Pathophysiology

Facial and scalp wounds are most often caused by a combination of sharp and blunt mechanisms. For example, a victim of a motor vehicle accident may bluntly strike the windshield and be cut by the glass as it shatters. People involved in interpersonal trauma or falls may have a similar pattern of injury. Lacerations caused by sharp objects are likely to have more discrete edges but may be deeper and involve underlying structures such as the muscles of facial expression, nerves, and/or arteries. Wounds caused by blunt forces burst the skin open, damage cells, and produce tissue edema, which slows down the wound-healing process. As a result, it takes an average of ten times fewer bacteria to cause an infection as in a blunt wound as opposed to a sharp wound. Blunt forces are more likely to cause diffuse underlying damage, such as fractures of the facial bones or skull. The presence of foreign bodies such as soil, glass, or wood fragments further complicates the potential for good healing.-,4,5. and 6

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