HEALTH NEWS: Wound Care

We all get cuts and scrapes from time to time. Most are minor and heal quickly by themselves. Others are more serious and may require a trip to the doctor. I am often surprised at the kind of home remedies used on minor injuries. Many are helpful, some are harmless and others may actually make things worse.
Our bodies have an almost miraculous ability to heal themselves. After a cut, scrape or fall our bodies use many different ways to kill germs and repair the injured area. Sometimes it’s best for us not to interfered with our bodies natural repair mechanisms.
Most minor wounds do not need extensive cleaning. For a small cut or scrape simply washing off any surface dirt, etc. with a mild soap (or even plain water if soap is not available) is all you need to do for first aid. Open areas can be covered with an adhesive bandage or some gauze. It’s best to put these dressings on loosely so as to not impair the circulation to the area.
A small amount of antibiotic ointment can also be used. I prefer bacitracin ointment as it is safe and well tolerated. I usually advise against using triple antibiotic ointments as they contain neomycin which can cause allergic rashes in the area. Do not put any creams, ointments, or other medications into puncture or deep wounds. These medications are meant to be used on the surface of the skin and can cause problems when put into a deep wound or body cavity.
I do not recommend the use of alcohol on any cut or abrasion. While it is true that alcohol kills germs it also kills the cells of the body responsible for preventing infection and healing the wound. Alcohol also removes the natural oils from the skin that protect the area from losing to much moisture.
Hydrogen peroxide, like alcohol, is often used on cuts or wounds. I feel that it may be appropriate to use peroxide to initially clean the surface of an abrasion. Repeated use, however, will actually keep the wound from healing as fast as it should. Never put peroxide into deep cuts or gashes. The bubbling you see when using peroxide on a wound is oxygen being released when it comes into contact with blood cells. It is not related to whether or not the wound has been adequately cleaned. Just as Clorox is a chlorine bleach, hydrogen peroxide is an oxygen bleach. Both are too strong to be used on injured areas.
Most of use were told to “let air get to the wound”. Current thinking is that most abrasions and cuts heal better if they are kept covered with a dressing that prevents the wound from drying out. The moist environment promotes healing and can help prevent scarring. A simple dressing with bacitracin ointment (or plain Vaseline) is usually sufficient. Make sure to inspect the wound and change the dressing every day until it is healed. When a wound is not covered it often forms a scab over itself. This is the bodies way off making it’s own protective layer so that the wound will not dry out. Scabs usually do not form on covered, well cared for wounds. This can speed up the healing rate and prevent scars.
Wounds that may require closure using sutures (“stitches”) should be seen by a doctor soon after the injury. Most lacerations cannot be sutured more than 8 hours after the injury. After this time the wound will usually not close well with sutures and is often left to close on it’s own. This can result in a larger scar. Wounds requiring closure usually require care different from that needed by minor wounds. Your doctor will tell you the best way to care for more serious injuries.
Wound infections are not common but do occur occasionally. Minor infections may respond to antibiotic ointment but any wound that develops redness, pain or drainage after the original injury may require evaluation by your doctor. “Red streaks” spreading from the wound or fever also require prompt medical attention. Oral antibiotics are sometimes needed to treat these infections. Foreign bodies (splinters, etc) that remain in a wound are often a source of infection that can be very hard to treat unless they are removed. Persons with diabetes or other significant health problems often have more problems with wounds and should consider seeing their doctor for any problems with wound healing.

This article is one in a series of monthly columns by Greene Family Medicine where doctors will answer your health-related questions. If you have any questions that you would like to ask a doctor for this column, please send them to: Greene Family Medicine, Attention: Paige Herndon, 140 Stoneridge Drive, Suite 100, Ruckersville, Virginia 22968