Soft Tissue Injuries

Tom RaderStaff - June 1, 2021

Soft tissue injuries are arguably the most common injuries you will come across in the backcountry. These can be anything from small nicks and cuts to
[See the full post at: Soft Tissue Injuries]

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In this lesson, you say:

We need to keep the scab intact and prevent it from getting wet. Otherwise, healing will be delayed and the wound can become infected.

However, this piece says:

Scabs are basically the waste materials of reconstruction, and they impede the healing process by blocking the formation of new tissue where the scab is. So by keeping the area protected and moist, you make it easier for the body to heal.

I’m confused — should I keep the scab moist or dry?

 

I updated the text, hopefully it’s clearer. You want to keep external moisture away from the wound, such as a scab becoming soggy while taking a shower/bath. Good moisture is what’s naturally created ‘internally’ by the wound. Burns can be an exception, described in that lesson.

I also want to re-cut this video to move the impalement stuff to that specific lesson.

 

Three questions:

1. My take-away on the impalement part of the video was that foreign objects should be left in if professional help is readily available to limit causing tissue damage/potential bleeds (unless it’s small like a splinter). So say an individual is already intensely bleeding from an area around an impalement but it’s an austere setting (say back country hiking) and professional help isn’t available for potentially days should the impalement still be removed? Or if extensive bleeding is occurring around the impalement is it possible the impalement is applying some pressure inside the wound preventing worse bleeding? I get that this would vary depending on where it is on the body and if a tourniquet/pressure could be applied but I’d appreciate any insights on what to do in such a situation.

2. At what point do you want to let the wound bleed a bit to flush out potential contaminants from an impalement? Does it just depend on size of impalement, location on the body and perceived cleanliness of the foreign object (i.e. accidentally putting a clean staple in one’s hand during a project is less likely to cause infection than stepping on a rusty nail in an old barn)? My thought was that if I nicked my hand with a fish hook impalement that was rusty I’d likely press on it a bit to make it bleed even knowing I’m up to date on my tetanus vaccine, but I’m not sure how to weigh letting a larger wound from an impalement bleed a bit to potentially flush out a deeper contaminant. In an austere setting I would lack confidence in whether or not losing a bit more blood may outweigh not flushing a deep contaminant out if there wasn’t access to antibiotics/soap/clean water etc. 

3. Apologies if this is a totally goofy “I saw it in a movie” question, but I’d like to know: is cauterization ever appropriate for a wound in an austere setting? I feel like it’s a Hollywood on screen quick fix to aggressive bleeds but it seems to me like it would really really damage/kill the soft tissue which could create a breeding ground for infection.