Let’s look at some common terms for the different types of wounds. Skin wounds can be classified as either open or closed. Open wounds cause a break to the skin tissue, whereas closed wounds leave the skin intact.
Closed Skin Wounds
Here are the types of closed skin wounds that you’ll want to know.
1. Contusion: This is the medical term for a bruise. Contusions cause a discoloration of the skin due to damage or trauma to underlying blood vessels. They can be tender but tend to be flat and soft. They can vary in color depending on the person’s skin tone and the stage of healing, appearing as purplish, dark green, brown, or yellowish.
2. Hematoma: This is similar to a contusion in that it is a closed wound caused by trauma, but it is more severe and in some cases may require medical intervention. The damage to the underlying vessels causes blood to pool under the skin, often creating a harder area or lump. The prefix “hema” refers to blood, and the suffix “toma” refers to a mass or tumor. So, this is a mass of blood under the skin.
4. Blister: This is a type of wound where a fluid-filled pocket develops under the surface of the skin (or between skin layers) due to some type of friction, allergy, or burn. The top layer of skin remains intact, but if the blister ruptures, it may be classified as an open wound.
5. Frostbite: This is a type of skin wound caused by prolonged exposure to freezing temperatures. It often affects the extremities, such as the fingers and toes, but it can also affect the nose, ears, and other parts of the body. Frostbite presents as a dark purple or black color. It can also cause damage to underlying tissue and may result in the loss of the affected tissue. If the skin breaks, it will become an open wound.
Also, frostbite can also be considered a type of burn (though it’s caused by cold rather than heat).
Open Skin Wounds
Now let’s look at open skin wounds.
1. Abrasion: This is a scrape that is going to mostly affect the epidermis, which is the outer layer of the skin. This can vary in its appearance, depending on what caused the friction on the skin. Abrasions usually have minor amounts of bleeding or even no bleeding, depending on the depth of the wound. However, it can be painful due to the nerve endings being exposed.
2. Laceration: This is caused by being cut by a sharp object or from some type of blunt trauma. This wound can have an appearance that is messy and irregular with lots of bleeding. These wounds are often very painful.
3. Incision: This is a type of wound that may seem similar to a laceration, but it is usually made intentionally via a surgical instrument such as a scalpel. The skin will generally be symmetrical and the wound edges will be neat compared to a laceration.
4. Skin Tears: Skin tears usually occur due to shearing or stretching of the skin tissue beyond its normal limit, leaving tears or flaps in the skin. This typically occurs in populations with thinning or fragile skin, such as patients on long-term corticosteroids, geriatric (elderly) patients, or pediatric (infant) populations.
5. Puncture Wound: Just as the name suggests, the skin tissue has been punctured or pierced with some type of sharp, narrow object such as knife or needle. However, the underlying tissue is usually not affected in a significant way.
6. Penetrating Wound: A wound that involves an object going beyond the skin and entering the deeper tissues of the body. For example, a stab wound or gunshot wound would usually be classified as a penetrating wound.
7. Avulsion: This is a serious type of skin wound that occurs when there is a removal of the skin and/or underlying tissue from the body. It may result from things like car accidents or an attack from a vicious animal, such as a bear or dog. This type of wound is at high risk for infection due to the complete loss of tissue.
8. Burns: This type of skin wound is caused by damage to the skin layers from an energy source like heat, chemicals, or other energy sources. Burns are categorized by degrees, depending on how deeply the energy source penetrates and damages each layer of the skin. Lesser-level burns, like first-degree, are considered closed wounds, while second, third, and fourth-degree burns are open wounds because the skin is no longer intact.
- First-Degree Burn (Superficial): Affects only the epidermis. They are red, painful, warm, and have no blisters. They usually heal in 7 days.
- Second-Degree Burn (Partial-Thickness): Affects the epidermis and dermis. They are painful, form blisters, and are red and swollen. The skin may need grafting if severe.
- Thrid-Degree Burn (Full-Thickness): All skin layers are affected. The nerves are destroyed, so it typically is not painful. This type of burn requires grafting, takes months to heal, and may present as black/yellow/eschar.
- Fourth-Degree Burn (Deep Full-Thickness): All layers are destroyed. This type of burn extends to muscles/bones. There is often no pain, and there can be significant black/charred amounts of sin. It often requires months to heal and will require grafting.
9. Pressure Injuries: These wounds are caused by the breakdown of skin integrity due to unrelieved pressure. This pressure can result from a bony area on the body that comes into contact with a hard surface or from a medical device that causes sustained pressure. There are various stages of pressure injuries:
- Stage 1: Intact skin contains a red area that does not blanch when pressed
- Stage 2: Partial loss of skin with no fatty tissue visible; may form a blister or shallow ulcer
- Stage 3: Full skin loss, fatty tissue visible; edges may roll (epibole); bone, muscle, or tendon are not visible
- Stage 4: Full skin loss exposing bone, muscle, tendon, or ligaments
- Unstageable: Full-thickness ulcer covered by slough or eschar; depth cannot be assessed
10. Venous and Arterial Ulcers: These are chronic type of wounds that do not heal properly due to underlying circulation problems. Learn more about venous and arterial ulcers.
Arterial Ulcers:
Arterial ulcers form due to poor arterial circulation. The arterial system fails to deliver fresh, oxygenated blood to specific tissues in the body, causing them to die. The most common areas affected are the toes, tops of the feet, and lateral ankles (malleolus). These ulcers have little drainage, contain pale or necrotic tissue, and have a deep “punched-out” shape with defined edges. Additionally, the skin around the ulcer will be very shiny and hairless. These ulcers are very painful.
Venous Ulcers:
Venous ulcers form due to poor venous circulation. The venous system fails to drain deoxygenated blood back to the heart, causing blood to pool in the extremities, leading to tissue damage and ulcer formation. The most common areas affected are the medial lower legs (inner part of the calf) and medial ankle (inner ankle). These ulcers are swollen, with high amounts of drainage, a deep pink or red granulation tissue in the wound bed, irregular edges, and are typically shallow. The surrounding skin will be dry, itchy, and may have pigmentation. Pain is also present.
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