Wounds and Wound Care

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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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• Wound Care Facts
• Wound Overview
• Wound Causes and Types
• Wound Signs and Symptoms
• When to Seek Medical Care for a Wound
• Wound Diagnosis
• Wound Treatment
• Wound Self-Care at Home
• Wound Medical Treatment
• Wound Prognosis
• Wound Prevention
• Synonyms and Keywords
• Author and Editor
• Read more on Wound Care from Healthwise
• Viewer Comments: Wound Care - Treatment

Wound Care Facts

• The skin is a barrier to the outside world protecting the body from infection, radiation, and extremes of temperature.
• There are many types of wounds that can damage the skin including abrasions, lacerations, rupture injuries, punctures, and penetrating wounds.
• Many wounds are superficial requiring local first aid including cleansing and dressing.
• Some wounds are deeper and need medical attention to prevent infection and loss of function, due to damage to underlying structures like bone, muscle, tendon, arteries and nerves.
• The purpose of medical care for wounds is to prevent complications and preserve function. While important, cosmetic results are not the primary consideration for wound repair.
• Animal and human bites should always be seen by a medical professional because of the high rate of infection.
• It is important to know a person's tetanus immunization status (for example, has the person had a tetanus shot or booster vaccine in the last 5 years?) so that it can be updated with a tetanus booster if needed.

Wound Overview

The skin is a large sensory organ that interacts with the environment, and sends signals to the brain about touch, pain, vibration, and position.

There are two layers of skin that cover the body, the epidermis and dermis.

The epidermis is the outermost layer of skin, the part that can be seen, and is very active with new skin cells being formed and gradually being shed. There are different kinds of epidermal cells:

• Keratinocytes are the main skin cells that we see. New epidermal cells begin where the epidermis and dermis meet. These cells gradually mature and rise to the surface of the skin and are eventually shed to be replaced by new ones. The epidermis has no blood vessels and receives nutrition from the underlying dermis.
• Melanocytes contain pigment and provide coloration to the skin and are responsible for absorbing radiation and protecting against the damage caused by ultraviolet radiation.
• Langerhan cells are made in the bone marrow and migrate to the surface of the skin and help fight infection.
• Merkel cells are specialized skin cells that help with sensing light touch. They are located on the tips of fingers and toes as well as other specialized areas.

The dermis is the deeper layer of skin. It has two layers that are responsible for supporting the epidermis:

• The papillary dermis is a thin layer of tissue located just beneath the epidermis and contains capillary blood vessels and a few elastic and collagen fibers.
• The deeper reticular dermis contains large bundles of collagen and elastic fibers that run parallel to the skin surface. The collagen and elastic fibers are responsible for helping the skin resist injury from shearing or other types of trauma, and allow the skin to return to its resting state after being stretched or compressed. This is the layer where hair follicles, sweat glands and sebaceous glands are found.

Subcutaneous fat tissue underlies the layers of epidermis and dermis and provides extra cushioning for the skin. Beneath this layer lie muscle and bone.