n.

創傷

関: bruise、hurt、injury、trauma、traumatize、undermine

WordNet

put in a coil
an injury to living tissue (especially an injury involving a cut or break in the skin) (同)lesion
the act of inflicting a wound (同)wounding
a casualty to military personnel resulting from combat (同)injury, combat injury
a figurative injury (to your feelings or pride); "he feared that mentioning it might reopen the wound"; "deep in her breast lives the silent wound"; "The right reader of a good poem can tell the moment it strikes him that he has taken an immortal wound--t
injure the underlying soft tissue or bone of; "I bruised my knee" (同)contuse
an injury that doesnt break the skin but results in some discoloration (同)contusion
break up into small pieces for food preparation; "bruise the berries with a wooden spoon and strain them"
damage (plant tissue) by abrasion or pressure; "The customer bruised the strawberries by squeezing them"
any physical damage to the body caused by violence or accident or fracture etc. (同)hurt, harm, trauma
an act that causes someone or something to receive physical damage
wrongdoing that violates anothers rights and is unjustly inflicted
an accident that results in physical damage or hurt (同)accidental injury
inflict a trauma upon (同)traumatise, shock
a wound that does not damage important internal organs or shatter any bones
people who are wounded; "they had to leave the wounded where they fell" (同)maimed

PrepTutorEJDIC

windの過去・過去分詞
(身体の)『傷』,負傷 / (感情・自尊心などに対する)『痛手』,傷《+to+『名』》 / …‘を'『負傷させる』 / 〈感情など〉‘を'傷つける,〈人〉‘の'感情などを傷つける
『打撲傷』,打ち身 / (果物・野菜の)傷 / …打に傷(あざ)をつける;〈果物など〉'を'傷つける / 〈感情〉'を'損なう,〈人〉‘の'気を悪くさせる / 打ち傷がつく,あざができる;〈果物などが〉傷む
『負傷』,『損害』,損傷 / (名誉などを)傷つけること,侮辱《+『to』+『名』》
…‘の'下を掘る,下に穴(トンネル)を掘る / (浸食作用で)…‘の'土台を壊す(削る) / 〈健康・名声など〉‘を'知らないうちに(徐々に)害する,弱める
(特に戦争で)負傷した;(感情などが)傷つけられた

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/06/27 09:25:38」(JST)

wiki en

[Wiki en表示]

This article is about wounds in humans and animals. For wounds in plants, see Plant pathology.

"Open cut" redirects here. It is not to be confused with Cut (earthmoving).

For other uses, see Wound (disambiguation).

A wound is a type of injury in which skin is torn, cut, or punctured (an open wound), or where blunt force trauma causes a contusion (a closed wound). In pathology, it specifically refers to a sharp injury which damages the dermis of the skin.

Classification[edit]

Open[edit]

Open wounds can be classified according to the object that caused the wound. The types of open wound are:

Incisions or incised wounds, caused by a clean, sharp-edged object such as a knife, razor, or glass splinter.
Lacerations, irregular tear-like wounds caused by some blunt trauma. Lacerations and incisions may appear linear (regular) or stellate (irregular). The term laceration is commonly misused in reference to incisions.
Abrasions (grazes), superficial wounds in which the topmost layer of the skin (the epidermis) is scraped off. Abrasions are often caused by a sliding fall onto a rough surface.
Puncture wounds, caused by an object puncturing the skin, such as a nail or needle.
Penetration wounds, caused by an object such as a knife entering and coming out from the skin.
Gunshot wounds, caused by a bullet or similar projectile driving into or through the body. There may be two wounds, one at the site of entry and one at the site of exit, generally referred to as a "through-and-through."

Closed[edit]

Closed wounds have fewer categories, but are just as dangerous as open wounds. The types of closed wounds are:

Contusions, more commonly known as bruises, caused by a blunt force trauma that damages tissue under the skin.
Hematomas, also called a blood tumor, caused by damage to a blood vessel that in turn causes blood to collect under the skin.
Crush injury, caused by a great or extreme amount of force applied over a long period of time.

An open wound
A laceration to the leg
A lacerated knee
An infected puncture wound to the bottom of the forefoot.
A puncture wound from playing darts.

Pathophysiology[edit]

Main article: Wound healing

To heal a wound, the body undertakes a series of actions collectively known as the wound healing process.

Management[edit]

Wound, sewn with four stitches

The overall treatment depends on the type, cause, and depth of the wound as well as whether or not other structures beyond the skin (dermis) are involved. Treatment of recent lacerations involves examining, cleaning, and closing the wound. Minor wounds, like bruises, will heal on their own, with skin discoloration usually disappearing in 1–2 weeks. Abrasions, which are wounds with intact skin (non-penetration through dermis to subcutaneous fat), usually require no active treatment except keeping the area clean, initially with soap and water. Puncture wounds may be prone to infection depending on the depth of penetration. The entry of puncture wound is left open to allow for bacteria or debris to be removed from inside.

Cleaning[edit]

Evidence to support the cleaning of wounds before closure is poor.^[1] For simple lacerations, cleaning can be accomplished using a number of different solutions, including tap water and sterile saline solution.^[1] Infection rates may be lower with the use of tap water in regions where water quality is high.^[1] Cleaning of a wound is also known as wound toilet.^[2]

Closure[edit]

If a person presents to a healthcare center within 6 hours of a laceration they are typically closed immediately after evaluating and cleaning the wound. After this point in time, however, there is a theoretical concern of increased risks of infection if closed immediately.^[3] Thus some healthcare providers may delay closure while others may be willing to immediately close up to 24 hours after the injury.^[3] A single study has found that using clean non sterile gloves is equivalent to using sterile gloves during wound closure.^[4]^[5]

If closure of a wound is decided upon a number of techniques can be used. These include bandages, a cyanoacrylate glue, staples, and sutures. Absorbable sutures have the benefit over non absorbable sutures of not requiring removal. They are often preferred in children.^[6] Buffering the pH of lidocaine makes the freezing less painful.^[7]

Adhesive glue and sutures have comparable cosmetic outcomes for minor lacerations <5 cm in adults and children.^[8] The use of adhesive glue involves considerably less time for the doctor and less pain for the person with the cut. The wound opens at a slightly higher rate but there is less redness.^[9] The risk for infections (1.1%) is the same for both. Adhesive glue should not be used in areas of high tension or repetitive movements, such as joints or the posterior trunk.^[8]

Dressings[edit]

The effectiveness of dressings and creams containing silver to prevent infection or improve healing is not currently supported by evidence.^[10]

Imaging[edit]

A wound may be recorded for follow-up and observing progress of healing with different techniques which consist of, but not limited to:^[11]

Photographs, with subsequent area quantification using computer processing
Wound tracings on acetate sheets
Kundin wound gauge

Complications[edit]

The patient has a deep wound at the knee, and radiography is used to ensure there is no hidden bone fractures.

Bacterial infection of wound can impede the healing process and lead to life threatening complications. Scientists at Sheffield University have identified a way of using light to rapidly detect the presence of bacteria. They are developing a portable kit in which specially designed molecules emit a light signal when bound to bacteria. Current laboratory-based detection of bacteria can take hours or even days.^[12]

Workup[edit]

Individuals who have wounds that are not healing should be investigated to find the causes. Many microbiological agents can be responsible for this. The basic workup includes evaluating the wound, its extent and severity. Cultures are usually obtained both from the wound site and blood. X rays are obtained and a tetanus shot may be administered if there is any doubt about prior vaccination ^[13]

Chronic[edit]

Non-healing wounds of the diabetic foot are considered one of the most significant complications of diabetes, representing a major worldwide medical, social, and economic burden that greatly affects patient quality of life. Almost 24 million Americans—one in every 12—are diabetic and the disease is causing widespread disability and death at an epidemic pace, according to the Centers for Disease Control and Prevention. Of those with diabetes, 6.5 million are estimated to suffer with chronic or non-healing wounds. Associated with inadequate circulation, poorly functioning veins, and immobility, non-healing wounds occur most frequently in the elderly and in people with diabetes—populations that are sharply rising as the nation ages and chronic diseases increase.

Although diabetes can ravage the body in many ways, non-healing ulcers on the feet and lower legs are common outward manifestations of the disease. Also, diabetics often suffer from nerve damage in their feet and legs, allowing small wounds or irritations to develop without awareness. Given the abnormalities of the microvasculature and other side effects of diabetes, these wounds take a long time to heal and require a specialized treatment approach for proper healing.

As many as 25% of diabetic patients will eventually develop foot ulcers, and recurrence within five years is 70%. If not aggressively treated, these wounds can lead to amputations. It is estimated that every 30 seconds a lower limb is amputated somewhere in the world because of a diabetic wound. Amputation often triggers a downward spiral of declining quality of life, frequently leading to disability and death. In fact, only about one third of diabetic amputees will live more than five years, a survival rate equivalent to that of many cancers.

Many of these lower extremity amputations can be prevented through an interdisciplinary approach to treatment involving a variety of advanced therapies and techniques, such as debridement, hyperbaric oxygen treatment therapy, dressing selection, special shoes, and patient education. When wounds persist, a specialized approach is required for healing.^[14]

History[edit]

Medieval treatment of wound with lance grittings

From the Classical Period to the Medieval Period, the body and the soul were believed to be intimately connected, based on several theories put forth by the philosopher Plato. Wounds on the body were believed to correlate with wounds to the soul and vice versa; wounds were seen as an outward sign of an inward illness. Thus, a man who was wounded physically in a serious way was said to be hindered not only physically but spiritually as well. If the soul was wounded, that wound may also eventually become physically manifest, revealing the true state of the soul.^[15] Wounds were also seen as writing on the "tablet" of the body. Wounds acquired in war, for example, told the story of a soldier in a form which all could see and understand, and the wounds of a martyr told the story of their faith.^[15]

References[edit]

^ ^a ^b ^c Fernandez, R; Griffiths, R (2012 Feb 15). "Water for wound cleansing". In Fernandez, Ritin. Cochrane database of systematic reviews (Online) 2: CD003861. doi:10.1002/14651858.CD003861.pub3. PMID 22336796.
^ Simple wound management on patient.co.uk website, viewed 2012-01-08
^ ^a ^b Eliya, MC; Banda, GW (2011 Sep 7). "Primary closure versus delayed closure for non bite traumatic wounds within 24 hours post injury". In Eliya, Martha C. Cochrane database of systematic reviews (Online) 9 (9): CD008574. doi:10.1002/14651858.CD008574.pub2. PMID 21901725.
^ Perelman, VS; Francis, GJ, Rutledge, T, Foote, J, Martino, F, Dranitsaris, G (2004 Mar). "Sterile versus nonsterile gloves for repair of uncomplicated lacerations in the emergency department: a randomized controlled trial". Annals of Emergency Medicine 43 (3): 362–70. doi:10.1016/j.annemergmed.2003.09.008. PMID 14985664.
^ van den Broek, PJ (2011). "[Sterile gloves are necessary in minor surgery]". Nederlands tijdschrift voor geneeskunde 155 (18): A3341. PMID 21466736.
^ "BestBets: Absorbable sutures in pediatric lacerations".
^ Cepeda MS, Tzortzopoulou A, Thackrey M, Hudcova J, Arora Gandhi P, Schumann R (2010). "Adjusting the pH of lidocaine for reducing pain on injection". In Tzortzopoulou, Aikaterini. Cochrane Database Syst Rev 12 (12): CD006581. doi:10.1002/14651858.CD006581.pub2. PMID 21154371.
^ ^a ^b Cals, JW; de Bont EGPM (2012). ". Minor incised traumatic laceration". BMJ 345: e6824. doi:10.1136/bmj.e6824. PMID 23092899.
^ Farion, K; et al (2002). "Tissue adhesives for traumatic lacerations in children and adults". In Farion, Ken J. Cochrane Database Syst Rev. doi:10.1002/14651858.CD003326.
^ D'Amico G, Pagliaro L, Pietrosi G, Tarantino I (2010). "Emergency sclerotherapy versus vasoactive drugs for bleeding oesophageal varices in cirrhotic patients". In d'Amico, Gennaro. Cochrane Database Syst Rev 3 (3): CD002233. doi:10.1002/14651858.CD002233.pub2. PMID 20238318.
^ Thomas, AC; Wysocki, AB (1990 Feb). "The healing wound: a comparison of three clinically useful methods of measurement.". Decubitus 3 (1): 18–20, 24–5. PMID 2322408. Retrieved 15 June 2013.
^ "Light to detect wound infection" (web). UK scientists have identified a way of using light to rapidly detect the presence of bacteria. bodat. BBC News. 11 March 2007. Retrieved 2008-03-17.
^ Work Up eMedicine General Surgery. Retrieved on 2010-01-27
^ "The Clinical Case for Use of Hyperbaric Oxygen Therapy in the Treatment of Diabetic Wounds," Diversified Clinical Services, copyright 2009
^ ^a ^b Reichardt, Paul F. (1984). "Gawain and the image of the wound". PMLA 99 (2): 154–161. doi:10.2307/462158. JSTOR 462158.

External links[edit]

Wikiquote has a collection of quotations related to: Wounds

Look up wound in Wiktionary, the free dictionary.

Wikimedia Commons has media related to: Wounds

WOUNDS, open-access, print and online, peer-reviewed journal featuring articles about wound care and related research.
Ostomy Wound Management, open-access, print and online, peer-reviewed journal featuring articles about wound care, ostomy care, incontinence care, and nutrition
Today's Wound Clinic, the leading journal decision makers read in US wound care clinics.
Journal of Burns and Wounds, online open-access journal featuring articles about wound care and related research
Journal of Wound Care, the leading monthly journal for nurses, medics and researchers working in wound care
US based wound healing society
Association for the Advancement of Wound Care AAWC
European Wound Management Association - EWMA works to promote the advancement of education and research.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 創傷マネージメントの基本原則 basic principles of wound management
2. 創傷治癒および治癒しない創傷の危険因子 wound healing and risk factors for non healing
3. 創傷の臨床評価 clinical assessment of wounds
4. 小さな創傷部の処置および洗浄 minor wound preparation and irrigation
5. 縫合糸による皮膚創傷部の閉鎖 closure of skin wounds with sutures

English Journal

Application of Cryopreserved Fibroblast Culture with Au Nanoparticles to Treat Burns.

Volkova N1, Yukhta M2, Pavlovich O3, Goltsev A4.
Nanoscale research letters.Nanoscale Res Lett.2016 Dec;11(1):22. doi: 10.1186/s11671-016-1242-y. Epub 2016 Jan 14.
The aim was to investigate a possibility of using the cryopreserved human culture of fibroblasts (CrHFC) with gold nanoparticles (AuNPs) to treat experimental burns in rats.The third-degree burns were modeled in white male rats. All the animals with burns were divided into three experimental groups:
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Japanese Journal

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