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Penetrating trauma is an open wound injury that occurs when an object pierces the skin and enters a tissue of the body, creating a deep but relatively narrow entry wound.In contrast, a blunt or non-penetrating trauma may have some deep damage, but the overlying skin is not necessarily broken and the wound is still closed to the outside environment.
The temporary cavity is the radial stretching of tissue around the bullet's wound track, which momentarily leaves an empty space caused by high pressures surrounding the projectile that accelerate material away from its path. [17] The extent of cavitation, in turn, is related to the following characteristics of the projectile:
It’s possible for a surgeon to get distracted by the wrong wound. The most dangerous wounds don’t always look the worst. People can get shot in the head and they’re leaking bits of brain from a hole in the skull and that’s not the fatal wound; the fatal wound is from another bullet that ripped through the chest.
Subcutaneous emphysema can result from puncture of parts of the respiratory or gastrointestinal systems. Particularly in the chest and neck, air may become trapped as a result of penetrating trauma (e.g., gunshot wounds or stab wounds) or blunt trauma. Infection (e.g., gas gangrene) can cause gas to be trapped in the subcutaneous tissues.
The symptoms are similar to PTSD: depression and anxiety, difficulty paying attention, an unwillingness to trust anyone except fellow combat veterans. But the morally injured feel sorrow and regret, too. Theirs are impact wounds caused by the collision of the ethical beliefs they carried to war and the ugly realities of conflict.
Whatever caused the moral injury, Amidon said, “we are not going to brush it aside. It did happen and it wasn’t OK. The point is to help them feel OK sitting in the darkness with the evil they experienced.” Often, patients feel guilty or ashamed, convinced they are unforgiven, worthless and impure.
Timing is important to wound healing. Critically, the timing of wound re-epithelialization can decide the outcome of the healing. [11] If the epithelization of tissue over a denuded area is slow, a scar will form over many weeks, or months; [12] [13] If the epithelization of a wounded area is fast, the healing will result in regeneration.
The great moral power of an army, as Shay puts it, makes its participants more vulnerable to violation, and to a sense of guilt or betrayal when things go wrong. It was his work with Vietnam combat vets, in fact, that led him to recognize that their trauma often came from a deep sense of betrayal.