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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:

  1. 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.
  2. Assess neurovascular compromise distal to the wound.
  3. Irrigate, irrigate, irrigate.
  4. 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.
  5. Assess for possible tendon or fracture, and splint.
  6. Transport

 

 

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