Soft Tissue Injuries And Nursing Care

The Skin

– The Largest Organ in the Body


Functions of the Skin

  • Protects the body from the environment and bacteria, viruses and other harmful organisms
  • Regulates body temperature
  • Contains nerves that sense heat, cold, touch, pressure and pain



Closed Injuries

Soft-tissue injuries sometimes appear worse than they actually are.

– A soft-tissue injury before cleaning.


– A soft-tissue injury after cleaning.




– A type of closed soft-tissue injury in which cells are damaged in the skin and blood vessels torn in the dermis; also called a bruise.


Contusion produced by an ankle sprain.




– A closed soft-tissue injury produced by an accumulation of blood under the skin.

– Similar to a contusion, but with more blood and tissue damage.


Crush injury:

– An open or closed soft-tissue injury resulting from blunt force trauma.

– A closed crush injury produced when a van wheel rolled over the patient



Open Injuries



– An open soft-tissue injury resulting from a scraping force.

Abrasions produce damage to the epidermis.




– A break in the skin of varying depth caused by a sharp object.

– Lacerations can be linear (regular) or stellate (irregular).



A severe open injury.




– A flap of skin that is torn or pulled loose.



Puncture wound:

– An open soft-tissue injury caused by an object being pushed into the skin.

– Sometimes referred to as a penetration wound.


Puncture wound and lacerations caused by a dog bite.




– The separation of an appendage from the body; such as a finger or an arm.

– Usually a result of great shearing forces.



Open crush injuries can result in  soft-tissue trauma and damage to the underlying organs.



Emergency Medical Care for Soft-Tissue Injuries

– Ensure patent airway

  • Provide ventilation with oxygen as necessary
  • – Treat for shock, if signs and symptoms
    are present
  • High-flow oxygen
  • Direct pressure for bleeding control
  • Shock position
  • Rapid transport

– Expose the wound

– Place sterile dressing over wound and bandage in place

– Assess patient for possible spinal injury and immobilize appropriately

– If stable and airway patent, splint any painful, swollen or deformed extremity


In penetrating injuries, always check for an exit wound.



Dressings are used to stop bleeding and cover the wound; while the bandage is used to secure the dressing in place.


Occlusive dressing:

– Made of nonporous material to prevent the entry of any air, and usually containing an ointment that seals the dressing.

– Plastic wrap or aluminum foil can be used as a seal.

– With open neck or chest wounds, use an occlusive dressing to prevent air from entering the circulation.


Dressings come in assorted styles and shapes.



Bandages include tape, triangular bandages, gauze and an air splint.



Dressing & Bandaging

– Follow BSI precautions

– Expose the injured area

– Place sterile dressing over
entire injury

– Maintain pressure to control bleeding

  • If bleeding not controlled, ensure pressure is being placed on the correct site

– Use bandage to secure dressing
in place

  • Assess distal skin color and circulation

– If dressing becomes saturated with diffuse bleeding, add additional dressings

  • Do not remove bottom dressing in contact with wound

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