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Soft Tissue injuries


Soft Tissue injuries
Soft Tissue injuries
Soft Tissue injuries
Soft Tissue injuries

Injury is an insult to the body with the resultant adverse effect. This can be brought up by physical insult, chemical/toxic injury or thermal injury. Usually the patient presents with symptoms upon arrival to the health facility which includes pain, bleeding, swelling or loss of function of the affected organ.

Signs and symptoms

Diagnostic Criteria

• Pain only, traumatic swelling, bruises with intact skin, cuts, abrasions, puncture wounds or open wounds of varying size and severity
• Injury to internal organs must be recognized and referred, including subtle

signs of organ damage, e.g.:

o blood in the urine – kidney or bladder damage
o shock – internal bleeding
o blood or serous drainage from the ear or nose – skull base fracture

• An injury causing a sprain or strain may be initially overlooked. Exclude fractures by performing appropriate X-rays

• Closed injuries and fractures of long bones may be serious and damage blood vessels
• Contamination with dirt and soil complicates the outcome of treatment



  • Pharmacological

    • Paracetamol 15 mg/kg PO 6 hourly per 24 hours

    • Diclofenac 75 mg IM 6hourly if can’t tolerate oral medication

    • Cloxacillin 500mg IV 6 hourly for 7 days
    • Ceftriaxone 1gm IV 8 hourly
    • Metronidazole 500mg IV 8 hourly

    • Tetanus prophylaxis: 0.5 mL Tetanus toxoid and 1 mL Tetanus immunoglobulin (Depending on the immunization protocol)

    Protocol in Provision of Tetanus Prophylaxis

    Patient Category - Immunized and booster within 5 years
    Non-tetanus prone - Nil
    Tetanus prone - Nil

    Patient Category - Immunized and 5 to 10 years since booster
    Non-tetanus prone - Nil
    Tetanus prone - TT

    Patient Category - Immunized and >10 years
    Non-tetanus prone - TT
    Tetanus prone - TT

    Patient Category - Incomplete immunization or unknown
    Non-tetanus prone - TT and TIG
    Tetanus prone - TT and TIG

    TT = Tetanus toxoid; TIG = Tetanus Immunoglobulin
  • Non-pharmacological

    Emergency management

    • Immobilize injured limb after reduction by POP cast or splint
    • Monitor vital signs
    • Monitor the arterial pulse and capillary refill below an injury on the limb with swelling.

    Wound care

    • Surgical debridement of the wound
    • Suture or splint when needed

    • Avoid primary suture if the wound is infected:

    o Dirty or contaminated
    o Crushed
    o In need of debridement
    o Projectile inflicted
    o Caused by bites


Updated on,

14 Novemba 2020 08:35:49


    1. STG
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