I assisted at my son’s Cub Scout meeting and helped dispel some wound care myths. Lots of questions need answers. . . here is how I address wounds.
- Allergies? to latex, antibiotics or anesthetics (the medicine to numb a wound)? I don’t want to make the situation worse.
- Tetanus status? Tetanus vaccine is due every 10 years.
- How did the injury occur?
- Is there a foreign body (wood, glass, asphalt) in the wound? (An x-ray may show me a solid object in the wound, but glass is hard to see).
- Are the nerves, tendons, joints, and blood vessels intact and working?
- Cosmetically, how and should I close the wound?
- Does the wound need a specialist?
- Is there another reason to NOT close (stitch) the wound?
Time. It is important. 19 hours seems to be the magic number. Studies show wounds stitched UP to 19 hours after the injury heal significantly better than those closed later. So, as a physician, I do not sew wounds that come to me more than 19 hours of age.
What can YOU do with a “fresh” wound?
- First, stop the bleeding. Apply direct pressure to the wound. Most wounds stop bleeding in 10-15 minutes.
- Wash out the wound. Studies found tap water works as well as saline.
- (If it needs to be sewn, it’s done at this step).
- Clean petrolatum (NOT your used lip chapstick) can be put on top of the wound so that the dressing or bandage does not stick to the wound. I do not use neomycin as it is one of the top 10 allergens (that cause wounds to LOOK red and infected).
- Keep the dressing on for 48 hours, then leave open to the air.
- Wash with gentle soap and water and pat dry twice daily.
Call the doctor with any fever, redness, streaking, or any concerns. Antibiotics are not suggested with most patients. Exceptions are a grossly contaminated wound (with dirt or saliva), immune compromised patients or the wound that extends into a joint.
Last question. . .did you earn a scout achievement badge?