Soft Tissue Trauma
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What types of soft tissue trauma occur in children?
Pediatric soft tissue trauma is responsible for 20 to 40% of emergency department visits annually. Soft tissue injuries are often associated with additional trauma to deeper structures which mandates meticulous assessment. Injuries can be classified as abrasions, contusions, lacerations, crush injuries and bites.
Abrasions are wounds caused by contact and friction with a hard surface which extends no deeper than the dermis. Most abrasions are superficial; however, large and deep abrasions need to be treated similar to burns.
Contusions occur from damage to capillaries in the subcutaneous tissue leading to ecchymosis on physical exam and, if large enough, hematoma formation.
A laceration is a tear in the skin and soft tissue, of varying extension and depth, as a result of shearing from a sharp object or tension from blunt opposing forces.
Crush injuries, like contusions, are also caused by blunt trauma - in this case by forceful compression between two hard objects. Crush injuries can be associated with lacerations, hemorrhage, fractures and ischemia of affected body part leading to complications like compartment syndrome and rhabdomyolysis depending on the severity. A degloving injury is a forceful detachment or avulsion of the skin from the underlying muscle and bone.