International Red Cross Wound Classification System
Encyclopedia
The International Red Cross wound classification system is a system whereby certain features of a wound
Wound
A wound is a type of injury in which skin is torn, cut or punctured , or where blunt force trauma causes a contusion . In pathology, it specifically refers to a sharp injury which damages the dermis of the skin.-Open:...

 are scored: the size of the skin wound(s); whether there is a cavity, fracture
Fracture
A fracture is the separation of an object or material into two, or more, pieces under the action of stress.The word fracture is often applied to bones of living creatures , or to crystals or crystalline materials, such as gemstones or metal...

 or vital structure injured; the presence or absence of metallic foreign bodies. A numerical value is given to each feature (E, X, C, F, V, and M). The scores can later be graded according to severity and typed according to the structures injured.

This scoring system is intended for quick and easy use in the field.

Wounds are scored after surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

 or initial assessment.
  • E = (Entry) centimetres. Estimate the maximum diameter of the entry.

  • X = (eXit) centimetres. Estimate the maximum diameter of the exit (X = 0 if no exit).

  • C = (Cavity) Can the "cavity" of the wound take 2 fingers before surgery? No: C=0, Yes: C=1.
This may be obvious before operation or only established after skin incision. For chest
Chest
The chest is a part of the anatomy of humans and various other animals. It is sometimes referred to as the thorax or the bosom.-Chest anatomy - Humans and other hominids:...

 and abdominal wounds it refers to the wound of the chest or abdominal wall.

  • F = (Fracture) No fracture: F=0. Simple fracture, hole or insignificant comminution
    Comminution
    Comminution is the process in which solid materials are reduced in size, by crushing, grinding and other processes. It occurs naturally during faulting in the upper part of the crust and is an important operation in mineral processing, ceramics, electronics and other fields. Within industrial uses,...

    : F=1. Clinically significant comminution: F=2.

  • V = (Vital structure) Are brain
    Brain
    The brain is the center of the nervous system in all vertebrate and most invertebrate animals—only a few primitive invertebrates such as sponges, jellyfish, sea squirts and starfishes do not have one. It is located in the head, usually close to primary sensory apparatus such as vision, hearing,...

    , viscera (breach of dura
    Dura mater
    The dura mater , or dura, is the outermost of the three layers of the meninges surrounding the brain and spinal cord. It is derived from Mesoderm. The other two meningeal layers are the pia mater and the arachnoid mater. The dura surrounds the brain and the spinal cord and is responsible for...

    , pleura or peritoneum
    Peritoneum
    The peritoneum is the serous membrane that forms the lining of the abdominal cavity or the coelom — it covers most of the intra-abdominal organs — in amniotes and some invertebrates...

    ) or major vessels injured? No: V=0. Yes: V=1.

  • M = (Metallic body) Bullet or fragments visible on X ray. None: M=0. One metallic body: M=1. Multiple metallic bodies: M=2.


The wound classification system has been criticised on the basis that "it fails to account for the synergistic effect of combined arms
Combined arms
Combined arms is an approach to warfare which seeks to integrate different branches of a military to achieve mutually complementary effects...

employment on the battlefield. It erroneously assumes that each soldier will be injured or killed by only one type of weapon."

The classification is typically found on hospital Trauma History and Examination Record forms and is used for classification of penetrating injuries on presenting patients.

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