Abrasions, Cuts, Lacerations
Abrasions, Cuts, Lacerations
The human skin is the largest organ of the body, providing a protective coverage for the internal structure and organs. Skin comprises an area of between 16.1 ft2 and 21.6 ft2 (1.5 m2 and 2.0 m2), at an average thickness of 0.00394 in (0.1 mm), accounting for between 15% and 18% of the total body weight. The layer of skin enveloping the body comprises three separate components: the epidermis (the outer shell), the dermis (the middle layer), and the sub cutis (the lower layer). Given its role as the protective shell for the internal organs and structure, the skin sustains constant contact and consequently, it is the most injured human organ.
Skin is often subjected to cavalier, uncaring treatment on the sports field. The athletic injuries sustained to the skin are typically classified as abrasions, cuts, lacerations, and blisters. Each has a distinct meaning that is, in essence, a description of the nature and the severity of the injury sustained to the skin. In general terms, abrasions and cuts are types of less serious, more superficial skin injuries, while lacerations are often regarded as a more serious wound, posing a threat to the health to the body beyond its skin covering. The depth of each injury is the chief distinction between each term.
An abrasion is an incident of superficial damage to the surface of the skin, with the injury generally penetrating no deeper than the epidermis, the skin's outer layer. An abrasion causes the skin to be roughened and take on a reddish color, sensitive to the touch. A common cause of an abrasion is the friction produced between the unprotected skin of an athlete contacting a rough surface, such as artificial turf or pavement. While most typical abrasions occurring in a sports context involve the skin, the cornea, which is the clear surface of the eye that covers the iris, can also sustain an abrasion when a sharp object such as a fingernail scrapes the corneal surface.
Abrasions will generally heal within a few days of the incident. Where small foreign particles are lodged in the surface of the skin, these are commonly removed with tweezers. To ensure that the risk of infection is reduced, a topical antibiotic is often applied to the surface of the affected area.
A cut is a penetration of the skin that generally results in the epidermis being punctured, causing the underlying circulatory system to be damaged, with blood being drawn into the opening. A cut may be of sufficient depth or extent to require repair through stitches to close the opening; a typical cut will not impair athletic performance beyond the time required to bandage the injury. A cut is often caused by contact with a sharp object, such as a stick or puck in ice hockey, or a cleat in sports such as rugby or soccer.
The time required for a cut to heal will depend upon the extent of the damage caused to the skin. A period of from 5 to 14 days is the general healing parameter. The medical attention to resolve a cut will include the cleaning of the damaged area, the removal of any foreign objects from the skin, the stitching or suturing of the opening to close it where required, and the covering of the injury with a bandage. While a cut exposed to the open air tends to heal more quickly than one bandaged, the covering will help reduce the risk of infection. Depending upon the location of the cut on the body, once bandaged and protected, this injury will not generally limit an athlete's participation in training; most competitive sport organizations have protocols concerning the return to competition by a player who has been cut and where blood flow resulted. These procedures are directed at the safety of other participants from possible infection through blood-borne causes.
A laceration is a more serious injury, described as a tearing or ripping of the skin and the fatty tissues or muscles beneath it. A laceration is often associated with a significant blood flow from the opening in the skin, as well as damage to the underlying structures. Where a cut is generally a neat symmetrical injury, a laceration will often result in jagged edges to the affected skin, and of sufficient depth that the blood flow from the opening is heavy. The repair of a laceration may require intricate suturing, and it may also result in a permanent scar.
The depth of a typical laceration to the skin creates a significant risk of infection, as foreign particles all types have access to the tissues and the bloodstream. Tetanus, a serious disease of the central nervous system caused by microbes present in the soil, is a prime concern in treating a laceration; a tetanus injection will often be administered. The nature and the depth of the laceration will almost always require stitches to close the wound. As with the treatment of a cut, the laceration will typically be bandaged to protect the skin and the sutures.
An athlete whose skin has been lacerated will often be restricted in both training and competition until the sutures have been removed (often a period of from 10 to 14 days from the insertion of the sutures in the skin), perhaps longer depending upon the extent of any other injury. As the ability of the skin to regenerate slows as the body ages (the epidermis of a 60-year-old person may be 30-80% thinner than that of a 20-year-old person), the healing time for a laceration will be significantly longer for the older athlete.
As of the early 2000s, techniques have been developed to assist athletes in speeding recovery from cuts and lacerations. Octylayanoacrylate, an adhesive-like compound marketed commercially as Dermabond, has been used successfully to repair injuries of up to 2.3 in (6 cm) in length, that would have otherwise required stitches.