Abrasion Wounds: A Quick Review

It’s nearly impossible to go through life without suffering an abrasion wound. A stumble over uneven sidewalk leads to scraped palms, a brush against a prickly bush results in a scratched leg – these are common examples of abrasions caused by everyday activities. Even friction from a zipper on clothing or a heavy backpack pressing into the shoulders can cause this type of injury to the skin.

However, not every abrasion wound is a simple scrape. In some cases, abrasions can be serious. In these situations, the body’s natural healing processes may be slowed or impaired, making even a superficial wound like an abrasion more prone to complications.

So, even if you think you’re familiar with an abrasion wound, it’s always a good idea to take the time and review the risks, assessment process, treatments, and prevention practices for abrasions, whether deep abrasions or minor injuries.

What is an Abrasion Wound?

What’s the difference between an abrasion wound, scrape, and laceration? That’s a crucial question. The Cleveland Clinic defines an abrasion as a superficial wound caused by scraping or rubbing off the skin’s outer layer. While scrapes are also a type of abrasion, the term “abrasion” has a specific definition and is more comprehensive.

Linear abrasions, which occur when something strips away the epidermis in a straight line, are a common type of abrasion wound.

In contrast, a laceration is a deeper, jagged tear in the skin caused by a sharp object or force. The distinction is crucial for treatment, as abrasions typically require simple cleaning, while lacerations may need suturing to prevent infection and ensure proper healing.

According to Healthgrades, abrasions can be categorized by the depth of skin damage. First-degree abrasions are the mildest, involving only the outer layer (epidermis), and usually heal without complications. This might be a scrape from a zipper or button on your clothing.

Second-degree abrasions affect both the epidermis and the dermis, often causing mild bleeding. Think a child scraping their knee on the sidewalk. Third-degree abrasions, or avulsion wounds, are the most severe, with damage extending through the skin’s deepest layers, often causing significant bleeding and requiring professional medical treatment. This might be a scrape picked up during a motorcycle accident, where the skin slid across the road with great force and speed.

What are the Types of Abrasion Wound?

An article in StatPearls discusses the abrasion wound as categorized into three types:

1. Linear or scratch abrasions: The simplest form of an abrasion wound, these occur when the epidermis is stripped away in a line on the skin—a scratch from a thorn, for example. 
2. Grazed or brush abrasions: These wounds result from friction against a rough surface, such as from concrete or asphalt – a fall on an outdoor asphalt basketball court, for example. The texture of the surface impacts the depth of the wound.
3. Patterned abrasions: A patterned abrasion can be broken into two categories known as pressure or impact abrasions. Pressure abrasions occur when there is prolonged compression on the epidermis – a very tight sock, for example. Impact abrasions occur from blunt force, such as a swift blow.

A skin abrasion can vary in appearance and size. Common symptoms of these skin wounds include:

• Light bleeding
• Swelling
• Pain and tenderness
• Redness
• Bruising at and around abrasion site
• Clear or pink fluid

Causes of Abrasions

Abrasions are injuries to the skin and underlying tissue caused by friction against a rough surface. The primary cause of abrasions is friction, which occurs when a hard, uneven, or rough surface, object, or material comes into contact with the skin. Common causes of abrasions include:

• Rubbing against a rough surface: This can happen when you fall on pavement or concrete, leading to skin abrasions.
• Sliding or falling on a hard surface: Activities like sports or outdoor adventures on rocky terrain can result in abrasions.
• Contact with sharp objects: Nails, glass, or other sharp items can cause linear or scratch abrasions.
• Sports and recreational activities: Biking, skateboarding, and contact sports often lead to minor injuries like abrasions.
• Daily activities: Gardening, construction work, or using abrasive materials can cause skin abrasions.
• Pressure or friction from tight clothing or protective gear: Prolonged pressure from tight socks or gear can lead to pressure abrasions.

Understanding these common causes can help in taking preventive measures, such as wearing appropriate protective gear and being cautious during activities that pose a risk of abrasions.

At-Risk Populations for a Minor Abrasion

As we mentioned, anyone can get one, abrasions are usually minor. Several patient populations, however, are at risk for a more severe abrasion, including children, geriatric patients, and those with cancer or immunosuppressant therapy.

For older patients, thinner and more fragile skin increases the risk of deeper tissue damage, while reduced circulation and slower cell regeneration can delay healing and increase the likelihood of infection or serious injury. Children are more likely to acquire minor abrasions through rough play, which may be similarly likely to end up infected.

On the infection front, individuals with compromised immune systems, such as those with diabetes, autoimmune diseases, or undergoing chemotherapy, may struggle to mount an effective immune response to bacteria or other pathogens that enter through the skin, even through a seemingly simple abrasion.

If the infection spreads, this can lead to prolonged wound healing, infections, and even systemic complications. In these populations, what starts as a superficial abrasion can quickly evolve into a more serious medical issue requiring advanced care and close monitoring by wound care professionals.wound care professionals.

Abrasion Symptoms and Complications

Abrasions can cause a range of symptoms, including:

• Pain or tenderness: The affected area may be sensitive to touch.
• Redness and swelling: Inflammation is a common response to skin abrasions.
• Bleeding or oozing: Minor abrasions may bleed or ooze clear or pink fluid.
• Blisters or scabbing: As the wound heals, blisters or scabs may form.
• Skin discoloration: The area around the abrasion may appear bruised or discolored.

In some cases, abrasions can lead to complications, such as:

• Infection: Bacteria can enter the wound, causing increased redness, swelling, and pus. It’s crucial to prevent infection by keeping the wound clean.
• Scarring: Deep abrasions can result in permanent scarring.
• Delayed healing: Improper care can prolong the healing process.

To prevent infection and promote healing, it’s essential to practice good wound management. This includes:

• Cleaning and disinfecting the wound: Use mild soap and water to clean the area.
• Applying antibiotic ointments: This helps to prevent infection and promote healing.
• Covering the wound: Use a bandage or dressing to protect the abrasion from further irritation.
• Changing the dressing daily: Keeping the wound clean and covered aids in faster healing.

By following these steps, you can help prevent secondary infections and ensure that your abrasion wound heals quickly and effectively. If you notice signs of infection or have a weakened immune system, seek medical attention promptly.

Poor Care Makes The Abrasion Wound Flare

Let’s look at a sample abrasion case. Abby, a 4-year-old girl, arrives at the local emergency room with a quarter-size scrape on her knee and gravel embedded. The skin around the scrape is swollen and warm to the touch with a smelly discharge. The wound is treated, and Abby is discharged.

At a follow-up visit, her condition is worse. Due to the symptoms, the physician sends Abby to their hospital’s wound care specialist for debridement. The gravel was carefully removed and the child placed on antibiotics to treat the infection.

Abrasions are the number one injury for children, with the majority of reported cases being on the head and torso. This type of wound also adversely affects anyone with poor motor coordination, making them prone to falls, and older adults with fragile skin. Most minor abrasions can be expected to heal within two weeks. However, in older adults, the very young, or those with poor immune systems, abrasions can lead to a cascade of issues.

Medical History and Treatment

These wounds, when minor, are easy to manage – until they’re not. Let’s take a hypothetical patient, Ray, who is 82, diabetic, and has a recent deep wound on his elbow. Ray scraped his elbow on a wall near the garden at his senior living facility. Because of his age and medical condition, the visiting wound care provider scheduled an appointment with Ray at her next visit to the facility. She noted that Ray’s wound wasn’t healing and conducted a more thorough exam, getting more insights into his medical history, including medications, lifestyle, eating habits, and other conditions.

Digging deep into a patient’s health status is crucial for wound care. Is the patient diabetic? Are they doing an activity that is putting stress on the wound site? Are they getting proper nutrients that support the healing process? In this deep dive, Ray’s wound care provider found some important information to help treat his non-healing abrasions. In addition to his diabetes, she discovered he had previously suffered a minor stroke and was on an anticoagulant. These insights helped her to revise her treatment plan and ensure she had clear images and documentation of care steps so that progress could be analyzed more completely at her next visit and shares with Ray’s other providers.

No Exception from Infection

Infection and scarring are concerns with any damage to the skin’s surface, so healthcare professionals treating even the most minor wounds, like Abby’s scrape, should follow best practices to avoid an abrasion wound becoming infected or healing improperly. In addition to prolonging the wound healing process, infection can spread to other areas of the body, lead to further medical visits or hospitalization, and increase pain and cost to the patient.

For providers, a poorly treated abrasion wound that is slow to heal or becomes infected can mean more time and resources spent on the patient, negative patient feedback and quality ratings, and a more cumbersome reimbursement process to track and report the various treatment stages.

Signs of an infected abrasion wound are similar to infection symptoms in other wound types:

• Cloudy or yellow discharge coming from the wound
• Skin around the wound is warm
• Skin around wound is swollen
• Foul odor coming from wound
• Red streaks on the skin around the wound

In addition, patients may suffer from flu-like symptoms, such as:

• Fever and chills
• Aches and pains
• Nausea and vomiting

Did Someone Say Abrasion Wound Prevention to Prevent Infection?

Wound care clinicians have the opportunity to help patients deal with their current abrasion wounds and prevent future wounds from occurring or becoming serious enough to require intervention by a healthcare professional. Patients and caregivers can be given tips about fall prevention and how to identify infections. Facilities can promote safety by minimizing objects that might lead to falls or scrapes and more closely monitoring at-risk patients.

Providers should also consider all contributing factors to a patient’s susceptibility to wounds, including medication regimens, underlying health conditions, and lifestyle. Is the patient at risk for falls? Could a simple change, such as the use of protective gear or mobility aids, reduce future injuries? Proactive strategies like these are essential for long-term patient health and for minimizing the need for repeated interventions.

Let’s Talk about Tech

Proper wound care includes the documentation steps that occur throughout the exam and treatment processes. Technology is making this process more efficient and manageable. AI-powered wound imaging platforms provide detailed photos and consistent measurements of wounds, as well as thorough methods of documentation and communication for healthcare professionals.

Wound care clinicians can track healing progress, record necessary information for reimbursement purposes, and exchange patient information with others involved in a patient’s medical care. Combining imaging platforms with specialty electronic health record (EHR) systems that include the latest ICD-10 codes, regulations and other information further streamlines workflows. AI can compare wound images to thousands of others, helping the practitioner provide a more accurate and informed treatment plan to the patient.

By using digital tools to free up time previously spent on administrative tasks such as handwritten charts and billing, wound care clinicians and their staff can spend more time with their patients, leading to improved patient-provider relationships and overall patient experience.

Proper Treatment Is Key for Wound Management by Clinicians

Though abrasions are common and often perceived as minor, they deserve the same level of attention and care as any other wound type. For wound care providers, accurately assessing, treating, and preventing abrasions is critical for ensuring proper healing and avoiding complications such as infection or scarring.

Equipped with advanced technology, like wound imaging platforms and specialty EHR systems, clinicians can streamline documentation, improve patient care, and support positive outcomes. Through proper treatment and patient education, providers can reduce the burden of these wounds and ensure better health for their patients.

By diligently treating all wounds, wound care clinicians can optimize treatment outcomes, foster strong patient-provider relationships, and support their patients in leading healthier lives.