What happens if you slash your wrists

This concept applies to all muscle groups, tendons and limbs. Sometimes this is referred to as "biomechanical cutting. Therefore, your flexors tendons or muscles of the forearm, the biceps and triceps muscles of your upper arms, and the major quadriceps muscles just above the knee, require reliable and effective protection from a deliberate attack or cut.

Just above the knee, where the muscles narrow and connect to the patellar tendon, this area is typically covered by a just single layer of trousers material. It is a comparatively large target, and if someone is close enough to reach your body, that person will clearly also be close enough to reach your quadriceps.

Cutting this target is called "mobility kill", and it means that you will no longer be able to effectively defend yourself. Perhaps the best-known reference comes from the Filipino martial arts. Cutting the muscles on the inside of the forearm can produce the same effect. Free access to newly published articles. Purchase access. Rent article Rent this article from DeepDyve. Access to free article PDF downloads.

Save your search. Customize your interests. Create a personal account or sign in to:. Cutting is sometimes but not always associated with depression, bipolar disorder , eating disorders, obsessive thinking, or compulsive behaviors.

It can also be a sign of mental health problems that cause people to have trouble controlling their impulses or to take unnecessary risks. Some people who cut themselves have problems with drug or alcohol abuse. Some people who cut have had a traumatic experience, such as living through abuse , violence, or a disaster. Self-injury may feel like a way of "waking up" from a sense of numbness after a traumatic experience. Or it may be a way of reliving the pain they went through, expressing anger over it, or trying to get control of it.

Although cutting may provide some temporary relief from a terrible feeling, even people who cut agree that it isn't a good way to get that relief. For one thing, the relief doesn't last. The troubles that triggered the cutting remain — they're just masked over.

People don't usually intend to hurt themselves permanently when they cut. And they don't usually mean to keep cutting once they start.

But both can happen. It's possible to misjudge the depth of a cut, making it so deep that it requires stitches or, in extreme cases, hospitalization. Cuts can become infected if a person uses nonsterile or dirty cutting instruments — razors, scissors, pins, or even the sharp edge of the tab on a can of soda.

Most people who cut aren't attempting suicide. Cutting is usually a person's attempt at feeling better, not ending it all.

Although some people who cut do attempt suicide, it's usually because of the emotional problems and pain that lie behind their desire to self-harm, not the cutting itself.

Cutting can be habit forming. It can become a compulsive behavior — meaning that the more a person does it, the more he or she feels the need to do it. The brain starts to connect the false sense of relief from bad feelings to the act of cutting, and it craves this relief the next time tension builds. When cutting becomes a compulsive behavior, it can seem impossible to stop. So cutting can seem almost like an addiction, where the urge to cut can seem too hard to resist.

A behavior that starts as an attempt to feel more in control can end up controlling you. Cutting often begins on an impulse. It's not something the person thinks about ahead of time. Shauna says, "It starts when something's really upsetting and you don't know how to talk about it or what to do. But you can't get your mind off feeling upset, and your body has this knot of emotional pain.

Before you know it, you're cutting yourself. And then somehow, you're in another place. Then, the next time you feel awful about something, you try it again — and slowly it becomes a habit. Natalie, a high-school junior who started cutting in middle school, explains that it was a way to distract herself from feelings of rejection and helplessness she felt she couldn't bear. In this study, there were gender differences in self-inflicted wrist cutting 4 female and 13 male patients , as opposed to other studies which showed a higher proportion of women with self-cutting injuries [ 7 , 10 ].

This suggests that deep injuries involving deep flexor tendons, artery and nerve are more likely to occur in male patients. Male wrist-cutting patients showed more extensive injuries and all patients who had deep structural injuries were also male. Furthermore, as patients with psychiatric disorder have a higher rate of recurrent suicide attempts [ 11 ], multidisciplinary approach together with the Psychiatric Department is essential in order to effectively treat these patients.

Schizophrenic patients are more likely to get devastating injuries and other psychiatric disorders including depression and borderline personality disorder have a higher risk of attempted suicide [ 12 ]. Even though some patients have not been previously diagnosed with psychiatric disorders, it is likely that they have an underlying mental problem [ 13 ]. In this study, two patients with the deepest injuries Patient no.

Therefore, in case of male patient who have attempted suicide by wrist cutting and who have been diagnosed with a psychiatric disorder such as schizophrenia, the high possibility of deeper injury should be considered. Ironically, this unpredictable trauma can be one of the most predictable injuries to a hand surgeon in three ways. First of all, as there are more right-handed people who hold implements with their right hands, there is higher probability of injury to the left wrist [ 7 ], as confirmed in our study, which showed injuries to the left wrist in Secondly, almost all patients have flexor side injuries 16 patients with injuries of the flexor side and one with injury of the radial side.

Wrist flexor tendons were the most frequently injured anatomical structures because they are located close to the skin surface and therefore more likely injured.

As can be seen through the results of this study, The author drew an axial anatomy of the left wrist focusing on the most common injury site Fig. Arterial bleeding from both the radial and the ulnar side on the wrist indicates the high probability of structural injuries in intentional self-cutting [ 15 ].

Similarly, injury of the radial artery is often accompanied by an associated injury of the flexor carpi radialis tendon Patient no. Thus, we should keep in mind the possibility of accompanying structural injuries if arterial bleeding is suspected in the patient.

Axial anatomy of left wrist of the most commonly injured level. When we consider the type of implements used and mechanism of injuries, they can be classified into cutting wounds and stabbing wounds [ 9 ]. From an anatomical perspective, cutting wounds can be considered as horizontal injuries and stabbing wounds as vertical injuries. In terms of the implements used, Knife was the most common tool for suicide attempts, followed by glass. In cases of injuries caused by cutter and razor, they were all horizontal injuries, whereas in case of injuries caused by glass or scissors, vertical injuries were observed.

Injuries by knife could be of both injury types, but cutting wounds were more common 8 cases of horizontal injuries and 1 case of vertical injury. Especially, if the patient has vertical injury on their wrists, more attention should be paid to the motor and sensory evaluation.

In case of Patient No. At initial examination, no specific functional deficits were detected and the patient was treated with primary wound closure in the emergency department. At further examination in our outpatient clinic, indication to surgical exploration was given: intraoperatively injuries to the 4th flexor digitorum superficialis and profundus tendons were detected and repaired. Since this kind of injury is often inconspicuous, proper evaluation is necessary depending on the mechanism of injury and implements used.

Especially, when vertical injury is suspected, it is important to check the injured area through proper exploration. As mentioned above, initial evaluation and proper treatment are the most important in the prevention of long-term functional impairment. Accordingly, it would be helpful to undertake a proper evaluation in order to understand the axial anatomy schematically at the level where wrist cutting injury occurs most commonly. From the point of view of an initial examiner, not a hand surgeon, it is one of the best ways to estimate the possibility of structural injury by using the palmaris longus tendon, which is the most prominent structure on the flexor side, as an anatomical landmark Fig.

The median nerve is located in the relatively shallow depth directly below the palmaris longus tendon. From a total of 17 patients in this study, there were 4 patients who inflicted damage on the median nerve, which was most commonly damaged nerve, and injury of the palmaris longus tendon was accompanied in all these cases. Of the 4 cases resulting in long-term disabilities, 3 of those cases were patients with median nerve damage which was the most likely structural injury to cause motor or sensory impairment Patient No.

Regarding the palmaris longus tendon as the central structure, the flexor side of the wrist can be divided into the radial and the ulnar sides.

FCR flexor carpi radialis tendon and FCU flexor carpi ulnaris tendon can be regarded as tendon group of superficial layer and it is relatively simple to detect the presence of injuries. Furthermore, as mentioned above in case of arterial bleeding, we should also consider injuries of the adjacent structure such as the accompanying damage to both ulnar artery and nerve Patient no.

This study has several limitations. First, there is a possibility of selection bias because this was a retrospective study and only patients who underwent operation at the Plastic and Reconstructive Department were included. Second, a sample size was small for statistical analysis because this was a preliminary study before we started prospective cohort study.

In the future, a prospective studies using larger number of patients will be required. Despite these limitations, this study is meaningful in that it allows all stakeholders to understand the clinical characteristics of self wrist-cutting injuries and evaluate properly. A further prospective study will analyze the results of long-term follow-up and rehabilitation program of these patients, which could be more helpful for those who treat these patients primarily.

In this study, we investigated 17 patients who had structural injury due to self-inflicted wrist-cutting as a pilot study. This demonstrated a different tendency in comparison with those with deep injuries. Male patients with a psychiatric disorder had a higher risk of more extensive wrist lacerations. In terms of implements used when inflicted injury, we can predict the type of damage to some degree depending on the type of implement used.