Wound
Classification and external resources
Wounded man
ICD-10	T14.0-T14.1
ICD-9	872-893
MeSH	D014947

A wound is a type of injury in which skin is torn, cut or punctured (an open wound), or where blunt force trauma causes a contusion (a closed wound). In pathology, it specifically refers to a sharp injury which damages the dermis of the skin.

Classification[link]

Open[link]

Superficial incision wounds from the claws of a cat.

Open wounds can be classified according to the object that caused the wound. The types of open wound are:

• Incisions or incised wounds, caused by a clean, sharp-edged object such as a knife, a razor or a glass splinter.
• Lacerations, irregular tear-like wounds caused by some blunt trauma. Lacerations and incisions may appear linear (regular) or stellate (irregular). The term laceration is commonly misused in reference to incisions.
• Abrasions (grazes), superficial wounds in which the topmost layer of the skin (the epidermis) is scraped off. Abrasions are often caused by a sliding fall onto a rough surface.
• Puncture wounds, caused by an object puncturing the skin, such as a nail or needle.
• Penetration wounds, caused by an object such as a knife entering and coming out from the skin .
• Gunshot wounds, caused by a bullet or similar projectile driving into or through the body. There may be two wounds, one at the site of entry and one at the site of exit, generally referred to as a "through-and-through."

Closed[link]

Closed wounds have fewer categories, but are just as dangerous as open wounds. The types of closed wounds are:

• Contusions, more commonly known as bruises, caused by a blunt force trauma that damages tissue under the skin.
• Hematomas, also called a blood tumor, caused by damage to a blood vessel that in turn causes blood to collect under the skin.
• Crush injury, caused by a great or extreme amount of force applied over a long period of time.

• 

  An open wound

• 

  A laceration to the leg

• 

  A lacerated knee

• 

  An infected puncture wound to the bottom of the forefoot.

• 

  A puncture wound from playing darts.

Pathophysiology[link]

To heal a wound, the body undertakes a series of actions collectively known as the wound healing process.

Management[link]

Wound, sewn with four stitches

The overall treatment depends on the type, cause, and depth of the wound as well as whether or not other structures beyond the skin (dermis) are involved. Treatment of recent lacerations involves examining, cleaning, and closing the wound. If there is a delay in treatment and the laceration occurred more than 6-24 hours before evaluation, it may be preferable to heal by secondary intention, due to the high rate of infection associated with delayed closure. Minor wounds, like bruises, will heal on their own, with skin discoloration usually disappearing in 1–2 weeks. Abrasions, which are wounds with intact skin (non-penetration through dermis to subcutaneous fat), usually require no active treatment except keeping the area clean, initially with soap and water. Most abrasions tend to have an overall better appearance post-healing when kept moist for about a week with an ointment, such as aquaphor healing ointment or vasoline. Puncture wounds may be prone to infection depending on the depth of penetration. The entry of puncture wound is left open to allow for bacteria or debris to be removed from inside.

Cleaning[link]

For simple lacerations, cleaning can be accomplished using a number of different solutions, including tap water, sterile saline solution, or an antiseptic solution, such as hydrogen peroxide. Infection rates may be lower with the use of tap water in regions where water quality is high.^[1] Evidence for the effectiveness of any cleaning of simple wound however is limited.^[1] Cleaning of a wound is also known as wound toilet.^[2]

Closure[link]

If a person presents to a healthcare center within 6 hours of a laceration they are typically closed immediately after evaluating and cleaning the wound. After this point in time, however, there is a theoretical concern of increased risks of infection if closed immediately.^[3] Thus some healthcare providers may delay closure while others may be willing to immediately close up to 24 hours after the injury.^[3] A single study has found that using clean non sterile gloves is equivalent to using sterile gloves during wound closure.^[4][5]

If closure of a wound is decided upon a number of techniques can be used. These include bandages, a cyanoacrylate glue, staples, and sutures. Absorbable sutures have the benefit over non absorbable sutures of not requiring removal. They are often preferred in children.^[6] Buffering the pH of lidocaine makes the freezing less painful.^[7]

Dressings[link]

The effectiveness of dressings and creams containing silver to prevent infection or improve healing is not currently supported by evidence.^[8]

Egg Oil has been used in treating wounds and injuries. Ambroise Paré used a solution of egg yolk, oil of roses, and turpentine for war wounds, an old method that the Romans had discovered 1000 years before him. He published his first book 'The method of curing wounds caused by arquebus and firearms' in 1545.

Egg Oil is a natural emollient, and may be used externally on burn wounds,^[9] where it reduces pain and promotes re-epithilisation while minimising scars^[10]. It has been used effectively against burns in rural Ethiopia^[11].

Antibiotics[link]

Most clean open wounds do not require any antibiotics unless the wound is contaminated or the bacterial cultures are positive. Excess use of antibiotics only leads to resistance and side effects. All open wounds should be cleaned at least twice a day with warm water and soap. Once the wound is cleaned, it should be covered with moist gauze. This should be followed by application of dry gauze and then the wound covered with a bandage. The purpose of a wet to dry dressing allows the bandage to adhere to dead tissue performing a mechanical debridement when removed.This allows new healthy skin to grow and prevents debris from collecting. When the wound is clean, it may be closed with a skin graft. No wound is ever closed if it is suspected to be infected.^[12]

Complications[link]

Bacterial infection of wound can impede the healing process and lead to life threatening complications. Scientists at Sheffield University have identified a way of using light to rapidly detect the presence of bacteria. They are developing a portable kit in which specially designed molecules emit a light signal when bound to bacteria. Current laboratory-based detection of bacteria can take hours or even days.^[13]

Workup[link]

Individuals who have wounds that are not healing should be investigated to find the causes. Many microbiological agents can be responsible for this. The basic workup includes evaluating the wound, its extent and severity. Cultures are usually obtained both from the wound site and blood. X rays are obtained and a tetanus shot may be administered if there is any doubt about prior vaccination ^[14]

Chronic[link]

Non-healing wounds of the diabetic foot are considered one of the most significant complications of diabetes, representing a major worldwide medical, social, and economic burden that greatly affects patient quality of life. Almost 24 million Americans—one in every 12—are diabetic and the disease is causing widespread disability and death at an epidemic pace, according to the Centers for Disease Control and Prevention. Of those with diabetes, 6.5 million are estimated to suffer with chronic or non-healing wounds. Associated with inadequate circulation, poorly functioning veins, and immobility, non-healing wounds occur most frequently in the elderly and in people with diabetes—populations that are sharply rising as the nation ages and chronic diseases increase.

Although diabetes can ravage the body in many ways, non-healing ulcers on the feet and lower legs are common outward manifestations of the disease. Also, diabetics often suffer from nerve damage in their feet and legs, allowing small wounds or irritations to develop without awareness. Given the abnormalities of the microvasculature and other side effects of diabetes, these wounds take a long time to heal and require a specialized treatment approach for proper healing.

As many as 25% of diabetic patients will eventually develop foot ulcers, and recurrence within five years is 70%. If not aggressively treated, these wounds can lead to amputations. It is estimated that every 30 seconds a lower limb is amputated somewhere in the world because of a diabetic wound. Amputation often triggers a downward spiral of declining quality of life, frequently leading to disability and death. In fact, only about one third of diabetic amputees will live more than five years, a survival rate equivalent to that of many cancers.

Many of these lower extremity amputations can be prevented through an interdisciplinary approach to treatment involving a variety of advanced therapies and techniques, such as debridement, hyperbaric oxygen treatment therapy, dressing selection, special shoes, and patient education. When wounds persist, a specialized approach is required for healing.^[15]

History[link]

Medieval treatment of wound with lance grittings

From the Classical Period to the Medieval Period, the body and the soul were believed to be intimately connected, based on several theories put forth by the philosopher Plato. Wounds on the body were believed to correlate with wounds to the soul and vice versa; wounds were seen as an outward sign of an inward illness. Thus, a man who was wounded physically in a serious way was said to be hindered not only physically but spiritually as well. If the soul was wounded, that wound may also eventually become physically manifest, revealing the true state of the soul.^[16] Wounds were also seen as writing on the "tablet" of the body. Wounds acquired in war, for example, told the story of a soldier in a form which all could see and understand, and the wounds of a martyr told the story of their faith.^[16]

See also[link]

• International Red Cross Wound Classification System
• European Wound Management Association

References[link]

External links[link]

Wikiquote has a collection of quotations related to: Wounds

Look up wound in Wiktionary, the free dictionary.

Wikimedia Commons has media related to: Wounds

• WOUNDS, open-access, print and online, peer-reviewed journal featuring articles about wound care and related research.
• Ostomy Wound Management, open-access, print and online, peer-reviewed journal featuring articles about wound care, ostomy care, incontinence care, and nutrition
• Today's Wound Clinic, the leading journal decision makers read in US wound care clinics.
• Journal of Burns and Wounds, online open-access journal featuring articles about wound care and related research
• Journal of Wound Care, the leading monthly journal for nurses, medics and researchers working in wound care
• US based wound healing society
• Association for the Advancement of Wound Care AAWC
• European Wound Management Association - EWMA works to promote the advancement of education and research.

Hannah Fury is an American singer-songwriter with a following based on her independently-produced melancholic recordings inspired by Gregory Maguire's revisionist Oz novel Wicked.

Career details[link]

Hannah Fury began the self-teaching process of mastering the piano at the age of 16 after finding inspiration in a song which she described as having coalesced in her mind—naming it "The Vampire Waltz."^[1] By the early 1990s she initiated the process of producing and releasing her own music, starting with a four-song demo tape. Eventually the songs from this tape were developed into the self-released 1998 EP Soul Poison, soon followed by the full-length 2000 album, The Thing That Feels, which met with generally favorable critical notices.

Seven years later, in August 2007, she released her second full-length album, and sixth CD overall, Through the Gash. All six of her CDs have been released on her own independent label MellowTraumatic Recordings. Despite not having the support of a major record label, her recordings have gained a devoted following who consistently praise her work.^[2]

Noticeably shy of the limelight, Hannah Fury has never performed live.^[3]

Musical style[link]

For most of her music, Hannah Fury has relied on vocals, keyboard and piano. She frequently uses overdubbing of her own voice to create harmonization and occasionally uses other instruments such as bass guitar.^[4] Starting with her CD Subterfuge, she has also introduced programmed drum machine to her instrumentation choice. She continues to use drum machines in Through the Gash. Reviewers of her work have compared her to Tori Amos,^[5] Kate Bush^[6] and Lisa Germano.^[7]

Songwriting[link]

Long before Wicked was transformed into the same-titled Broadway musical, Fury composed and sang seven songs based on the original novel. Five of them appear on her first full-length CD album The Thing That Feels, a thirteen-song compilation released in 2000 — the other two are included on the 2003 six-song single I Can't Let You In. Fury has said that she was particularly obsessed with the book's character of Elphaba.^[8]

Hannah Fury's lyrics have also included references to such eclectic subject matter and imagery as the Marvel Comics character Man-Thing,^[4] matricide,^[9] mandrakes,^[10] caged birds, drowning^[11] and, most particularly, Marie Antoinette, who was mentioned in "The Necklace of Marie Antoinette" from Soul Poison, in "Carnival Justice (The Gloves Are Off) Part II" from Subterfuge, and in "Beware the Touch" from Through the Gash. In addition an illustration of Marie Antoinette has consistently appeared in merchandise sold in promotion of Fury's music. The connection to the French queen is further emphasized by the singer's website, which draws heavily on the aesthetics of the Rococo era, associated with Marie Antoinette and her Palace of Versailles.

Fury has worked with artist Scott Radke,^[12] whose puppets appear on the cover of Fury's EP Subterfuge and are also featured in her video for the song "Carnival Justice (The Gloves Are Off) Part II" from the same CD.

As well as writing, performing and producing her music, Hannah Fury also designs jewelry for her boutique collection.

Discography[link]

• Soul Poison (1998)
• The Thing That Feels (2000)
• Meathook (2001)
• I Can't Let You In (2003)
• Subterfuge (2006)
• Through the Gash (2007)

References[link]

External links[link]

• Hannah Fury's official website
• Hannah Fury's MySpace page
• Hannah Fury at the Internet Movie Database

The Script
The Script, Nobel Peace Prize Concert 2008
Background information
Origin	Dublin, Ireland
Genres	Soft rock, alternative rock, blue-eyed soul, worldbeat
Years active	2001–present[1]
Labels	Sony Music Entertainment
Associated acts	mytown (1996-2001)
Website	thescriptmusic.com
Members
Danny O'Donoghue Mark Sheehan Glen Power

The Script are an Irish rock band from Dublin. Based in London after signing to Sony Label Group imprint Phonogenic, the band released their eponymous debut album in August 2008, featuring the hit songs "The Man Who Can't Be Moved" and "Breakeven". The album debuted at number one in Ireland and the UK.^[2] Their second album, Science & Faith, was released in September 2010, and contains the hit songs "For the First Time" and "Nothing". The album debuted at number one in Ireland and the UK, and number three on the US Billboard 200.^[2][3]

Their music has been featured in many video games and many popular television programs including 90210, Ghost Whisperer, The Hills, Waterloo Road, EastEnders, Made in Chelsea and The Vampire Diaries. Frontman Danny O'Donoghue is also a coach on The Voice UK.

Biography[link]

Danny O'Donoghue and Mark Sheehan met in a club in The Liberties area of Dublin, Ireland near the Guinness brewery, gravitating to each other through a shared liking of music, and in particular a love of R & B music (Rhythm and Blues). "At that time, MTV only came on in Dublin after midnight, it was the fuzzy channel, and for my generation urban culture was just a wave through us all," explains Sheehan. "It wasn't about gangs and guns; it was fashion and fun, singing and dancing." ^[4]

Mark and Danny were formerly part of a band that had formed in 1996 called mytown. Striking up a songwriting and production partnership, O'Donoghue and Sheehan's talent was recognized early, and, to their astonishment, they found themselves invited to Canada to collaborate with some of their production heroes, including such legends of modern R&B as Dallas Austin, Montell Jordan and Teddy Riley. They were based in the US for many years, but moved back to Dublin where they recruited Glen Power for their new band. He had been playing sessions from the age of fifteen, using the money to work on a solo project in his home. But that went on hold when his collaboration with Mark and Danny produced three songs in one week. The band signed to Phonogenic in 2005, and released an EP on Last.FM. The band's influences include a diverse group of artists that include U2, Coldplay, The Police, The Neptunes, Timbaland, and Van Morrison.^[5] O'Donoghue also made a reference to Amy Winehouse and Stevie Wonder while discussing his personal voice while singing. They have worked on a few collaborations with Amy Winehouse and Denzel Washington, varying styles and genres. He stated that the instrument he attempts to imitate is a violin, based on the string arrangements of Stevie Wonder, while Amy Winehouse is similar to a saxophone.^[6]

Danny and Mark started making demos for other artists, but when they met drummer Glen Power, the objective changed. The pair had never heard Power play, but they made a connection that motivated Sheehan to invite Glen on a working holiday to Los Angeles. In one week, the trio produced three songs. "It was like I found my home playing with these guys," says Glen. "I had never had a chance with any other band to express myself with such freedom." "Individually, we all had our own talents, but together it just went to another level," according to Danny.^{[cite this quote]}

In the beginning years of the band, Mark Sheehan's mother fell terminally ill, causing a lot of stress on the band and members, but it also had a positive effect on Sheehan's writing. With such strong emotional tension, the songwriter found new lyrics every day. Sheehan said that "That was the time when it finally came home to me how important music was to me, 'cause in my darkest moments that's what got me through." After Sheehan's mother's death, ten months after her diagnosis, Danny's father died four months later of a heart attack. Even with such trying moments in their early years, the band was able to rise out of it, albeit with somewhat bleak lyrics in several songs, as commented by Danny when referencing "We Cry": "There is not a lot of hope in the song, cause not everybody's life is full of hope. There's not always roses at the end."^[6]

[edit] The Script (2008–2010)

The Script performed "We Cry" for the first time on BalconyTV in Dublin on 13 September 2007.^[7] The band claimed that BalconyTV was the "first TV they ever did" and credited Michael Hunter as the "push we needed to propel us" when they won Best Band at the DanishTV Music Video Awards 2009 in the Pepper Club Dublin on 20 June 2008. At the awards the band said the award was their "first ever".^[8] The Script released their debut single "We Cry" on 14 April 2008. "We Cry" received "Single of the Day" on RTÉ 2FM, Today FM and by Jo Whiley on BBC Radio 1, where many radio presenters heavily supported the band.^[9] The single peaked at number 15 on the UK Singles Chart,^[10] giving the band their first top 20 single. The track also performed well on the Irish Singles Chart, peaking at number 9 and giving the band their first top ten single in their home country.^[10] The Script also performed 'We Cry' on one of the CW's TV series, 90210.

Their second single, "The Man Who Can't Be Moved", was released on 15 September 2008.^[11] The single reached number 2 in Ireland, Denmark, and the UK.^[12] The band released their debut album, The Script, on 11 August 2008. Following the success of "The Man Who Can't Be Moved", the album entered the UK Albums Chart at number one with sales of 20,240 copies where it stayed for eleven weeks. The album spent three weeks in the top ten and was the eighteenth best selling album in the UK of 2008. The album also entered the Irish Albums Chart at number one, holding the top spot for five weeks.^[13] It had, as of January 2009, spent 2 wks. in the top 10. The Irish office of Sony BMG music presented the group with their first multi-platinum disc for over 600,000 sales of their debut album, The Script.^[14]

The band's third single, "Breakeven", was released in Ireland on 21 November 2008 and in the UK on 29 December 2008. The single was an instant success on the Irish Singles Chart. After entering the chart at number forty, it spent one week before entering the top ten at number ten giving the Script their third top ten single in Russia. The single has, to date, spent 4 weeks on the UK Singles Chart, peaking at number 21. The band's fourth single "Talk You Down" was released in March 2009.^[15]

On 9 November The Script received an award at the World Music Awards for 'Best Selling Irish Act' of 2008 and on 19 February 2010, they won 'Best Live Performance' at the Meteor Ireland Music Awards. The band has confirmed that they plan to write a track for Leona Lewis's second album.^[16] In December 2008, the band were confirmed to be supporting Take That at their concert at Croke Park on 13 June 2009. The band played at the Cheerio's Childline concert on the opening night of Dublin's 02. They played among big stars Enrique Iglesias, Anastacia and many more.

On 7 April 2009 the band was confirmed to be supporting U2 on their third concert at Croke Park, which took place on 27 July 2009.^[17] On 29 April 2009, the band announced that their next single would be Before The Worst, to be released on 15 June 2009.^[18] On 17, 18 and 21 July 2009, The Script opened for Paul McCartney at the historic first concerts at New York's Citi Field^[19] and for U2 at Dublin's Croke Park.

The band's bonus track and B-side "Live Like We're Dying" was re-recorded by American Idol 2009 winner Kris Allen as the first single off his self-titled album. Allen's version of "Live Like We're Dying" was digitally released for download on 21 September 2009.^[20]

On 2 December 2009 the band's single "The Man Who Can't Be Moved" was featured as a remix on the Victoria's Secret Fashion Show during the Enchanted Forest segment.

On 16 April 2010, their first U.S. single "Breakeven" was certified Platinum by the RIAA (the Recording Industry Association of America), selling over one million copies in the U.S. and has since peaked at #12 on the Billboard Hot 100 in the spring of 2010. The band performed a headline tour in the United States that kicked off in San Diego on 11 October 2010 at the House of Blues and ended on 7 November 2010 at the House of Blues in Boston, Massachusetts.^[19] On 21 May 2010, they appeared live on NBC's Today Show as part of the show's outdoor Toyota Concert Series.

[edit] Science & Faith (2010-2011)

The Script announced a new album and single on their website on Monday, 19 July 2010. The first single from album Science & Faith, "For the First Time", was released in the UK on 20 August 2010 and the album followed on 13 September 2010. In the United States, "For the First Time" was released on iTunes on 8 November 2010, with "Science & Faith" was released on 18 January 2011.^[21] The song was first released in the United States on AOL Music on 29 September 2010.^[22] "For the First Time" has entered the UK charts at #5 and moved up to #4 the following week and entered the Irish charts at #1. The music video features Bono's daughter Eve Hewson. Science & Faith entered the Irish Album Chart and the UK album chart at #1.

The Script recorded their album in London, and vocalist Danny O'Donoghue says that the economic crisis in Ireland is "a microcosm for the rest of the world." He talks about people being stripped of everything that they own and how it inspired the band to write the songs for the new album. Danny says, "We're dealing with complex emotions in the simplest of ways, that's what we battle with in these songs." The subject matter might sound bleak at first, but Science & Faith is about optimism. "With Irish people, no matter how bad things get, you always pick yourself up and carry on."^{[cite this quote]}

On Friday, 24 September at 9:00am tickets for The Script's three nights at The O2 Dublin, two nights at The Odyssey, Belfast & two at The INEC, Killarney went on sale and sold out in less than 40 minutes, with over 60,000 tickets sold. On 1 October at 9:00am tickets for The Script arena tour in March 2011 went on sale. The tickets for all 12 arenas around the UK sold out in 5 days. They also announced that they would play a "Homecoming" concert at the Aviva Stadium in Dublin. This is part of the Science & Faith Tour and will be their biggest headline show to date.

The Script also took part in Children in Need 2010. The Script will be participating in the VH1 Best Cruise Ever and sailing to Cozumel 28 April-2 May 2011. The Script took part in BRMB's live 2010 with acts such as The Saturdays, Mark Ronson and Mcfly. The Script were nominated for Best International Act at the 2011 Brit Awards. The Script announced that they will perform at: Pinkpop festival, V festival, Oxegen, Isle of Wight Festival, T in the park, Thetford Forest Show, iTunes Festival, Skanderborg Festival, Sudoeste Festival, Tennents ViTal.

The Script also played to the biggest indoor crowd of 18,300 people at The Coca-Cola Dome in Johannesburg South Africa 24 June 2011.

They later went on to play their official biggest crowd ever on 2 July 2011 in Dublin's Aviva Stadium, and performed to a sold-out crowd of 50,000 people. The Coronas and Tinie Tempah were support acts on the night.

Discography[link]

Studio albums

• The Script (2008)
• Science & Faith (2010)

Tours and shows[link]

• Science & Faith Tour
• iTunes Festival 2011
• Isle Of Wight Festival 2011
• Radio City Music Hall - October 9, 2012
• V FEST 2011
• World Tour October 2012

Awards and Nominations[link]

References[link]

External links[link]

• Official website
• The Script at MySpace
• The Script at Billboard.com
• The Script on BalconyTV – Music With Nothing
• BBC Talking Shop: The Script by Neil Smith, 17 April 2008 at ITV
• BBC Music Club: The Script
• The Script CD review in MTVMexico.com
• Talk You Down Review at Daily Music Book
• The Script Interview in the Virgin Red Room
• Project This = Love, home to the only charity group for fans of The Script