from this, treatment is often also associated with wound healing problems or infections. Open contusion wounds in particular become infected quickly if, for example, an irritating ointment is applied or the wound is not adequately cared for. The use of painkillers can cause occasional discomfort and thus restrict those affected in their daily lives. In rare cases, serious cardiovascular problems can occur if the patient has an undiagnosed previous illness and if the medication interacts with other medications. More common are side effects such as headache, muscle and limb pain, and allergic reactions.
When should you see a doctor?
With bruising, it is not always necessary to see a doctor. If the discomfort disappears on its own after a short time or if the wound does not hurt particularly, there is no need to see a doctor, as this usually results in self-healing. However, in the case of serious injuries or very severe pain, it is advisable to consult a doctor to avoid further complications. A doctor should be consulted urgently if there is very severe swelling that does not go away on its own. Likewise, a hematoma usually forms, which may be associated with pain. Also, if there are restrictions in movement or severe disturbances in sensitivity in the affected area, a doctor should be consulted immediately in order to treat the contusion wounds properly. In the first place, a general practitioner or the hospital can be visited. In emergencies, the emergency doctor should be called. In most cases, contusion wounds can be treated relatively well and do not limit the life expectancy of the affected person.
Treatment and therapy
In most cases, a contusion wound is treated by rest and possibly decongestants. This means that if the affected area is swollen, for example, it should be cooled and kept a little quieter. So if the foot is affected, you should treat it with a cold pack and keep it elevated for a few hours. Or at least as long as significant pain is present. In addition, numerous ointments and creams are available in the pharmacy, which benefit a faster healing of contusion sores. Weaker and smaller contusion wounds can thus often be treated by oneself without hesitation. However, caution is advised if a bone fracture or even serious internal injuries cannot be completely ruled out. The situation is similar for open contusion wounds and for injuries that hurt for a supernaturally long time or need a long time to heal. On average, a contusion wound needs between two to six weeks to heal completely. Here it depends entirely on the severity of the wound.
Prevention
A contusion wound is very difficult to prevent, because it is usually caused by accidents or by careless actions. Really take action yourself, so you can actually only by a fair amount of caution. As is well known, however, injuries cannot always be avoided or prevented. What can be reduced, however, are the consequences of a contusion. By immediately cooling and immobilizing the affected part of the body, swelling and hematomas can be kept within limits. However, one must be very careful with open wounds. One should clean the wound immediately and keep it as sterile as possible to avoid inflammation of the wound.
Aftercare
Similar to similar injuries, contusion wounds should be followed up. The specialist checks the healing. Depending on the extent of the injury, aftercare prevents scarring or inflammation in the wound. Other goals are (acute) pain relief, swelling of the bruised area and finally complete healing without permanent damage. In the case of minor injuries, medical follow-up is usually not necessary. They manifest themselves as a bruise and heal on their own. Careful cooling of the affected area additionally accelerates the reduction of swelling. In some cases, aftercare is not only useful, but a necessity. Inflamed contusion wounds, ruptured tissue, and extensive, open injuries absolutely belong in medical treatment. During aftercare, the wound is rinsed or disinfected and, if necessary, sutured. Follow-up checks provide information on the state of healing. Inflammations require the administration of antibiotics.During follow-up, it is checked whether the medication is proving effective and containing the inflammatory process. Crush wounds can be accompanied by greater blood loss. The deficiency is compensated for during follow-up care. A pressure dressing on the injured area prevents secondary bleeding. The wound is kept sterile during this process. After the injury has healed, the dressing can be removed.
What you can do yourself
Most contusion wounds are bruises that heal easily on their own. However, if in doubt, the patient should not take any risks, but should consult a doctor. This is especially true if larger areas are affected or the wound is open. There may be a risk of internal bleeding. A bone in the wound area could also be injured. Depending on the size and type of injury, the doctor will surgically clean and close it. This is important because bacteria quickly settle into jagged wound edges, which are common in a contusion wound. Depending on the type of bacteria, this not infrequently leads to so-called gas gangrene, an infection that can be fatal. Especially in view of the risk of infection, the wound should be kept sterile and cared for according to the doctor’s instructions. Cooling several times a day relieves swelling as well as pain and at the same time improves blood circulation to the entire wound area. Good blood circulation is important so that germs and pus can be quickly drained and the body’s own healing process can be initiated at the same time. However, the skin should not feel ice-cold during cooling, otherwise there is a risk of cold damage. Depending on the size of the wound, the patient should allow himself plenty of rest and show patience: It can take up to six weeks for a contusion wound to heal completely.
