Crush wounds can have many “faces” and are unfortunately quite common. They are usually noticeable through pain and bluish-red discoloration and swelling of the skin. Under certain circumstances, however, a bruise can also be open and therefore even bleed and require medical attention as soon as possible.
What are crush wounds?
Basically, a contusion wound is nothing more than damage to the skin caused by a contusion, the tissue underneath and also the surrounding muscles and tendons. See AbbreviationFinder for abbreviations related to Crush Wounds.
However, depending on the severity of the crush wound, the bones can also be damaged by a crush wound. Because one crush wound is far from being the same as another.
A bruise can also result from a slight bruise, for example from being trapped in a door, window or drawer, or from a serious accident. For example, when a body part is pinched by a heavy object. The best examples of this can be severe wounds resulting from a car accident.
Causes
Contusions are mostly caused by external violence on the affected part of the body. The overarching causes can be very diverse and range from a too firm grip on the later damaged part of the body to mechanical influences from the outside.
An unfortunate fall can be enough. As a result, crush injuries are predominantly associated with other injuries such as lacerations, sprains and fractures.
Since the skin and tissue are primarily affected in the event of a bruise, even minor bruises quickly and often show hematomas – technical terms for bruises and discolouration. However, more severe crush wounds often also have exposed wounds, which in turn entails a higher risk of infection.
Symptoms, Ailments & Signs
Crush wounds are characterized by severe tissue damage, which, however, does not consist of superficial injuries. Crush wounds are primarily characterized by the fact that numerous small blood vessels in the tissue have been injured. This quickly leads to swelling and the formation of a hematoma.
The affected area can turn red and dark blue. In most cases, the crush wound affects the middle and lower layers of the skin and the tissue immediately below. However, it can also damage underlying bones or tissue further inwards.
There is sometimes very severe pain and restricted movement in the affected areas. Sensitivity disorders 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 toe, there will be severe discoloration underneath the nail. The nail bed can become detached later on. Severe bruises lead to necrosis in the area of the wound. These often lead to an even darker discoloration. In the case of severe wounds, the edges of the wound are usually torn and heavily bloodshot.
Diagnosis & History
A crush wound can usually be seen very easily with the naked eye – even by a medical layperson. Because it is always shown by more or less severe hematomas, swelling and pain.
The latter manifest themselves primarily in the fact that the directly affected area of the crushed wound is very sensitive to touch. Often, however, a contusion also restricts freedom of movement.
Less severe bruises usually heal on their own without any problems. However, if the symptoms are too severe or if there are even wounds, you should definitely consult a doctor. Because a bruise can also cause severe internal bleeding.
Complications
A contusion is often associated with a large loss of blood, which can lead to shock. If there is also an open skin injury, there is an increased risk of wound infection. As a result of nerve injuries, sensory disturbances or signs of paralysis can occur in the affected region.
Pronounced crush 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 cuts off the blood supply, which can cause permanent damage to muscles, blood vessels, and nerves. If the injury is severe, a contusion wound may necessitate amputation of the injured limb.
Apart from that, treatment is often associated with wound healing disorders or infections. Open bruises in particular can quickly become inflamed if, for example, an irritating ointment is applied or the wound is not properly cared for. The use of painkillers can occasionally cause symptoms and restrict those affected in their everyday life.
In the case of undetected previous illnesses and in interaction with other medications, serious cardiovascular problems can occur in rare cases. Side effects such as headaches, muscle and body aches and allergic reactions occur more frequently.
When should you go to the doctor?
It is not always necessary to see a doctor with bruises. If the symptoms go away on their own after a short time or the wound is not particularly painful, there is no need to see a doctor, as it usually heals itself. However, if the injury is severe or the pain is very severe, it is advisable to see a doctor to avoid further complications. A doctor should be consulted urgently if the swelling becomes very severe and does not go away on its own. Likewise, a hematoma usually forms, which can be associated with pain. If you are restricted in your movement or have severe sensory disturbances in the affected area, you should see a doctor immediately to treat the crushed wounds properly.
In the first place, a general practitioner or the hospital can be consulted. In emergencies, an ambulance should be called. Most of the time, crush wounds can be treated relatively well and do not limit the life expectancy of the person affected.
Treatment & Therapy
In most cases, a contusion is treated with rest and possibly a decongestant. This means that in the event of swelling, for example, you should cool the affected area and keep it a little still.
If the foot is affected, you should treat it with an ice pack and put it up for a few hours. Or at least as long as there is significant pain. In addition, numerous ointments and creams are available in pharmacies that help to heal bruises more quickly. Weaker and smaller bruises can often be treated without hesitation. However, caution is required if you cannot completely rule out a broken bone or serious internal injuries.
It’s a similar story with open bruises and injuries that hurt preternaturally or take a long time to heal. On average, a crush wound takes between two to six weeks to heal completely. It all depends on the severity of the wound.
Prevention
A contusion is very difficult to avoid as it is most often caused by accidents or careless actions. So you can only really become active yourself with a good deal of caution. It is well known that injuries cannot always be avoided or prevented.
What can be reduced, however, are the consequences of a crush wound. Because immediate cooling and immobilisation of the affected part of the body can possibly keep swellings and hematomas within limits. But you have to be very careful with open wounds. The wound should be cleaned immediately and kept sterile as much as possible to avoid inflammation of the wound.
Aftercare
Similar to comparable injuries, crush wounds should also be treated after-care. The specialist checks the healing. Depending on the extent of the injury, scarring or inflammation in the wound is prevented during follow-up care. 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 care is usually not necessary. They manifest themselves as bruises and heal by themselves. Careful cooling of the affected area also accelerates the swelling down. In some cases, follow-up care is not only useful, but a necessity. Inflamed bruises, torn tissue and large, open injuries must be treated by a doctor.
During aftercare, the wound is rinsed or disinfected and sewn up if necessary. Follow-up checks provide information about the healing status. Inflammation requires the administration of antibiotic agents. As part of the aftercare, it is checked whether the drug is proving to be effective and is curbing the inflammatory process.
Crush wounds can be associated with increased blood loss. The deficiency is compensated for during follow-up treatment. A pressure bandage on the injured area prevents secondary bleeding. The wound is kept sterile. After the injury has healed, the bandage can be removed.
You can do that yourself
Most crush injuries are bruises that will heal on their own without any problems. In case of doubt, however, the patient should not take any risks, but consult a doctor. This is especially true when 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 jagged edges of a wound, such as those found in a contusion, are easily infected with bacteria. Depending on the type of bacteria, this often leads to so-called gas gangrene, an infection that can be fatal.
Especially with regard to the risk of infection, the wound should be kept sterile and cared for according to the doctor’s instructions. Cooling the wound several times a day reduces swelling and pain while also improving blood circulation in the entire wound area. Good blood circulation is important so that germs and pus can be drained out quickly 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 damage from the cold. Depending on the size of the wound, the patient should allow himself plenty of rest and be patient: it can take up to six weeks for a contusion wound to heal completely.
