a common cause of both military and civil injuries. Gunshot wounds are usually produced by high-velocity missiles: deep-seated tissue destruction of thermal origin is a major complication.
A wound is any breach suddenly produced in the tissues of the body by direct violence. An extensive injury of the deeper parts without corresponding injury of the surface is known as a bruise or contusion.
Varieties These are classi?ed according to the immediate e?ect produced: INCISED WOUNDS are usually in?icted with some sharp instrument, and are clean cuts, in which the tissues are simply divided without any damage to surrounding parts. The bleeding from such a wound is apt to be very free, but can be readily controlled. PUNCTURE WOUNDS, or stabs, are in?icted with a pointed instrument. These wounds are dangerous, partly because their depth involves the danger of wounding vital organs; partly because bleeding from a stab is hard to control; and partly because they are di?cult to sterilise. The wound produced by the nickel-nosed bullet is a puncture, much less severe than the ugly lacerated wound caused by an expanding bullet, or by a ricochet, and, if no clothing has been carried in by the bullet, the wound is clean and usually heals at once. LACERATED WOUNDS are those in which tissues are torn, such as injuries caused by machinery.
Little bleeding may occur and a limb can be torn completely away without great loss of blood. Such wounds are, however, especially liable to infection. CONTUSED WOUNDS are those accompanied by much bruising of surrounding parts, as in the case of a blow from a cudgel or poker. There is little bleeding, but healing is slow on account of damage to the edges of the wound. Any of these varieties may become infected.
First-aid treatment The ?rst aim is to check any bleeding. This may be done by pressure upon the edges of the wound with a clean handkerchief, or, if the bleeding is serious, by putting the ?nger in the wound and pressing it upon the spot from which the blood is coming.
If medical attention is available within a few hours, a wound should not be interfered with further than is necessary to stop the bleeding and to cover it with a clean dry handkerchief or bandage. When expert assistance is not soon obtainable, the wound should be cleaned with an antiseptic such as CHLORHEXIDINE or boiled water and the injured part ?xed so that movement is prevented or minimised. A wounded hand or arm is ?xed with a SLING, a wounded leg with a splint (see SPLINTS). If the victim is in SHOCK, he or she must be treated for that. (See also APPENDIX 1: BASIC FIRST AID.)... wounds
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