Start caring for a bruise by employing the RICE method of rest, ice, compression, and elevation.
When treating an injury of any kind, it is paramount to first identify the type and severity of the wound. When determining the proper care for bruises, once identified, it is critical that the proper steps be taken to treat the injury effectively and efficiently. Depending on the type and severity of a bruise, the appropriate wound care treatment will vary.
What Is a Bruise?
A bruise is a condition in which small blood vessels under the skin rupture, causing blood to leak into the underlying skin tissue. There are three common types of bruises that can occur based on the severity of an injury: contusions, hematomas and purpura.
Contusions are the most common type of bruises and are typically caused by blunt-force trauma. If the trauma damages the blood vessels under the skin, a bruise known as a contusion may appear.
A contusion is typically identified by the color shifting of the skin as the injury transitions through the healing process. A contusion will initially turn red—then black, blue, or purple—until eventually transitioning to green or yellow as the leaked blood under the tissue breaks down and is resorbed by the body.
Hematomas are a type of bruising where a massive collection of blood has pooled at the injury site. Hematomas are often the result of the same type of trauma that causing contusions, but they are typically accompanied by more severe pain and additional swelling in the injured area.
A hematoma may also be caused by a blood vessel spontaneously rupturing or as a result of undergoing a surgical procedure. Hematomas are particularly dangerous when they occur in vital organs of the body, and in such cases a consultation with your physician is highly advised.
Purpura is bruising indicated by purple-colored patches and spotting that occur on the skin, often in the lining of the mouth. Purpura occurs when small blood vessels rupture and leak blood beneath the skin.
Purpura is not caused by traumatic injury, but instead by a variety of conditions or diseases such as fragile blood vessels in the elderly, congenital rubella, or even drugs that may reduce your platelet count.
Treating a Wound or Bruise
Wounds are typically categorized into four different stages that help standardize the severity of the injuries. Many non-penetrating wounds are also accompanied by bruising, which makes it critical to identify the severity and stage of the wound—along with the type and classification of bruising—to determine the appropriate level of treatment.
For the vast majority of bruises including minor to moderate contusions and hematomas, the standard RICE method (rest, ice, compression, and elevation) is the only treatment required, particularly during the acute phase over the first 24 to 48 hours. For contusions afflicting the knee or upper thigh, crutches are also recommended to reduce strain to the injured area which could cause additional damage or excess pain.
Following the initial period of RICE treatment for muscular or bone bruising, it has been shown that mobilization of the muscles or joints near the bruised area may dramatically reduce recovery time. Maintaining slight mobilization during this recovery phase will establish normal tissue planes and removes excess detritus from the soft tissue in the area.
Unlike contusions and hematomas, purpura treatment will vary on a case-by-case basis as determined by a medical professional by evaluating the underlying cause of the purpura.
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