Wounds And Mechanical Injuries

A wound may be defined as a 'breach of continuity in the structures of

the body, whether external or internal, suddenly occasioned by

mechanical violence.' The law does not define 'a wound,' but the true

skin must be broken. Wounds are dangerous from shock, hæmorrhage, from

the supervention of crysipelas or pyæmia, and from malum regimen on

the part of the patient or surgeon. Is the wound dangerous to life?

This ques ion can only be answered by a full consideration of all the

circumstances of the case; a guarded prognosis is wise in all cases.



=Burns= are caused by flames, highly heated solids, or very cold solids,

as solid carbonic acid; scalds, by steam or hot fluids. Burns may cause

death from shock, suffocation, oedema glottidis, inflammation of serous

surfaces, bronchitis, pneumonia, duodenal ulcer, coma, or exhaustion. A

burn of the skin inflicted during life is followed by a bleb containing

serum; the edges of this blister are bright red, and the base, seen

after removing the cuticle, is red and inflamed; if sustained after

death, a bleb, if present, contains but little fluid, and there are no

signs of vital reaction. There are six degrees of burns: (1) Superficial

inflammation; (2) formation of vesicles; (3) destruction of superficial

layer of skin; (4) destruction of cellular tissue; (5) deep parts

charred; (6) carbonization of bones.



The larger the area of skin burnt, the more grave is the prognosis.

Burns of the abdomen and genital organs are especially dangerous. Young

children are specially liable to die after burns.