Sports Medicine

1. Sports Medicine Unit 11, Part A Wound Dressing and Bandaging

2. Caring for Skin Wounds • Skin wounds are extremely common in sports • Soft pliable nature of skin makes it susceptible to injury • Numerous mechanical forces can result in trauma • Friction, scrapping, pressure, tearing, cutting and penetration

3. WOUND DRESSINGS • Definitions • A bandage is a strip of cloth or other material used to hold a dressing in place • A dressing is a material, such as gauze, that is applied directly to a wound

4. WOUND DRESSINGS • A bandage, when properly applied, can contribute greatly to the healing process • When improperly applied it can… • Cause discomfort • Allow wound contamination • Hamper wound healing

5. WOUND DRESSINGS • In ALL cases bandages must be firmly applied. • Care should be taken not to hamper circulation by applying too tightly or allowing the dressing to move by applying too loosely

6. WOUND DRESSINGS • As we have already learned, skin lesions are very common in sports • It is important that these wounds be cared for immediately • All wounds, even minor ones, should be considered to be contaminated

7. WOUND DRESSINGS • The wound must be cleansed, medicated, and dressed • Dressings require a sterile environment to prevent infections

8. WOUND DESCRIPTONS • Since we have already discussed these earlier, just be reminded of the wound types most often dealt with in sports medicine… • Abrasions • Puncture Wounds • Lacerations • Incisions • Avulsions

9. Types of wounds • Abrasions • Skin scraped against rough surface • Top layer of skin wears away exposing numerous capillaries • Often involves exposure to dirt and foreign materials = increased risk for infection • Laceration • Sharp or pointed object tears tissues – results in wound with jagged edges • May also result in tissue avulsion • Incision • Wounds with smooth edges

10. Puncture wounds • Can easily occur during activity and can be fatal • Penetration of tissue can result in introduction of tetanus bacillus to bloodstream • All severe lacerations and puncture wounds should be referred to a physician • Avulsion wounds • Skin is torn from body = major bleeding • Place avulsed tissue in moist gauze (saline), plastic bag and immerse in cold water • Take to hospital for reattachment

11. Immediate Care • Should be cared for immediately • All wounds should be treated as though they have been contaminated with microorganisms • To minimize infection clean wound with copious amounts of soap, water and sterile solution • Avoid hydrogen peroxide and bacterial solutions initially

13. Are sutures necessary? • Deep lacerations, incisions and occasionally punctures will require some form of manual closure • Decision should be made by a physician • Sutures should be used within 12 hours • Area of injury and limitations of blood supply for healing will determine materials used for closure • Physician may decide wound does not require sutures and utilize steri-strips or butterfly bandages

14. TETANUS • Tetanus (aka “Lockjaw”) is an acute disease causing fever and convulsions • Tetanus bacteria enters the body as a spore and attacks the CNS • Most people are immunized against tetanus in childhood • After 10 years, a booster should be taken

15. TETANUS • If there has never been a tetanus immunization, then one should be given at the time of injury • If there was an immunization, but no recent booster, then one should be given

16. Wound Care Materials • Gauze • Used in 3 forms • Sterile pads for wounds • Non-sterile pads for padding • Roller bandage to hold and compress dressings

17. Wound Care Materials • Cotton cloth • Used primarily for ankle wraps and triangular bandages • Elastic roller bandages • Can be used for wounds, but used more often for muscular support

18. Wound Care Materials • Plastics • Playing an increasingly important role in sports medicine • Come in a number of forms… • Aerosol sprays to protect wounds • Adhesive tapes • Plastic coated gauze pads (commonly known as “Telfa Pads”) • Plastics are useful because they can hold in or keep out moisture, provide insulation, and prevent infection

19. Wound Care Materials • Wound cleansers • Hydrogen peroxide • not highly recommended anymore because it can damage living tissues • Povidone-Iodine • More commonly referred to as Betadine or Beta Scrubs • Good ol’ soap and water

20. Wound Care Materials • Cotton tipped applicators & tongue depressors • Used to apply medications, clean wounds, etc. • Adhesive strips • “Bandaids” • Come in numerous sizes and styles

21. Wound Care Materials • Medications • 1st Aid creams • Bacitracin/Triple Antibiotics • Strawberry ointment • Steristrips • Used to close a wound, or hold a wound closed after stitches are removed • Also known as a “butterfly closures”

22. Wound Care Materials • Tincture of Benzoin Compound • A sterile adhesive liquid often used in combination with steristrips or other dressings to hold them in place • Cover strips • Adhesive gauze material now being used to help protect skin wounds and abrasions from being further injured during games/practices

23. The 8 Basic Uses for Dressings and Bandages • Protect wounds from infection • Protect wounds from further injury and contamination • Control external and internal bleeding • Act as a compress over exposed and unexposed injuries • Immobilize and injured part • Protect an unexposed injury • Support an injured part • Hold protective equipment in place

24. Common Types of Bandages Used in Sports Medicine • Roller bandages • Made of many materials such as gauze, cotton cloth, and elastic wrapping • Width and length may vary depending on the use • Most frequent sizes include lengths of 6-10 yards • Common widths are 2”, 3”, 4”, and 6” • The size of the wrap used is determined by the body part that you are wrapping