Lacerations
- First Aid and Wound Care
Our skin is our largest organ. It protects us from the elements
as well as other environmental factors. However the integrity
of the skin is frequently disrupted. I personally do not know
anyone who has not suffered an abrasion or cut. These are
even more common when one ventures into the outdoors, whether
hunting, fishing, camping or backpacking.
It
always surprises me as to the amount of misinformation in
the medical field and the amount of healthcare providers with
different opinions regarding how to avoid infection and promote
healing. A common saying is “The solution to pollution
is dilution,” meaning irrigate, irrigate, irrigate.
In the outdoors, if you are quite a distance from home, you
can even use lake water to irrigate the wound. This is better
than no water at all. Please see our first aid tips, where
we talk about using a plastic bag with a small hole in it
to create pressure irrigation. This is very helpful in irrigating
out debris that may be imbedded in the wound.
Hydrogen
Peroxide is a great cleanser for the initial cleaning of a
wound. However it is important to note that Hydrogen Peroxide
use after that does not promote healing and actually does
the opposite. It absolutely will start tearing down some of
the cells and will stop the epithelialization of the wound.
This is important because numerous individuals are under the
erroneous impression that they should clean their wound daily
with Hydrogen Peroxide.
Lacerations
on the scalp can be temporarily closed (provided your hair
is at least 3-4 inches long) by taking hair on either side
of the laceration and tying it tight. Please see first aid
tips in our first aid tips section.
The
next step is to apply direct pressure with elevation, if possible.
Direct pressure for 15-20 minutes will stop 95-98% of all
bleeding wounds. Elevation also helps.
Bandage
the wounds with nonstick bandages such as Telfa or Xeroform.
These are beneficial; by the time the individual gets to a
healthcare provider, the bandage will not stick to the wound
which will cause less pain when removed.
Abrasions
Patients
can use liquid Diphenhydramine on a bandage and lie that over
the top of an abrasion. This also has a very mild numbing
effect which will ease the pain.
If
a laceration is severe enough that one is concerned about
possible tendon or bone damage, it is very important to bandage
the injured area, then splint the extremity and transport.
Closing
wounds with superglue has been done. However in this day and
age, being in such close proximity to medical providers of
one sort or another, this rarely has to be done. If used improperly,
it can actually do more harm than good. Never ever use this
on the face as it is too close to the eyes. It is best just
to use direct pressure, bandage and transport.
This
author has also had many questions regarding an over-the-counter
blood clotting powder. This does work to clot and stop bleeding.
However it is a thorn in a healthcare provider’s side
in terms of irrigating and cleaning. It is very difficult
to get out of wounds and this author has not seen any research
to verify increased infections.
In
summation:
-
Remove any jewelry, watches, or rings if the laceration
is to the hands, fingers, or wrists as there could be swelling
and this could be extremely dangerous if left on.
-
Assess neurovascular compromise distal to the wound.
- Irrigate,
irrigate, irrigate.
-
Pressure dressing: Apply direct pressure for 15-20 minutes.
There is hardly any laceration or wound where the bleeding
cannot be stopped with direct pressure. Bandage.
-
Assess for possible tendon or fracture, and splint.
-
Transport
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