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При проникающих травмах могут быть также задеты более глубокие мягкие ткани, мышцы, фасции и костные структуры [2](https://centr-hirurgii.ru/surgery/operativnaya-travmatologiya-ortopediya/otkrytaya-rana/). \n\nНекоторые типы открытых ран: \n* **Рваные** — имеют неровные края, возникают в результате механического воздействия [1](https://semeynaya.ru/directions/khirurgiya/otkrytaya-rana/). \n* **Укушенные** — нанесены зубами животного или человека [3](https://dzo44.ru/upload/files/%D0%9F%D0%9C%D0%9F%20%D0%BF%D1%80%D0%B8%20%D1%82%D1%80%D0%B0%D0%B2%D0%BC%D0%B0%D1%85%20%D0%B8%20%D1%80%D0%B0%D0%BD%D0%B5%D0%BD%D0%B8%D1%8F%D1%85.pdf)[4](https://n-d-c.ru/publications/travmatologiya/otkrytaya-rana/). \n* **Ожоги** — вызваны горячими жидкостями, парами, огнём или электричеством [1](https://semeynaya.ru/directions/khirurgiya/otkrytaya-rana/). \n* **Хирургические** — возникают после медицинских манипуляций [1](https://semeynaya.ru/directions/khirurgiya/otkrytaya-rana/).\n\n\n\n## Причины\nПовреждения возникают, когда на кожу или слизистую оболочку действуют механические силы, интенсивность которых превышает запас прочности тканей [2](https://centr-hirurgii.ru/surgery/operativnaya-travmatologiya-ortopediya/otkrytaya-rana/). Чаще всего это острые предметы [2](https://centr-hirurgii.ru/surgery/operativnaya-travmatologiya-ortopediya/otkrytaya-rana/). Реже причиной являются термические и химические воздействия, огнестрельное оружие, хирургические манипуляции [2](https://centr-hirurgii.ru/surgery/operativnaya-travmatologiya-ortopediya/otkrytaya-rana/).\n\n## Симптомы\nОткрытые раны могут иметь разнообразные симптомы в зависимости от их типа, глубины и локализации [8](https://duetclinic.ru/diseases/otkrytaya-rana/). Некоторые распространённые симптомы: \n* **Боль в области раны** — может варьироваться от лёгкой до острой и нестерпимой в зависимости от повреждения тканей [8](https://duetclinic.ru/diseases/otkrytaya-rana/). \n* **Кровотечение** — может быть слабым или интенсивным, в зависимости от размеров и глубины раны [8](https://duetclinic.ru/diseases/otkrytaya-rana/). \n* **Покраснение и отёк вокруг раны** — часто признак воспалительного процесса, сопровождающего заживление [8](https://duetclinic.ru/diseases/otkrytaya-rana/). \n* **Выделение гноя или других жидкостей** — может указывать на наличие инфекции [8](https://duetclinic.ru/diseases/otkrytaya-rana/). \n* **Повышенная температура тела** — может свидетельствовать об инфекционном процессе [8](https://duetclinic.ru/diseases/otkrytaya-rana/).\n\n## Диагностика\nДиагностика открытых ран включает комплексный осмотр, который позволяет определить тип раны, степень её тяжести и наличие возможных осложнений [8](https://duetclinic.ru/diseases/otkrytaya-rana/). Некоторые методы оценки состояния раны: \n* **Визуальный осмотр** — выявление признаков воспаления и инфицирования [8](https://duetclinic.ru/diseases/otkrytaya-rana/). \n* **Лабораторные анализы** — общий анализ крови и бактериальный посев для диагностики инфекции [8](https://duetclinic.ru/diseases/otkrytaya-rana/). \n* **Рентгенографические исследования** — могут быть показаны при подозрении на повреждение костей или инородные тела в ране [8](https://duetclinic.ru/diseases/otkrytaya-rana/).\n\n## Лечение\nЛечение открытой раны зависит от её размера, глубины и причин появления [1](https://semeynaya.ru/directions/khirurgiya/otkrytaya-rana/). Основные цели — предотвращение инфицирования, стимуляция заживления и обеспечение комфорта пациента [1](https://semeynaya.ru/directions/khirurgiya/otkrytaya-rana/). \n\nВ зависимости от давности получения повреждений и их особенностей специалисты проводят **первичную или вторичную обработку** [2](https://centr-hirurgii.ru/surgery/operativnaya-travmatologiya-ortopediya/otkrytaya-rana/): \n* **Первичная обработка** — если с момента получения ранения прошло не более 3–6 часов [2](https://centr-hirurgii.ru/surgery/operativnaya-travmatologiya-ortopediya/otkrytaya-rana/). Хирурги расширяют рану, чтобы удалить инородные предметы и повреждённые ткани, остановить кровотечение и провести антисептическое промывание [2](https://centr-hirurgii.ru/surgery/operativnaya-travmatologiya-ortopediya/otkrytaya-rana/). При необходимости устанавливается дренажная система, на края накладывают швы [2](https://centr-hirurgii.ru/surgery/operativnaya-travmatologiya-ortopediya/otkrytaya-rana/). \n* **Вторичная обработка** — выполняется, если с момента получения травмы прошло более 6 часов, имеются признаки инфицирования [2](https://centr-hirurgii.ru/surgery/operativnaya-travmatologiya-ortopediya/otkrytaya-rana/). Полость раскрывают, удаляют гнойное содержимое, участки некроза, промывают антисептиками и устанавливают дренаж [2](https://centr-hirurgii.ru/surgery/operativnaya-travmatologiya-ortopediya/otkrytaya-rana/). 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