Contusions of soft tissues

Contusions of soft tissues or contusio are a closed trauma of tissues or internal organs that do not affect or damage the skin. As a rule, the bruise of soft tissues does not disturb the anatomical integrity of the injury zone and is not accompanied by serious complications. All kinds of injuries, which are complicated by inflammation, deformation, have their own nosological definitions.

Contusions are carried out by doctors specializing in traumatology, but each of us needs to have information about what a bruise is, and what actions should be taken as first aid in case of trauma. This is due to the widespread spread of bruises, which occur literally daily both in everyday life and in the external environment. The algorithm for diagnosing and differentiating the injury from a fracture, dislocation or stretching will help you quickly navigate and take the necessary measures.

First of all, bruises of soft tissues should be separated from more serious damage to the bone, blood, other systems and organs. Soft tissues are primarily the skin, underlying cellulose, which can contain a lipid layer, depending on the localization of the body. In addition, soft tissues include connective tissues that connect and cover muscle tissue (fascia), muscles proper, ligaments, tendons. All soft tissues are permeated with blood vessels and nerves, which are also damaged by bruises.

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Soft tissue injuries - the mechanism of injury

A bruise is a direct injury caused by a stroke, a fall, an industrial or domestic injury, a sports injury, and so on. Accidents, both automobile and any other related to transport, as well as man-made disasters and natural disasters are not included in the list of the main causes of bruises, since they are high-energy in the sense of the mechanism of injury. Direct damage, considered a bruise, provokes a disruption in the integrity of the vessels of the subcutaneous tissue, collagen tissue and fatty layer. Fiber tissue as a result of trauma is separated from the connective fibers (fascia), if the bruise is strong, the fasciae themselves, as well as the muscle tissue, are damaged. The more dense and multi-structure the soft tissue, the higher their damping ability to protect bone tissue, including the periosteum. If soft tissues are insignificant in density and there are few of them, for example in the fingers of the limbs, the sternum, the anterior part of the tibia, the bone itself is often injured, and the periosteal hematoma develops.

How are soft tissue injuries manifested?

• Pain of varying intensity, depending on the density and structure of the soft tissue. 
• Hemorrhage in the subcutaneous layer, the appearance of bruises (hematomas). 
• Puffiness.

Contusions of soft tissues, which need attention

A bruise of the soft tissues of the head that requires medical attention. It is almost impossible to differentiate the bruise and concussion independently, in addition, craniocerebral injuries can manifest themselves as distant symptoms, therefore, in any head trauma it is better to undergo a neurological examination. 

If contusions of soft tissues are accompanied by crepitus, when exudate and air accumulate under the skin, palpation is characterized by characteristic "creaking", it is necessary to call a doctor. Particularly serious these symptoms are considered with injuries of the nose, cheekbones, knees, chest. 

A bruised chest is often accompanied by fractures or cracks in the ribs. Independently, you can palpate the damaged area and, if there is crepitus, atypical mobility, severe swelling, you need to call an ambulance. Crepitation can testify to developing emphysema, as well as swelling, and difficulty breathing. 

Contusion of abdominal region (abdomen). With a bruise, damage to the internal organs is possible, so the pallor of the skin, a drop in the pulse, nausea and tachycardia, severe pain are signals that urgent medical attention is needed. 

A bruise of the spine. This injury is one of the most dangerous. To avoid the risk of complications, even if there is no clinical manifestation of a vertebral fracture, it is better to see a doctor. With the help of an X-ray, possible threatening damage can be ruled out.

Contusions of soft tissues, despite their seemingly commonness, are an injury, which means that self-treatment is possible only with a firm belief that the injury belongs to the category of light injuries. In all other cases, professional medical care is needed.

First aid rules provided that soft tissue injuries are diagnosed

Cold compress in the form of a container with ice, ice water or cloth soaked in cold water. If there is a possibility of a bruise to be treated with chloroethyl ("freeze"). Cold helps to reduce the intensity of imbibition (impregnation and penetration of blood from the subcutaneous tissues.) Cold compresses should be changed as they warm up, to avoid heat exposure to the injured area. 

Immobilization - rest, so that the damaged part of the body was immovable. If the bruise falls on the chest, a horizontal position with an elevation of the upper trunk is shown. If contusions of soft tissues affect the lower limbs, it is also possible to have a horizontal position where the leg is slightly raised to ensure blood flow (roller, pillow). If this is a head injury, a horizontal position is mandatory, however, you should closely monitor the manifestation of the symptoms in the first hour to avoid the risk of serious complications. 

Fixation in order to reduce puffiness and imbibition. Immobility is ensured by bandaging (elastic material), overlapping of the langets, banding of the limb to the healthy part of the body. 

If the pain is intense, you should take an anesthetic (analgin, paracetamol, ketanov, ibuprofen). However, the intake should be limited to one or two tablets per day. If the symptoms show the development of complications, taking medications can distort the clinical picture that helps to establish the correct diagnosis. 

The second day after the injury should be dedicated to procedures that help the process of resorption of hematomas, reduce inflammation and swelling. It can be sparing rubbing with ointments containing heparin, diclofenac. Also showing the intake of drugs that belong to a non-steroidal anti-inflammatory group - orthophene, ibuprofen, nimesil, nylid. 

After three or four days, you can take physiotherapy - electrophoresis, magnetotherapy.