Bruised wound of the scalp. Therapeutic measures for bruises. Hematoma on the head from a bruise: treatment

A head wound is damage to the integrity of soft tissues with their divergence (open wound) or with the formation of a hematoma (closed wound), which occurs due to a bruise, blow or fall from a height. Wounds, depending on the type, can be life-threatening with the development of large-scale bleeding. First aid and comprehensive treatment will help reduce the risks of complications.

Considering the nature of the damage, there are several types of wounds:

Based on the depth of damage to the head area, wounds are classified into:

soft tissue damage;
damage to nerve fibers;
damage to large blood vessels;
damage to bone tissue;
damage to parts of the brain.

Each wound has its own causes and characteristics. In the event of accidents or disasters, injuries can be complex and include several types of wounds with their own characteristics.

Open

An open head wound is accompanied by a dissection of the skin with characteristic development bleeding. The amount of blood discharge depends on the location of the wound, its depth and the cause of its occurrence. The danger of this group of wounds is that there are large vessels, violation of the integrity of which entails the development of full-scale bleeding. Lack of qualified help can cost a person his life.

Open wounds are accompanied by loss of consciousness, nausea, numbness of the extremities, which indicates a concussion and bruise of the meninges. Along with stopping the bleeding, the victim is resuscitated, restoring everything vitally. important processes in organism.

Closed

Most often, a closed wound is the result of impact on the head area with a blunt heavy object, or a fall from a height. A hematoma and bruise are formed, while the skin does not diverge and does not provoke the development of bleeding.

Clinical manifestations are similar to open wounds except for the absence of bleeding. Because the we're talking about about the head, in addition to eliminating the hematoma, it is necessary to make sure that there is no damage to the meninges and the brain itself, which may develop somewhat later.

Characteristic signs and clinical manifestations of all types of wounds

Differentiating wounds is not difficult. To do this, you should pay attention to clinical manifestations and the patient's condition.

Gunshot wounds to the head are fatal in 99% of cases. They are characterized by deep penetration of a bullet or shrapnel into the deep layers of the brain with damage to large blood vessels, bone tissue and nerve endings. Only if there is a tangential gunshot wound can a person be conscious. A blind and through wound in almost all cases provokes instant death.

Bite wounds have such distinctive features as:

lacerated wound with no straight ends of connective tissue;
bleeding;
accession inflammatory process.

On the teeth of animals or humans is great amount microbes that, when bitten, enter the victim’s bloodstream. Therapy involves antibacterial therapy and vaccinations against rabies and tetanus.

The following manifestations are typical for a laceration:

irregular shape of the wound, many edges not touching each other;
heavy bleeding and strong pain;
impaired sensitivity of organs located on the head.

Numerous and deep lacerations can provoke the development of painful shock, which is characterized by complete loss of sensitivity, loss of consciousness and coma.

A bruised closed wound has a relatively smooth outline in the form of a circle, crumpled inside. Often the appearance of the wound resembles the imprint of the object that provoked its appearance. Small capillaries cause bleeding, which causes the development of a rich purple and purplish-red hematoma. Bleeding is absent completely or partially. Predominantly superficial capillary bleeding develops, caused by a violation of the integrity of the outer layer of skin. Swelling and swelling appears at the site of the injury. Soon a lump forms, which gradually disappears.

Chopped wounds are characterized by a large depth and area of damage to the head. From strong blow the victim often loses consciousness. There is proliferation of soft tissues and bones, after which there may be death. The wounds are accompanied high probability infection, since the item was previously used for its intended purpose, which leads to the penetration of pathogenic microflora into the deep layers of the cranium.

Incised wounds are accompanied heavy bleeding, as well as the presence of a lumen of varying depths. Soft tissues and nerve fibers. The brain is not injured. Appears sharp pain, causing development painful shock. When pathogenic microflora enters the general bloodstream, it joins clinical picture intoxication with fever, chills and fever.

For puncture wounds distinctive features are:

relatively smooth edges inlet;
slight swelling and hyperemia of the skin around the puncture;
no heavy bleeding.

When a punctured object is in the wound, its edges are directed inward. The injury is accompanied by severe pain, dizziness and nausea.

First aid algorithm

First aid kit for wounds

First aid, regardless of the type of wound, is carried out according to the following scheme:

press into the wound and set bone fragments on your own;
rinse deep wounds water;
extract by yourself foreign objects from the head;
Give the victim medication.

A bruised wound to the scalp is almost always accompanied by a concussion and vomiting. Therefore, the patient is placed on his side, with a cushion placed under his head.

At laceration it is necessary to transport the patient to the hospital as quickly as possible, as stitches will be required.

You can treat a head wound with brilliant green or iodine if it is minor.

Treatment methods depending on the nature of the damage

Providing first aid for head wounds

Hematomas and closed wounds are treated with absorbable heparin-based creams. The wound does not require additional treatment. Special attention pay attention to symptomatic treatment, selecting it taking into account individual characteristics body.

Open wounds, especially the lacerated type, require sutures. After this, the scar is treated with brilliant green or iodine solution. A colloidal scar may form at the wound site, to reduce the appearance of which Contractubex ointment is used.

Included complex therapy the following groups of drugs are prescribed:

A scalp wound may have different kinds and shape, as well as the degree of damage. Gunshots are considered the most dangerous, since the survival rate after them is minimal. Treatment of a head wound helps prevent pathogenic microflora from entering the general bloodstream. Correctly provided assistance will save a person’s life.

A head injury can occur due to an impact with a hard surface, which is accompanied by damage to the brain. Wounds can also be classified as injuries; they can be cut, chopped, torn, scalped, etc. After a head injury has occurred, the type of injury, the degree of blood loss and the severity of the person’s condition should be determined.

What can cause head injuries: causes

There are two types of head trauma:

Mechanical damage only to the soft coverings of the head, when the bones of the skull and brain are not affected.
Mechanical damage to the bones of the brain and skull.

In the first case, such an injury is called a head contusion, this type damage occurs in most cases. Damage by mechanical energy to the skull and its contents - the brain, blood vessels, membranes and cranial nerve, is regarded as a traumatic brain injury.

The main causes of such injuries include:

Accidents resulting from car accidents, catastrophes, household or industrial damage.
Falling from height.
Infliction of physical violence by another person or group of people.

Symptoms of head injury

With a head injury accompanied by a hematoma, a person may feel pain in the area of the injury. You can cope with such an injury on your own without medical help. If bleeding from the wound does not stop, you feel severe pain in the head, there is dizziness, the pain radiates to the neck, and nausea sets in, then you need to urgently contact a medical facility.

At the following symptoms you will need emergency medical attention:

Leaking from nose and ears clear liquid or blood.
Temperature 38 degrees or more.
If, in addition to the head, the neck, back of the head and back are damaged.
Onset of seizures.
Consciousness is impaired.
The person cannot move independently.
The gaze is wandering.
The speech reflex is damaged.
When vision is blurred or pupils become deformed.
If a person has difficulty breathing.
In case of loss of consciousness.

What complications can there be?

Since a head injury entails serious consequences, against its background the following complications may arise:

Personality change.
Nervous system disorders.
Speech is impaired.
Memory and thinking disorder.
Hearing, speech, vision, smell, and touch may disappear.
The appearance of seizures.
A person can be paralyzed.
Falling into a coma.

Treatment of head injury

As already said, slight bruise does not require hospitalization, home procedures, application of cold to the bruise, complete rest, etc. will be sufficient. If you have a severe head injury, the symptoms of which were described above, you will need the following first aid:

Providing peace to the victim. The first thing to do before the ambulance arrives is to put the person in a dark room and try not to disturb him, especially try not to turn your neck. His body position should be such that his head and shoulders rise slightly.
Stop bleeding. Need to apply pressure to the wound sterile bandage or a bandage. But if there is a suspicion of it, then you should not press directly on the wound.
Control the victim’s breathing and consciousness. If you see that a person is not showing signs of life, you should begin cardiopulmonary resuscitation.

Among other things, if the injury is not so severe, then first aid should consist of additional actions:

If this severe bruise, you need to apply ice to the resulting hematoma or swelling.
Do not give any medications to the victim until the doctor arrives.
Provide rest to the patient on the first day.
To check if a person has memory loss, ask him a few questions about where he lives, his name, etc.

After the ambulance arrives, doctors will take all measures to treat the injured person.

To eliminate the possibility of serious injury, the patient will be referred for additional examinations, which include x-rays of the cervical vertebrae and skull. If you have any doubts about internal bleeding and tumors, a CT scan is performed.

Treatment of complex head trauma in mandatory carried out in a hospital setting.

Preventing head injury

To prevent head injuries, follow these simple rules:

When riding a motorcycle or even a bicycle, do not neglect a helmet.
Monitor your children and provide them with safe places for games.
Don't break traffic rules.
Do not drive when you are in poor condition.
Do not ride a bicycle at night.
Do not forget about protective equipment (helmet on a motorcycle, belt in a car).
Never drive after drinking alcohol or sit as a passenger in a car where you think the driver is drunk.
If you have a child, purchase a child seat for your car.

Open injuries. With an open injury, skin damage, aponeurosis is observed, the bottom of the wound exposes the cranial bone or deep-lying tissues. If the hard shell of the cranial bone is damaged, the wound is considered penetrating.

Closed injuries. In this case, the aponeurosis is not injured, but the scalp may be damaged.

Traumatic brain injuries are divided into several types:

Shake. Violations brain activity Hardly ever. Over a certain period of time, the symptoms of such an injury disappear. If they don't pass long time, which means there is more serious damage. In this case, the person may lose consciousness. Nausea, vomiting, pallor and cardiac dysfunction are sometimes observed.
Compression. Compression of the brain may be due to a large hematoma, foreign body, accumulated air or source of damage.
Injury. It can be mild, moderate and severe.
Diffuse axonal injury.
Subarachnoid bleeding in the brain.

Some of these types can be combined with each other.

Head injury in a child

If a head injury occurs in a child, treatment and hospitalization are carried out in the same way as in an adult. It is very important for parents to know that after receiving a brain injury with fractures, symptoms may not appear immediately, but only after some time. Therefore, after your child is injured, constantly monitor his actions and at the first signs of disturbances, urgently take him to the hospital for examination.

Be sure to call ambulance in the following situations:

If the child is less than 9 months old, at this time the baby’s skull bones have not yet formed, and the neck muscles are weak.
There is a large hematoma or lump on the head.
The child has different sized pupils.
Blood does not stop flowing from the wound for more than 5 minutes, even after first aid.
After the injury occurred, the child developed a headache within a few minutes.
Vomiting, lethargy appeared, consciousness was impaired, movements were difficult.

If after a bruise the child behaves as usual, but in some cases feels nauseous, refuses to eat and complains of headache, also consult a doctor; you may still need a brain scan.

Even with a minor injury, you should provide rest to the child, put him to bed, let him lie down for a while. And in the next 3 days, do not allow noisy games.

If the injury occurred in evening time, then do not let the child fall asleep for at least half an hour, as you will have to observe the baby’s behavior so as not to miss dangerous symptoms. At night you will have to wake up the child several times to make sure that his consciousness is normal. The next day you also need to monitor the baby’s behavior and in case of alarming behavior or symptoms, contact medical assistance. Do not give your child any medications until the doctor arrives.

Sometimes the baby’s activity results in dangerous wounds appearing on his body that need immediate attention. sanitization. A wound on a child's head can cause purulent formations, and therefore it must be eliminated immediately after detection.

Dealing with a small wound

A wound on a child’s head may appear due to various reasons, but most often this problem occurs due to careless play or a strong blow received during a fall. There is no need to panic, because in this stressful situation It is important that both the baby and adults maintain a sober mind.

The first thing adults should do is to carefully examine the wound that appears and try to clean its edges with a bandage and warm water. Once the dried blood and dirt have been removed, you can proceed to treatment with hydrogen peroxide. Peroxide should only be used that has not expired. When interacting with an open wound, this composition will begin to actively foam. The child may also feel a burning sensation, so parents should blow on the sore spot.

The next stage is treating the wound with brilliant green, iodine or alcohol. The composition should be applied not only to the wound itself, but also to the area around it. Here the child may also feel a sharp burning sensation. Now all that remains is to apply a sterile bandage to the sore spot and carefully secure it with an adhesive plaster.

These procedures must be repeated until the wound begins to decrease in size and disappears completely. Light scratches should not be ignored, because infection can enter the child’s body through them. Scratches need to be treated with peroxide and iodine, but applying a special bandage will be unnecessary. Parents should carefully examine the wound for several days. acute inflammation. If such inflammations occur, it means that the wound has become infected with microbes, and you should immediately consult a doctor.

Sometimes even the smallest wound can cause severe bleeding, which parents are unable to eliminate on their own. In this case, it is necessary to consult a doctor as soon as possible, since a professional can easily resolve the problem.

Necessary actions when detecting large wounds on the head

It is extremely dangerous to eliminate large wounds on a child’s head on your own. The most important thing here is to eliminate heavy bleeding and remove foreign objects that may be in the wound. It should be carefully examined, try to clean it and then fill it with hydrogen peroxide. Also, such wounds can be treated with a solution of potassium permanganate.

It is useless to treat a large wound with iodine or brilliant green, since the primary task is to stop the bleeding. That is why parents need to carefully bandage their head, applying a bandage to the wound in advance. After the manipulations have been performed, it is necessary to monitor the child’s condition. If the bleeding cannot be stopped, you should immediately consult a doctor for qualified help. Large wounds are often deep and can be life threatening to the child. Parents, instead of going to the hospital, prefer to tightly bandage their head, limiting the access of oxygen to the sore spot. The bandage should not be tight, should not interfere with the child and limit his movements.

As soon as the bleeding stops, parents need to start antibacterial treatment of the wound. By washing with alcohol or brilliant green, it will be possible to prevent the wound from festering. Typically, large wounds take a very long time to heal, and therefore parents have to monitor the condition of the baby for several weeks.

If the bleeding cannot be stopped by applying a bandage and treating with hydrogen peroxide, you should contact a specialist. The wound may have to be sutured, and only a doctor with sufficient qualifications is capable of such manipulations.

Large wounds around the eyes are considered the most difficult, since they are very difficult to remove on your own. With such wounds there is always a risk of damage optic nerves, so self-processing seems impossible.

An attentive parent will always be able to notice a wound that appears in time, before it begins to threaten the life and health of the baby. Eliminating such damage is a very serious matter, and it is worth taking on it only if the parents are confident in their own abilities.

All wounds of the soft tissues of the head and face bleed significantly even with minor damage due to the abundant blood supply.

Bruised wounds characterized by rapidly increasing swelling and profuse bleeding, and may be accompanied by significant soft tissue detachment and contamination. In the scalp area, skin damage may be small, and soft tissue is usually exfoliated over a significant area. If the aponeurosis is cut, the wound gapes.

Lip wounds often spread to the oral mucosa.

Incised wounds always bacterially contaminated, loss of facial tissue and its protruding parts (nose, chin) is often noted.

Gunshot wounds characterized by facial disfigurement, significant tissue defects, and penetration into the oral cavity, nose, and skull.

In addition, there may be chopped, stab, or scalp wounds, in which a significant area of the scalp is torn off and the skull is exposed.

In case of tissue injuries, one should always remember the possibility of damage to the skull bones and intracranial complications. In case of facial injuries, damage to the facial skull is possible, parotid gland, facial nerve, air sinuses of the nasal cavity.

Head wounds, especially bruises, bites and gunshot wounds, can be complicated by suppuration of soft tissues. The infection may spread to bone tissue, meninges, cause brain abscess, venous sinus thrombosis.

First aid and treatment

Immediate stop of bleeding at the scene of the incident is necessary.. For minor wounds, it is enough to apply a pressure bandage. For more severe bleeding, apply pressure to the bleeding vessel. throughout and transport the patient to the hospital.

Soft tissue wounds require surgical treatment. A special feature of the treatment of wounds of the face and head is the gentle excision of only clearly non-viable and severely contaminated edges. A thorough inspection of the wound bottom is required. To apply sutures, use nylon or horsehair to form a neat scar. For incised wounds, the edges can be brought together using an adhesive plaster; in this case, no suture is applied.

Wounds of the tongue and oral mucosa must be sutured with catgut. Treatment of wounds of the scalp is always performed in the operating room with the patient in the supine or prone position.

The hair around the wound is first carefully cut 3-4 cm as short as possible, and then soaped and shaved, making movements away from the edges of the wound. The wound is cleaned with a 3% solution of hydrogen peroxide, a solution of furatsilin or chlorhexidine, removing hair and other foreign bodies from the wound.

After applying the bandage, the patient is advised to bed rest, cold on the head. He needs to be monitored. If severe headaches, changes in behavior, drowsiness, disturbances in consciousness, changes appearance, weakness, the patient must be hospitalized immediately, and if he is in the hospital, nurse should immediately report these changes to your doctor.

Open injuries to the soft tissues of the head. Wounds can be gunshot or non-gunshot. Gunshot wounds There are bullet, fragmentation and shotguns. When soft tissue is injured, a wounding projectile can impact the bones of the skull and brain with the energy of a side impact.

Non-gunshot soft wounds- head tissues can be cut, chopped, punctured, bruised, torn, patchwork and scalped. All head wounds are dangerous, since the developing inflammatory process along the lymphatic and venous vessels can easily spread to the contents of the skull - the brain and membranes. Hair contributes to wound contamination.

Symptoms: cut wound gapes and is accompanied by severe bleeding. A chopped wound is often combined with damage to the bones of the skull. With puncture wounds, the tip of the piercing weapon can penetrate the bone, break and get stuck in it. Bruised and crushed wounds often do not bleed at all as a result of compression, twisting or contraction of the ends of ruptured vessels. With bruised and lacerated wounds, significant detachment of the skin from the underlying tissues often occurs with the formation of flaps of different sizes and shapes, consisting of one skin or skin with subcutaneous fatty tissue. Their edges are usually uneven and jagged. Scalp wounds to the head often occur when long hair fall into moving mechanisms (machine, etc.). Soft fabrics heads can be scalped over a large area according to the level of hair growth. Pain from a fresh wound depends on damage and irritation of the endings of the sensory nerves; the appearance of pain in late period indicates the development of an inflammatory process, often deep in the wound.

Head wounds with soft tissue injuries require follow-up care, as symptoms of brain injury may not appear until some time after the injury.

Brain damage can be judged based on changes in hemodynamics (peripheral pulse, blood pressure), state of consciousness, focal and meningeal neurological symptoms. It is necessary to pay serious attention to the general condition of the patient.

Treatment. When providing first aid - lubricate the wound circumference with iodine tincture and apply an aseptic pressure bandage. Washing and rinsing the wound with water and various solutions. Administration of a prophylactic dose antitetanus serum and toxoid.

Primary debridement soft tissue wounds of the head: the hair around the injury is shaved wide. Local anesthesia - layer-by-layer infiltration with 0.5% novocaine solution. Novocaine is injected under the aponeurosis in an amount that ensures the appearance of an infiltrate extending 4-5 cm beyond the edges of the wound. It is acceptable to use short-term intravenous anesthesia(sombrevin). This is followed by a thorough inspection of the wound. It is necessary to decide whether there is damage bone structures. Excision of the edges of the wound is not performed, or it is minimal in extent. When excision, it is necessary to take into account the possibility of matching the edges of the wound at the end of the operation. Wounds with a large tissue defect are not excised. Sutures for tendon stretching and skin. For scalped wounds, flap replantation is indicated. Long flaps must be perforated. Drains made of glove rubber or Redon. Good blood supply to the tissues of the head with timely surgery promotes healing by primary intention. Wounds to the scalp are sutured with a vertical mattress suture. The ends of the threads are cut off. Stepping back 2 cm from this suture line, the wound is stitched through all layers with additional strong long threads. The distance between the seams is 2 cm. Sterile gauze and a tightly twisted roller with a diameter of up to 3 cm are applied to the wound. The roller is strengthened by tying long threads. The bandage can be removed on the 3-4th day by smearing the open suture line with BF-6 glue, Tserigel, or furaplast. There are some peculiarities when suturing wounds of the facial part of the head. Wounds in the eyebrow area are sutured with simple interrupted sutures. Wounds of the lower eyelid and forehead are sutured with a continuous single-row or double-row suture. Adaptation of the wound edges is ensured by gluing sterile gauze strips parallel to the suture line. Wounds upper eyelid closed with interrupted sutures. On auricle Only the skin is sewn together. The stitches are removed after 3 days. Lip wounds are stitched with interrupted or continuous sutures, and interrupted sutures are placed along the edge of the red border. In case of a penetrating wound, the lips first sew together the muscle layer, then the mucous membrane, and then the skin and red border. The first seam is at the border of the skin and the red border. Throughout facial area and single- and double-row sutures are placed on the neck. The line of interrupted sutures on the back of the nose is formed in steps. On one side of the wound, a longer edge of the epithelial layer is left, which is then applied to the subcutaneous tissue after a stepwise intersection of the epithelial-dermal layer on the opposite side. The seams are tied slightly away from the incision line.