Treating A Wound

Wound is the medical term for an injury that occurs when skin is torn, cut, sore, bruised, punctured, or similarly damaged. A few of the more common wounds we may be exposed to include open wounds, puncture wounds, and pressure (or bed) sores.

• Open wound: an injury that is exposed due to broken skin, and is at high risk for infection.
• Puncture wound: an injury caused by a pointed object that pierces or penetrates the skin. Any puncture wound through tennis shoes (as with a nail) has a high risk of infection, because the foam in tennis shoes can harbor the bacteria Pseudomonas. Puncture wounds also carry a danger of tetanus.
• Pressure sore: a sore area of skin that develops when the blood supply to it is cut off for more than two to three hours due to pressure on it and lack of movement. As the skin dies, the pressure sore first appears as a red painful area, which in time turns purple. Left untreated, the skin can break open and become infected. A pressure sore can become deep (ulcerate) and extend into the underlying muscle. Once a bed sore develops, it is often very slow to heal. Untreated pressure sores can become gangrenous or seriously infected.

Treatment of Wounds

Most wounds can be treated at home using ordinary first aid techniques (discussed below). Other wounds need professional attention. These wounds may include, but are not limited to:

• Gunshots, stabs, or puncture wounds 
• Wounds ½ inch deep or ½ inch long
• Wounds around nerve tissue, particularly in the face, neck, hands, and fingers
• Wounds resulting from tears to tissue surrounding a body orifice
• Wounds that do not stop bleeding within five minutes
• Wounds from animal bites
• Wounds from nails, or wounds obtained outside (such as a puncture wound obtained through a shoe while walking)

Tetanus

Puncture wounds may be at risk for a disease called tetanus. According to the National Foundation for Infectious Diseases, tetanus, commonly called lockjaw, is a bacterial disease that affects the nervous system. Tetanus is caused by bacterium called “clostridium tetani” and it is contracted through a cut or wound that becomes contaminated with tetanus bacteria.
The National Foundation for Infectious Diseases states that tetanus bacteria are present worldwide and are commonly found in soil, dust, and manure. Infection with tetanus causes severe muscle spasms, leading to "locking" of the jaw so the patient cannot open his/her mouth or swallow, and may even lead to death by suffocation. Tetanus is not transmitted from person to person.
If you obtain any puncture wound that is deep, or is obtained while outside, consult with your doctor to be sure you are not at risk for tetanus. Ensuring that you are up-to-date on all immunizations, such as a tetanus shot, will help minimize your risk of infection.

Treating a Wound - First Aid

There are six main steps for treating a small wound, or a wound that does not require a doctor’s attention:

1. Put on rubber gloves (if applicable)     
2. Stop the bleeding         
3. Clean the wound
4. Apply an antibiotic
5. Dress the wound
6. Check for infections

1. Put on Rubber Gloves

If you are treating a person with a communicable or infectious disease, pull on a pair of rubber gloves.

2. Stop the Bleeding

Before you clean or dress the wound, you need to stop the bleeding.
Light Pressure
Most wounds stop bleeding with light pressure. Cover the wound with sterile gauze or a clean cloth and then apply gentle pressure with the palm of your hand. The cloth absorbs the blood and will promote clotting. If blood soaks through, don’t disturb the cloth. Apply a second cloth on top of the first.
Elevation
If the wound is on an arm or leg that doesn’t appear to be broken, applying light pressure and elevating the body part to a height above the person’s heart will allow gravity to slow the blood flow.
Arterial Pressure
Applying pressure to the major artery supplying blood to the wound should slow bleeding. In the upper arm, apply pressure to the brachial artery which runs along the bone in the arm. In the leg, apply pressure to the femoral artery by pressing on the inner crease of the groin against the pelvic bone.   
Tourniquets
Use a tourniquet if the bleeding can’t be stopped by any of the other methods.  A tourniquet is a strip or band of cloth tightly tied above the wound to cut off circulation.  However, reducing circulation also reduces the flow of oxygen to the body part and may damage the limb.
If you are unable to stop or slow the bleeding, the wound may be deeper than you originally thought, or more severe. Please contact a health care professional immediately.

3. Clean the Wound

Run water over a wound, and use a cotton ball with water to remove dirt from the wound. According to the Mayo Clinic, “Soap can irritate the wound, so try to keep it out of the actual wound. If dirt or debris remains in the wound after washing, use tweezers cleaned with alcohol to remove the particles. If debris remains embedded in the wound after cleaning, see your doctor. Thorough wound cleaning reduces the risk of tetanus. To clean the area around the wound, use soap and a washcloth. There's no need to use hydrogen peroxide, iodine or an iodine-containing cleanser. These substances irritate living cells. If you choose to use them, don't apply them directly on the wound.”

4. Apply an Antibiotic

After you clean the wound, apply a thin layer of an antibiotic ointment to help prevent infection. These ointments may help the wound heal better (without scarring), and act as a barrier against infection. Check with your local pharmacy for over-the-counter products, or ask your health care professional for recommendations.

5. Dress the Wound

After covering the wound with an antibiotic ointment, gently cover the wound with sterile gauze wrap, adhesive-free dressings, or an adhesive bandage. A covered wound heals better. For large wounds, be sure to change the dressing each day, and whenever the dressing becomes wet or dirty. Before you apply new dressing, make sure to thoroughly clean the wound, and treat with an antibiotic ointment. Check with your local pharmacy to find wound dressings. For smaller wounds, you may want to try hydrocolloid bandages that do not have to be changed—they stay on for the life of the wound. The bandage itself acts as a seal, leading to less pain and scarring. Be sure to check with your healthcare professional about specific treatments and types of bandages.

6. Check for Infection

Swelling, tenderness, localized pain or warmth, pus and red streaks spreading away form the wound may be signs of infection. A wound that does not appear to be healing may also be infected. See your doctor immediately if you notice any sign of infection.