Low risk vs. High risk vs. Cosmetic/Functional (HB)

Determining the type of wound does not change anything about how we will treat that wound—it only affects how quickly we decide to transport, if at all.

Low-risk wounds are simple to clean injuries. Think of nicking your finger with a kitchen knife while cutting vegetables. Low-risk wounds don’t involve deep structures and aren’t contaminated.

High-risk wounds are wounds that involve deep structures–muscles, fascia/connective tissue, and bone. We also consider wounds that are grossly contaminated, puncture, bites, etc. High-risk wounds are hard to clean and come with an outsized risk of contamination. They are hard to close and to keep from further contamination. Because of this, we should plan on getting this patient out as soon as possible.

Cosmetic/Functional wounds are pretty subjective. If you are a hand model, a wound on your hand might be problematic for you. We are also concerned about wounds that impact the patient’s ability to do things. E.g., a wound on the bottom of the foot can interfere with walking out. Suppose a patient is concerned with the cosmetics of a wound or the wound poses a functional risk. In that case, you should consider it in the same category as a high-risk wound. This patient needs to get to medical care at a hospital or clinic as soon as safely possible.