Three steps to follow for minor wounds
Farmers and ranchers and their families have a better-than-average chance to have cuts and scrapes as a result of where they work and live.
Puncture wounds; animal or human bites; wounds to the face or mucous membranes; deep wounds with muscle and tendon exposed, or with loss of dermal tissue; wounds showing signs of infection; and wounds with foreign material remaining after cleaning should all be seen by a health care provider.
Adequate treatment may require systemic antibiotics, surgical exploration of the wound or suturing.
Diabetes or poor circulation may hinder wound healing. Medications such as cancer drugs, corticosteroids or anticoagulants may also delay healing. People with these conditions or treatments should have any minor wound that does not heal within a week evaluated by their primary care provider.
Other minor wounds can be self-treated if the following three steps are followed: cleansing, using topical antibiotics and applying a suitable dressing. Based on research about wound healing, each step may differ with what you learned from your grandmother.
Cleanse the wound
You may have learned that hydrogen peroxide is the best solution to clean a wound. Not so!
Neither peroxide, iodine nor poviodine-iodine (Betadine) should be used to clean the wound. They destroy dermal tissue cells in an open wound and delay healing and encourage scarring.
These work well as antiseptics for intact skin around a cut or scrape. But for the broken or cut skin, use normal saline, bottled water, or plain water along with mild soap. Flush the wound, irrigating it until it is free of all dirt or other material.
Apply antibiotic as needed
The risk of infection for a wound that does not have dirt or foreign particles in it is low. But, if before cleaning, the wounded skin was dirty, then a topical antibiotic can reduce the risk of infection by killing potentially infectious bacteria.
Many references suggest topical preparations that do not include neomycin are the better choice because some are sensitive to neomycin, which may cause an allergic response at the wound site. Apply topical antibiotics one to three times daily for up to five days.
Apply a dressing
The desired result in the care of any wound is non-infected healing with as little scarring as possible. For most simple cuts and scrapes, an adhesive gauze-type bandage is satisfactory. Choose a bandage with a non-adhering pad to reduce the likelihood that the gauze will lift away the scab that the body forms over a healing wound. Leaving the scab in place promotes healing.
Alternatives for dressing small wounds include tissue adhesives. These “super glue” adhesives bond with the skin and create a flexible dressing that functions like the scab and resists bacterial growth. Another type of dressing for larger wounds, the hydrocolloid creates a moist environment and permits oxygen to permeate the wound.
Regardless of the dressing chosen, the wound should be observed regularly for signs of infection. Some initial redness is normal. Signs of infection include increasing redness, heat at the site, increasing pain and formation of pus.
Remember, antibiotic-resistant bacteria are far more common today than they once were, and even small wounds can be the source of infections that spread to other parts of the body.
Jones is professor emeritus in the School of Nursing, Texas Tech Health Sciences Center, at Lubbock.
This article published in the March, 2010 edition of THE FARMER-STOCKMAN.