Acute Sports Injuries - SKIN

Acute skin injuries are common in athletes, particularly those competing in contact sports and cycling. Open wounds may be caused by a scraping (abrasion), cutting (laceration) or piercing (puncture) force. Possible damage to underlying structures, such as tendons, muscles, blood vessels and nerves, should always be considered.

The principles of treatment for all open wounds are:

1. Stop any associated bleeding

Apply a pressure bandage directly to the injured part and elevate it. If the wound is open and clean, bring the wound edges together using adhesive strips or sutures. A contaminated wound should not be closed.

2. Prevent infection

Remove all dirt and contamination by simple irrigation. Extensively wash and scrub with antiseptic solution as required as soon as possible. If the wound is severely contaminated, prophylactic antibiotic therapy should be commenced (e.g. flucloxacillin, 500mg orally 4 x a day). If anaerobic organisms are suspected (e.g. wound inflicted by a bite), add an antibiotic such as metronidazole (400mg orally 3 x a day).

3. Immobilisation (where needed)

This applies when the wound is over a constantly moving part, for example, the anterior aspect of the knee. Certain lacerations, such as pretibial lacerations, require particular care and strict immobilisation to encourage healing.

4. Check tetanus status

All contaminated wounds, especially penetrating wounds, have the potential to become infected with Clostridium tetani. Tetanus immunisation consists of a course of 3 injections over 6 months given during childhood. Further tetanus toxoid boosters should be given at 5 to 10 year intervals. In the case of a possible contaminated wound, a booster should be given if none has been administered within the previous 5 years.

REFERENCES Brukner, P., 2012. Brukner & Khan's clinical sports medicine. North Ryde: McGraw-Hill.