Abrasions


Related Terms

  • Scrapes

Specialists

  • Emergency Medicine Physician
  • Family Physician
  • General Surgeon
  • Plastic Surgeon

Comorbid Conditions

Factors Influencing Duration

Primary factors that can lengthen disability time are the location (especially face, hand, and foot), extent, depth of injury, and risk of infection. Deep abrasions involving muscle tissue and bleeding (hemorrhage) may mean a longer period of disability. An abrasion involving a dominant arm or hand requires more time to regain normal functioning. Any abrasion involving a leg or foot may take longer to heal, especially in the presence of vascular compromise.

Medical Codes

ICD-9-CM:
917.0 - Superficial Injury of Foot and Toe(s); Heel; Toenail, Abrasion or Friction Burn without Mention of Infection
917.1 - Superficial Injury of Foot and Toe(s); Heel; Toenail, Abrasion or Friction Burn, Infected
919.0 - Superficial Injury of Other, Multiple, and Unspecified Sites, Abrasion or Friction Burn without Mention of Infection
919.1 - Superficial Injury of Other, Multiple, and Unspecified Sites, Abrasion of Friction Burn, Infected

Definition

An abrasion is an open wound caused when the topmost layers of skin are rubbed or scraped off. Rope burns, floor burns, and skinned knees or elbows are common examples of abrasions. Abrasions can result from falls or handling coarse objects. In addition, individuals who work on floors or carpets or in tight, confined spaces are at greater risk of sustaining abrasion wounds as a result of skinning the knees, elbows, or knuckles along the floor or rough surfaces.

This type of wound tends to ooze blood or clear fluid. Abrasions can easily become infected because dirt and germs are usually ground into the tissues. However, since abrasions have minimal bleeding, the wound is rarely life-threatening.

Source: Medical Disability Advisor



History

History: Individuals may report a recent injury or accident. History should include information regarding where the injury or accident occurred (on a tar, cement, sand, or gravel surface). Individuals may report a recent scraping of skin over the area involved. Individuals may have had a fall or brushed up against the surface of something rough.

Physical exam: The exam may reveal an area where the skin surface has been rubbed down to bright pink or red tissue with little or no bleeding. Instead, there may be oozing of clear-colored fluid. A slight swelling may be seen around the site and is tender to the touch.

Tests: There are generally no tests indicated in the diagnosis of abrasion wounds. If the wound is old and infection is suspected, a complete blood count and wound culture may be ordered to detect the presence of a wound infection.

Source: Medical Disability Advisor



Treatment

Abrasions are very common and rarely serious. Applying direct pressure to the wound may be necessary to control bleeding. Any dirt or debris that is embedded in the wound should be removed. The area should be cleansed with mild soap and water. Dressing and bandaging may be sufficient, but the wound should be monitored for signs of infection. If deeper layers of tissue are involved or when the damaged area is large, wound débridement, antibiotic therapy, and possible plastic or reconstructive surgery may be required.

Source: Medical Disability Advisor



Prognosis

Outcome is good for most individuals. Proper care should be taken to guard against infection.

Source: Medical Disability Advisor



Complications

Infection is the primary complication. Scarring or tattooing may follow deeper abrasions.

Source: Medical Disability Advisor



Return to Work (Restrictions / Accommodations)

Work restrictions and accommodations are determined based on the site and size of the abrasion and if it interferes with the individual's job responsibilities. For example, work restrictions would likely be required if the abrasion is on the hand(s) and the individual works outside.

Source: Medical Disability Advisor



Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • What was the mechanism of the injury?
  • Did the exam reveal skin surface that has been rubbed down to bright pink or red tissue?
  • Was there any bleeding? Oozing of clear-colored fluid?
  • Was there swelling around the site? Was it tender to the touch?
  • Did infection occur?

Regarding treatment:

  • Were strong antiseptics applied such as iodine, methylate, Mercurochrome, or alcohol to clean abrasion?
  • Is individual monitoring the wound for infection?
  • Were wound debridement or antibiotic therapy needed?
  • Was plastic or reconstructive surgery necessary?
  • When did individual last have a tetanus booster?

Regarding prognosis:

  • Does individual have diabetes or any other condition that can affect circulation or the immune system?
  • Where is the abrasion on the body?
  • Does individual use that part of the body when performing job responsibilities? If so, is this putting individual at risk for infection?
  • Was the abrasion deep and did it involve muscle tissue?
  • Does the abrasion affect the dominant hand or arm?

Source: Medical Disability Advisor



References

General

Marx, J. A., et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 5th ed. Philadelphia: Elsevier, Inc., 2004. MD Consult. Elsevier, Inc. 19 May 2005 <http://home.mdconsult.com/das/book/47333531-2/view/999?sid=368456024>.

Source: Medical Disability Advisor






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