Wounds of this variety usually gape considerably, especially when there
is much laceration of the skin. It is not uncommon to have considerable
portions of skin, muscle, or tendon completely torn away.
Haemorrhage is seldom a prominent feature, as the crushing or tearing of
the vessel wall leads to the obliteration of the lumen.
The _special risks_ of these wounds are: (1) Sloughing of the bruised
tissues, especially when attempts to sterilise the wound have not been
successful. (2) Reactionary haemorrhage after the initial shock has
passed off. (3) Secondary haemorrhage as a result of infective processes
ensuing in the wound. (4) Loss of muscle or tendon, interfering with
motion. (5) Cicatricial contraction. (6) Gangrene, which may follow
occlusion of main vessels, or virulent infective processes. (7) It is
not uncommon to have particles of carbon embedded in the tissues after
lacerated wounds, leaving unsightly, pigmented scars. This is often seen
in coal-miners, and in those injured by firearms, and is to be prevented
by removing all gross dirt from the edges of the wound.
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