The Secret of Great Health Care

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Wounds

Wounds

                                                (Free health ebook chapter on wounds)


A wound is an injury where the skin is cut, torn or punctured. It may also include an injury where a trauma causes a bruise. This section will focus minor wounds.

Abrasion: Wearing away of the top layer of skin from trauma

Incision: An injury caused by a sharp object that causes an opening in the skin – they have smooth edges

Laceration: Opening on the skin that is irregular in shape

Puncture: The item that caused the wound goes in and out

Skin Tear: Separation or loss of the top layer of skin due to an injury

When to see a doctor

 

 

 

 

What will happen when you get a wound

Multiple things will be noticed around the wound when you get a wound. This will include:

  • Pain/tenderness
  • Redness
  • Bleeding
  • Swelling

These things should improve over the first 24 hours. If they worsen and there is associated fever or red streaks around the wound than infection may have set in. Numbness, tingling or loss of function indicate possible nerve damage.

 

 

 

 

 How to treat

  1. Stop the bleeding with direct pressure
  2. Flush the area with water – remove any foreign products (do not flush a puncture wound).
  3. Wash the wound with soap and water or saline
  4. Antibiotic wound ointment can be used on wounds
  5. If edges of the wound are together – it may be covered with a non-adherent dressing/liquid bandage to keep it clean
  6. If the edges of the wound are not together the use of steri-strips may be needed
  7. May need a tetanus shot if you are not up do date. If you have not had a tetanus shot in the last five years you may need a booster after a wound.

 

 

 

 

 

 

OTC Products





Washing the wound can occur with plain soap and water, but a popular OTC product is saline wound wash sprays. These sprays are normal saline in a bottle that effectively removes dirt from wounds and causes less discomfort than soap (as plain water has a tendency to sting).

Over-the-counter antibiotic creams or ointments are helpful to prevent a wound infection. There are essentially three antibiotic ointments:

  1. Neosporin
  2. Bacitracin
  3. Polysporin

Neosporin and its generic counterparts is an ointment that contains three active ingredients used to prevent bacterial infections of the skin. Neosporin contains a combination of bacitracin, neomycin and polymyxin B. Bacitracin fights bacteria known as gram-positive bacteria. Gram-positive bacteria are the most common type of bacteria that can lead to skin infections. Polymyxin B and neomycin are other antibiotics that provide coverage against other bacteria that are less likely to cause infection of the skin.

Neomycin is the most likely antibiotic to cause an allergic reaction. It is a common cause of contact dermatitis. Because there is little extra benefit of neomycin and there is a risk of an allergic reaction, it is a product that is often not favored by doctors in the prevention of wound infection. Instead bacitracin or polysporin are used.


Bacitracin contains one product bacitracin, which is active against the most common causes of skin infections.

 

 

 

 

 Polysporin contains two active ingredients – bacitracin and polymyxin B. It is likely not more effective in preventing infection than bacitracin.

To purchase products discussed in this chapter visit The Drug Store.

 

 

 

 

 Dressings

A wound should not be covered until it is cleaned properly. If you cannot clean a wound properly do not cover it – seek the advice of a health care provider. A wound should also not be dressed until the bleeding has stopped.

Dressings are used to cover an open wound to prevent infection. They should be changed about every 12 hours.

Band-Aid Brand Adhesive Bandages, Variety Pack, 280-Count Assorted Sizes (Pack of 2)

Dukal 1212 White 12-Ply 2" x 2" Sterile Gauze Pads (DKL1212) Category: Bandages and Dressings

Lacerations or incisions where you can see the fatty tissue may require stitches. If you want to treat these without stitches you will increase the risk of infection and scaring. To manage them at home you need to pull the edges together and apply steri-strips. Place the antibiotic ointment over the steri-strips and than a band-aid or dressing over top.

The easiest dressing to use for small and even medium sized wounds are band-aids. They come in a variety of shapes and sizes, but their main job is to cover a wound and help prevent infection. Some band-aid products come as large adhesive pads and are good for large wounds.

Avoid sticking the adhesive tape to the base of the wound. The band-aid should be big enough that the pad covers the wound. Band-Aids have an absorbent pad that will not stick to the wound and allow for better healing.

Gauze products can also be used for wounds. They are a little bit more difficult to use as they do not self-adhere. They need to be wrapped or taped to the wound. They serve the same purpose, but are a little harder to use. Key points:

  • Keep any open wound covered to keep it clean, dry and non-irritated
  • Watch for infection (increasing pain, drainage from the wound, increased redness, increased swelling or an odor from the wound or fever)
  • Steri-strips fall off in about five days – don't peel them
  • Certain situations are at greater risk for complications and warrant input from a health care provider including: any diabetic, any wound associated with numbness or reduced ability to move the area around the wound, uncontrolled bleeding (Call 911), bite wounds, dirt that will not come out of the wound and wounds that meet criteria for stitches.

Do you need stitches?
 
Stitches can be used for wounds that are lacerations, incisions and some punctures. Ideally you should get stitches within 6-8 hours of the injury to reduce the risk of infection. Stitches do not work for abrasions.

 

 

 

 

 Stitches are used to:

  • Close a wound to help the healing process
  • Prevent infection
  • Decrease the risk of a scar

 

Stitches may be necessary when:

  • The wound is deep enough to see fatty tissue
  • If the wound cannot be pulled together easily
  • Scarring would be obvious
  • Certain areas of the body heal better with stitches. Areas of the body that have a lot of movement should be stitched. A wound in the middle of the forearm does not move a lot and may not require stitches, whereas a wound on the forehead, where there is more movement, would.

MRSA

For more information on MRSA infections visit: MRSA products.

A product to reduce the risk of MRSA and swine flu

 

 

 

 

 

 

 

 

 

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