The damage that is done to the layers under the skin can be just as dangerous as a skin tear on the skin. A bump to the shin causes bleeding that may lead to a hematoma or large accumulation of blood that forms a mass under the skin. A hematoma is a collection of blood under the skin that occurs as a result of the separation of the skin and the layer under the skin from the muscle tissue called fascia. Blood vessels, muscles, and nerves are often injured as well. Pressure from an injury may cause compartment syndrome that could cause nerve damage. People on blood thinners will have more bleeding than those who are not taking blood thinners. Adults are at risk for bumping the lower legs that may result in a hematoma under the skin. As we age the skin is less elastic, with less amount of that layer under the skin called subcutaneous tissue. The space then fills with blood that may cause enough pressure to cause the cells to die (called necrosis). Even a minor bump may cause a big problem. This mass of blood under the skin often may become infected. The hematoma may need to be evacuated by a surgeon. If the hematoma is not managed correctly it often extends to a full thickness skin loss that may require a skin graft or a prolonged healing process that starts from the inside out. Early evacuation of the hematoma may prevent weeks of costly treatments and grafts. Other factors like balance, disease of the veins and arteries, and disease that effects the nerves called neuropathy contribute to the risk of already aging skin. Medications may also reduce the ability for skin to heal. The best way to manage a wound is to prevent it in the first place. Amen to that.