What is an open wound?
What is an open wound?
An open wound is a break in the skin. The open wound can vary in depth and range from a minor injury to a severe injury that exposes underlying structures. All open wounds are a break in the protective surface of the skin which can increase the risk of infection and complications in healing if not properly cared for. Superficial open wounds are typically treated at home and deeper wounds may require medical management.
What types of open wounds occur is related to the type of injury. Abrasions are scrapes to the skin often as a result of a fall or other minor accident. Lacerations are cuts that can be superficial, like a paper cut, or deep injuries with sharp things like knives, machinery, or tools. They are often caused by an accident or trauma injury. Puncture wounds occur when a sharp object pierces the skin, which often leads to small surface open areas with deeper damage. Open wounds can also be caused by surgical incisions that open or pressure injuries caused by friction, shear, and pressure on bony prominences. Open wounds can be related to health issues like diabetes, poor circulation, and lymphedema, making individuals prone to skin damage. Comorbid conditions will need addressing to maximize the ability to heal quickly.
When you have an open wound it is important to take immediate action to prevent infection and encourage healing. The first step is to clean the wound thoroughly and remove any visible debris. Using soap and water is acceptable on initial injury, however, a pH-balanced wound cleanser is ideal. If there are signs of infection like pus, redness, and pain, then an antimicrobial or antiseptic cleanser may be warranted. Bleeding after initial injury is another factor to monitor. Bleeding should stop fairly quickly, especially if the wound is superficial and overpressure is applied. A wound that will not stop bleeding is a reason to seek emergency medical care.
When bleeding will not stop, it is likely an indication that the damage has been done to deeper tissues. The epidermis is the most superficial layer of skin and contains three types of cells; squamous, basal and melanocytes. Blood supply comes from vessels that are located in the deeper layer of the dermis. Below the dermis lies the subcutaneous fat, muscles, tendons and bones, as well as the more robust circulatory systems like arteries and veins that will bleed more aggressively when damaged. Injuries that are superficial and only involve the epidermis will bleed a lot less and heal much faster. Wounds that penetrate deeper to the dermis and down to the underlying structures will have a greater chance of infection, necrotic tissue and complicated healing.
How an open wound heals depends on how deep the damage is. A superficial open wound should heal quickly if kept clean, dry and covered. Epithelial tissue will replace itself unlike dermal tissue which fills in with a scar. Research has shown that wounds heal faster when a moist wound healing environment is maintained. Moist wound healing can be mostly achieved with quality dressings versus using open weave gauze, which allows a wound to dry out. Dry gauze also sticks to the wound, pulls off new cell growth, often causing pain on removal and providing a poor barrier to bacteria. A deeper wound may require the open space be filled with a primary dressing in direct contact with the wound bed. The primary dressing of choice should consider the amount of drainage, undermining, tunneling and infection. The dressing choice will likely change as the wound heals and becomes more shallow with less drainage.
When an open wound is kept covered, there will be less chance for bacteria to penetrate the wound. A covered wound will have less direct trauma from friction and shearing with activity which can be another source of injury and delayed healing. Necrotic dead tissue and scabs will be softened and breakdown encouraged by keeping the wound covered. This may cause some concern if there is some yellow pus-like drainage forming, causing individuals to question if infection is starting. Signs of infection typically have some pain, swelling and odor associated and can be diagnosed by medical professionals. Some believe that airing out a wound is a benefit but essentially the wound healing is slowed by allowing for the wound to dry out. Drainage can be better managed by changing the dressing more frequently and using a more absorbent dressing.
How an open wound closes is through the proliferation of new tissue to fill in the open wound space. Multiple cells and biological processes work in concert to promote wounds to close. Cells migrate from the deepest point up to the surface and from the outside toward the center of the wound to fill in the space that was previously open. The new tissue that grows is granulation tissue so the cells are not exactly the same as the tissue that was lost in the injury. A wound is considered a closed wound when it is no longer draining and epithelial tissue has covered the entire surface. Epithelial scar tissue grows roughly 1 millimeter every 24 hours if protected and typically has a silvery appearance as it’s forming.
When wounds are closed, scars will take 6-24 months to fully mature. Scars will progress from a red, purple or dark color and fade over time. Scar shape and size will be affected by the kind of injury, healing process and history of scarring for the individual and family. Abnormal scars like keloids are often hereditary and may require specialized treatments to promote a flatter appearance. The greatest predictor of keloids are past keloids and a good thing to be aware of in order to seek medical advice early in the healing process for prevention.
Everyone will have an open wound injury at some point and scars are a natural part of the healing process. Superficial open wounds should heal within a few weeks when kept clean and covered. Wounds that are deeper and more complicated will take more time to heal. They should still continue to show progress every week if the wound presentation is adequately addressed through dressings, medical management of infection, pain and blood flow, nutritional support and mobility concerns.
©2020 Human Biosciences, Inc. The content presented here is for your information only. It is not a substitute for professional medical advice.
Mrs. Vann is responsible for branding, design, and public outreach efforts for the company. Mrs. Vann has over five years of experience in the creative design arena. She has spearheaded multiple marketing campaigns, both domestic and international. She also has experience producing several television and live-stage programs. She has a Bachelor’s Degree in Film and Video Studies from George Mason University.
Mr. Patel is the Vice President of Operations for Human BioSciences. As such, he is responsible for strategy development for optimal growth, organizing multiple teams and implementing optimal product delivery for the growth of HBS. He has served multiple positions within HBS since 2001, including Operations Manager. With an MBA in Pharmaceutical Healthcare and a Bachelor’s in Pharmaceuticals, Mr. Patel brings deep technical knowledge in collagen product production with a rich history in managing teams.
As the President of Human BioSciences, Dr. Rohan K Jain is responsible for the company’s overall operations, with a focus on research and development. Dr. Jain has supervised and conducted extensive research in the collagen, biomaterials, and protein space, resulting in the release of numerous new products to the market. Prior to his role at HBS, Dr. Jain was a capital markets attorney at Shearman & Sterling LLP. He received his Doctorate in Law and his MBA from New York University; his Bachelor’s degrees in Biomedical Engineering and Materials Science and his Master’s in Engineering Management from Johns Hopkins University. He is a member of the New York and Maryland bars.
Cheryl Carver, LPN, WCC, CWCA, CWCP, DAPWCA, FACCWS is responsible for clinical education and training initiatives for customer accounts. Ms. Carver has amassed a wealth of clinical knowledge and industry experience in her more than 20 years as a board-certified wound care nurse. She has authored over 200 published white papers, ebooks, blogs, and articles for WoundSource and freelance.
Dr. Goebel is responsible for the company’s physical infrastructure and global expansion efforts through partnerships. Prior to joining HBS, Dr. Goebel was Managing Director at the Graf Matuschka Group in Munich, Germany, where he was actively involved in restructuring and privatization in East Germany and Eastern Europe. He was also a member of the American group of the EBRD European Bank for Reconstruction and Development in the privatization of the Russian economy and military complex. He has over forty years’ experience in many different industries including medical devices, pharmacy, and others. Dr. Goebel earned his Doctorate and Postdoctoral degrees in Economics in East Berlin.
Mr. Kumar is responsible for the company’s overall accounting and finance activities with a focus on internal control and taxation.
Mr. Kumar has over 25 years of public and corporate accounting experience. He is a Certified Public Accountant, licensed in the State of Virginia, Maryland, and Washington D.C., and an Enrolled Agent authorized to practice before the Internal Revenue Service. Mr. Kumar is also a Chartered Accountant and fellow member of the Institute of Chartered Accountants of India. Mr. Kumar received his Master’s degree in Commerce from Himalayan University in India.
Mr. Slovick is responsible for all regulatory and quality affairs in the company. Mr. Slovick has worked in regulatory, quality, and clinical services within the medical device and diagnostics industry for nearly 40 years. He founded Methodize Inc., to offer strategic support for approval of medical devices and in vitro diagnostics products. Mr. Slovick has a Bachelor’s degree in Management Information Systems.
Mr. Agarwal is responsible for Corporate Business Development, Sales, and Product Development, both locally and internationally for the company. Mr. Agarwal has over six years of corporate sales and business development experience. He completed his Master of Science in Engineering Management degree from Johns Hopkins University with a technical concentration in Mechanical Engineering. In the past, he has also worked as a fundraising volunteer for three years and thus gained insights in community fundraising and business development. Additionally, he has interned at a manufacturing firm and understood various intricacies involved in manufacturing ranging from the floor level to the supply chain. He has published a paper on Omni Channel Supply Chain and is a certified Lean Six Sigma associate. He has also interned as a business development consultant to a startup for market research and pricing strategies in Israel. Equipped with a combination of management and technical background acquired from his diverse experiences and education, he is perfectly suited to lead the business development efforts for Human BioSciences.