An avulsion is an injury in which a chunk of tissue has been removed from the body, including at least all the 3 skin layers. As an undesirable injury, an avulsion puts an individual at high risk for infection. Avulsions are typically caused by industrial equipment, animal bites or vehicular accidents.
Close look on avulsions
An avulsion that covers the entire diameter of an extremity and causes the tissue layers to pull away is called a degloving injury. Remember that it is likely for rings to clasp on objects and lead to degloving injuries involving the finger. In some cases, it can also result to an amputation.
In most cases, it is hard to differentiate between an avulsion and a severe case of laceration. A characteristic indication of an avulsion is ability to lift some of the skin and fat. Essentially, the management for a deep laceration is similar for an avulsion.
Steps in managing an avulsion
- Before attempting to help an individual with an avulsion, always observe universal precautions and use personal protective equipment if available.
- Bleeding is controlled by applying direct pressure and raising the affected limb. Avoid using a tourniquet unless the bleeding could not be controlled and medical care is not available for several hours. Do not hesitate to apply pressure on fat tissue or raw muscle. You can utilize an absorbent dressing or any clean cloth that is available.
- Rinse the wound using saline solution or water. If available, sterile irrigation is the best choice.
- In case the tissue is not fully torn away, you have to replace the flap and apply dressing on the wound. If the tissue is fully separated from the body, collect it if available and bring it along as the individual is taken to the emergency department.
An avulsion always requires medical care, especially if the injury was due to an animal bite. In most circumstances, stitches are needed and animal bites have a high risk for infection.
In case the bleeding could not be controlled or if the area of avulsion could not be covered by both palms of the individual, call for emergency assistance. Take note that a large-sized avulsion is considered as a medical emergency.