Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Open Wound


Related Terms

  • Abrasion
  • Avulsion Injury
  • Cut
  • Laceration
  • Puncture Wound
  • Stab Wound

Differential Diagnosis

Specialists

  • Emergency Medicine Physician
  • General Surgeon
  • Infectious Disease Internist
  • Neurosurgeon
  • Orthopedic (Orthopaedic) Surgeon
  • Plastic Surgeon
  • Vascular Surgeon

Comorbid Conditions

Factors Influencing Duration

The severity of the wound and the degree of muscle, nerve, blood vessel, tendon and bone injury influence the length of disability.

Medical Codes

ICD-9-CM:
870.1 - Laceration of Eyelid, Full-thickness, Not Involving Lacrimal Passages
870.2 - Laceration of Eyelid Involving Lacrimal Passages
870.3 - Penetrating Wound of Orbit, without Mention of Foreign Body
870.8 - Open Wound, Ocular Adnexa, Specified, Other
871.0 - Ocular Laceration without Prolapse of Intraocular Tissue
871.3 - Avulsion of Eye
871.4 - Laceration of Eye, Unspecified
871.5 - Penetration of Eyeball with Magnetic Foreign Body
871.6 - Penetration of Eyeball with Nonmagnetic Foreign Body
871.7 - Ocular Penetration, Unspecified
871.9 - Open Wound, Eyeball, Unspecified
872.00 - Open Wound, External Ear, Unspecified Site
872.01 - Open Wound, Auricle, Ear
872.02 - Open Wound, Auditory Canal
872.10 - Open Wound, External Ear, Unspecified Site
872.11 - Open Wound, Auricle, Ear
872.12 - Open Wound, Auditory Canal
872.61 - Open Wound, Other Specified Parts of Ear, without Mention of Complications, Ear Drum; Drumhead; Tympanic Membrane
872.62 - Open Wound, Other Specified Parts of Ear, without Mention of Complications, Ossicles
872.63 - Open Wound, Other Specified Parts of Ear, without Mention of Complications, Eustachian Tube
872.64 - Open Wound, Other Specified Parts of Ear, without Mention of Complications, Cochlea
872.69 - Open Wound, Other and Multiple Sites of the Ear without Mention of Complications
872.71 - Open Wound, Other Specified Parts of Ear, Complicated, Ear Drum
872.72 - Open Wound, Other Specified Parts of Ear, Complicated, Ossicles
872.73 - Open Wound, Other Specified Parts of Ear, Complicated, Eustachian Tube
872.74 - Open Wound, Other Specified Parts of Ear, Complicated, Cochlea
872.79 - Open Wound, Other and Multiple Sites of the Ear, Complicated
872.8 - Open Wound, Ear, Part Unspecified, without Mention of Complication
872.9 - Open Wound, Ear, Part Unspecified
873.0 - Open Wound, Scalp, without Mention of Complication
873.1 - Open Wound, Scalp, Complicated
873.20 - Open Wound, Nose, Unspecified Site, without Mention of Complication
873.21 - Open Wound, Nose, without Mention of Complication, Nasal septum
873.22 - Open Wound, Nose, without Mention of Complication, Nasal cavity
873.23 - Open Wound, Nose, without Mention of Complication, Nasal sinus
873.29 - Open Wound, Nose, Multiple Sites without Mention of Complication
873.30 - Open Wound, Nose, Unspecified Site, Complicated
873.31 - Open Wound, Nose, Unspecified Site, Complicated, Nasal septum
873.32 - Open Wound, Nose, Unspecified Site, Complicated, Nasal cavity
873.33 - Open Wound, Nose, Unspecified Site, Complicated, Nasal sinus
873.39 - Open Wound, Multiple Sites, Complicated
873.40 - Open Wound, Face, Unspecified Site, without Mention of Complication
873.41 - Open Wound, Cheek, without Mention of Complication
873.42 - Open Wound, Forehead, without Mention of Complication
873.43 - Open Wound, Lip, without Mention of Complication
873.44 - Open Wound of Jaw, without Mention of Complication
873.49 - Open Wound, Face, Other and Multiple Sites, without Mention of Complications
873.50 - Open Wound, Face, Unspecified Site, Complicated
873.51 - Open Wound, Cheek, Complicated
873.52 - Open Wound, Forehead, Complicated
873.53 - Open Wound, Lip, Complicated
873.54 - Open Wound, Jaw, Complicated
873.59 - Open Wound, Other and Multiple Sites, Complicated
873.60 - Open Wound, Mouth, without Mention of Complications, Unspecified Site
873.61 - Open Wound, Internal Structures of Mouth, without Mention of Complications, Buccal Mucosa
873.62 - Open Wound, Internal Structures of Mouth, without Mention of Complications, Gum (Alveolar Process)
873.63 - Open Wound, Internal Structures of Mouth, without Mention of Complications, Tooth (Broken) (Fractured) (Due to Trauma)
873.64 - Open Wound, Internal Structures of Mouth, without Mention of Complications, Tongue and Floor of Mouth
873.65 - Open Wound, Internal Structures of Mouth, without Mention of Complications, Palate
873.69 - Open Wound, Other and Multiple Sites of Internal Structures of Mouth
873.70 - Open Wound, Mouth, Complicated, Unspecified Site
873.71 - Open Wound, Internal Structures of Mouth, Complicated, Buccal Mucosa
873.72 - Open Wound, Internal Structures of Mouth, Complicated, Gum (Alveolar Process)
873.73 - Open Wound, Internal Structures of Mouth, Complicated, Tooth (Broken) (Fractured) (Due to Trauma)
873.74 - Open Wound, Internal Structures of Mouth, Complicated, Tongue and Floor of Mouth
873.75 - Open Wound, Internal Structures of Mouth, Complicated, Palate
873.79 - Open Wound, Other and Multiple Sites of Internal Structures of Mouth
873.8 - Open Wound, Other and Unspecified Open Wound of Head without Mention of Complication
873.9 - Open Wound, Other and Unspecified Open Wound of Head, Complicated
874.00 - Open Wound, Neck, Larynx and Trachea, without Mention of Complication, Larynx with Trachea
874.01 - Open Wound, Neck, Larynx and Trachea, without Mention of Complication, Larynx
874.02 - Open Wound, Neck, Larynx and Trachea, without Mention of Complication, Trachea
874.10 - Open Wound, Neck, Larynx and Trachea, Complicated, Larynx with Trachea
874.11 - Open Wound, Neck, Larynx and Trachea, Complicated, Larynx
874.12 - Open Wound, Neck, Larynx and Trachea, Complicated, Trachea
874.2 - Open Wound, Neck, Thyroid Gland, without Mention of Complication
874.3 - Open Wound, Neck, Thyroid Gland, Complicated
874.4 - Open Wound, Neck, Pharynx, without Mention of Complication; Cervical Esophagus
874.5 - Open Wound, Neck, Pharynx, complicated
874.8 - Open Wound, Other and Unspecified Parts of Neck, without Mention of Complications
874.9 - Open Wound, Other and Unspecified Parts of Neck, Complicated
875.0 - Open Wound, Chest without Mention of Complication
875.1 - Open Wound, Chest, Complicated
876.0 - Open Wound, Back without Mention of Complication
876.1 - Open Wound, Back, Complicated
877.0 - Open Wound, Buttock, without Mention of Complication
877.1 - Open Wound, Buttock, Complicated
878.0 - Open Wound, Genital Organs (External), Including Traumatic Amputation, Penis, without Mention of Complication
878.1 - Open Wound, Genital Organs (External), Including Traumatic Amputation, Penis, Complicated
878.2 - Open Wound, Genital Organs (External), Including Traumatic Amputation, Scrotum and Testes, without Mention of Complication
878.3 - Open Wound, Genital Organs (External), Including Traumatic Amputation, Scrotum and Testes, Complicated
878.4 - Open Wound, Genital Organs (External), Including Traumatic Amputation, Vulva, without Mention of Complication; Labium (Majus) (Minus)
878.5 - Open Wound, Genital Organs (External), Including Traumatic Amputation, Vulva, Complicated
878.6 - Open Wound, Genital Organs (External), Including Traumatic Amputation, Vagina, without Mention of Complication
878.7 - Open Wound, Genital Organs (External), Including Traumatic Amputation, Vagina, Complicated
878.8 - Open Wound, Other and Unspecified Parts of Genital Organs, without Mention of Complication
878.9 - Open Wound, Genital Organs (External), Including Traumatic Amputation, Other and Unspecified Parts, Complicated
879.0 - Open Wound, Breast, without Mention of Complication
879.1 - Open Wound, Breast, Complicated
879.2 - Open Wound, Abdominal Wall, Anterior, without Mention of Complication; Epigastric Region; Hypogastric Region; Pubic Region; Umbilical Region
879.3 - Open Wound, Abdominal Wall, Anterior, Complicated
879.4 - Open Wound, Abdominal Wall, Lateral, without Mention of Complication; Flank; Groin; Hypochondrium; Iliac (Region); Inguinal Region
879.5 - Open Wound, Abdominal Wall, Lateral, Complicated
879.6 - Open Wound, Other and Unspecified Parts of Trunk, without Mention of Complication
879.7 - Open Wound, Other and Unspecified Parts of Trunk, Complicated
879.8 - Open Wound, Multiple Unspecified Sites, without Mention of Complication
879.9 - Open Wound, Multiple Unspecified Sites, without Mention of Complication
880.00 - Open Wound, Shoulder and Upper Arm, without Mention of Complication, Shoulder Region
880.01 - Open Wound, Shoulder and Upper Arm, without Mention of Complication, Scapular Region
880.02 - Open Wound, Shoulder and Upper Arm, without Mention of Complication, Axillary Region
880.03 - Open Wound, Shoulder and Upper Arm, without Mention of Complication, Upper Arm
880.09 - Open Wound, Shoulder and Upper Arm, without Mention of Complication, Multiple Sites
880.10 - Open Wound, Shoulder and Upper Arm, Complicated, Shoulder Region
880.11 - Open Wound, Shoulder and Upper Arm, Complicated, Scapular Region
880.12 - Open Wound, Shoulder and Upper Arm, Complicated, Axillary Region
880.13 - Open Wound, Shoulder and Upper Arm, Complicated, Upper Arm
880.19 - Open Wound, Shoulder and Upper Arm, Complicated, Multiple Sites
880.20 - Open Wound, Shoulder and Upper Arm, with Tendon Involvement, Shoulder Region
880.21 - Open Wound, Shoulder and Upper Arm, with Tendon Involvement, Scapular Region
880.22 - Open Wound, Shoulder and Upper Arm, with Tendon Involvement, Axillary Region
880.23 - Open Wound, Shoulder and Upper Arm, with Tendon Involvement, Upper Arm
880.29 - Open Wound, Shoulder and Upper Arm, with Tendon Involvement, Multiple Sites
881.00 - Open Wound, Elbow, Forearm, and Wrist, without Mention of Complication, Forearm
881.01 - Open Wound, Elbow, Forearm, and Wrist, without Mention of Complication, Elbow
881.02 - Open Wound, Elbow, Forearm, and Wrist, without Mention of Complication, Wrist
881.10 - Open Wound, Elbow, Forearm, and Wrist, Complicated, Forearm
881.11 - Open Wound, Elbow, Forearm, and Wrist, Complicated, Elbow
881.12 - Open Wound, Elbow, Forearm, and Wrist, Complicated, Wrist
881.20 - Open Wound, Elbow, Forearm, and Wrist, with Tendon Involvement, Forearm
881.21 - Open wound of elbow, with tendon involvement
881.22 - Open Wound of Wrist, with Tendon Involvement
882.0 - Open Wound, Hand, Except Finger(s) Alone, without Mention of Complication
882.1 - Open Wound, Hand, Except Finger(s) Alone, Complicated
882.2 - Open Wound, Hand, Except Finger(s) Alone, with Tendon Complication
883.0 - Open Wound, Finger(s), without Mention of Complication
883.1 - Open Wound, Finger(s), with Complication
883.2 - Open Wound, Finger(s), with Tendon Involvement
884.0 - Open Wound of Upper Limb, Multiple and Unspecified, without Mention of Complication
884.1 - Open Wound of Upper Limb, Multiple and Unspecified, Complicated
884.2 - Open Wound of Upper Limb, Multiple and Unspecified, with Tendon Involvement
890.0 - Open Wound of Hip and Thigh, without Mention of Complication
890.1 - Open Wound of Hip and Thigh, Complicated
890.2 - Open Wound of Hip and Thigh, with Tendon Involvement
891.0 - Open Wound of Knee, Leg [except Thigh], and Ankle, without Mention of Complication
891.1 - Open Wound of Knee, Leg [except Thigh], and Ankle, Complicated
891.2 - Open Wound of Knee, Leg [except Thigh], and Ankle, with Tendon Involvement
892.0 - Open Wound, Foot except Toe(s) Alone, without Mention of Complication
892.1 - Open Wound, Foot except Toe(s) Alone, Complicated
892.2 - Open Wound, Foot except Toe(s) Alone, with Tendon Involvement
893.0 - Open Wound of Toe(s) including Toenail, without Mention of Complication
893.1 - Open Wound of Toe(s) including Toenail, Complicated
893.2 - Open Wound of Toe(s) including Toenail, with Tendon Involvement
894.0 - Open Wound of Lower Limb, Multiple and Unspecified, without Mention of Complication
894.1 - Open Wound of Lower Limb, Multiple and Unspecified, Complicated
894.2 - Open Wound of Lower Limb, Multiple and Unspecified; With tendon involvement

Treatment

The primary goal of open wound management is to restore optimal function to the involved area by prompt and thorough repair of injured tissue and to minimize the risk of infection and deformity. Initial treatment consists of controlling the bleeding, treating for shock if necessary, and thoroughly cleansing the wound to reduce the risk of infection. Administration of local or regional anesthesia may be necessary in order to evaluate a wound, control bleeding (hemostasis), and thoroughly cleanse the area by high-pressure irrigation with saline before repair can begin.

After bleeding is controlled and the individual is stabilized, wound care can be initiated. The treatment approach is the same whether the wound involves the hand, finger, leg, knee, or foot. Any open wound extending into deep surrounding structures such as bone, blood vessels, or nerves requires surgical intervention. Open wounds associated with a fracture of nearby bones (open fractures) require urgent surgery (reduction and internal fixation of open fracture) to stabilize the fracture and close the wound. Open wounds extending to tendons, nerves, and major blood vessels near joints and bones of the hand, feet, and ankle typically require prompt surgical repair (repair and / or reconstruction of tendon, nerve, or vessel). Amputations and some avulsion wounds usually require urgent plastic surgery to reattach amputated parts (reimplantation). Grafting of skin on wounds with large amounts of skin and tissue loss (avulsion wounds) can take place at the time of injury or a few days later. In some circumstances, severe wounds to the hands or feet may necessitate amputation of any tissue that has severely compromised circulation and cannot be salvaged.

Treatment of less extensive abrasions, lacerations, and puncture wounds begins with control of bleeding. This is followed by cleansing the wound thoroughly using high-pressure irrigation (syringe or water pik) with saline or mild antiseptic solution (Fernandez). Any remaining foreign matter is removed, and the ragged or unhealthy tissue is débrided. Most wounds are then closed using stitches, tissue adhesive, surgical tape (steri-strips), staples, or a combination of these methods.

Wounds with a high risk of infection (puncture wounds to the foot, human and animal bites) or wounds 12 to 24 hours old are left open and then closed with stitches, if needed, in 5 to 7 days (delayed primary closure). This allows time for control of any potential infection by treatment with antibiotics. In larger wounds more than 24 hours old, the area is cleansed, débrided, and then packed with wet to dry dressings. The wound is then either allowed to heal naturally (healing by secondary intention), or it may be closed surgically in 5 to 7 days.

Repaired wounds are covered with an antibiotic ointment and appropriate bandage. A tetanus shot (tetanus toxoid) may be given if 7 to 10 years have passed since the individual's last booster shot, or if there is a question about when the individual was last vaccinated. If the individual has never been immunized against tetanus, human tetanus immune globulin may be given in addition to tetanus toxoid.

Wounds that extend over bending joints, such as the fingers, hand, or ankle, are sometimes splinted to immobilize the area and help prevent pulling on the wound edges. Wounds should be checked for signs of infection daily; infection usually develops within the first 48 hours after injury. Oral antibiotics may be prescribed to treat or prevent infection (Gosselin).

Source: Medical Disability Advisor






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