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:
- Put on rubber gloves (if applicable)
- Stop the bleeding
- Clean the wound
- Apply an antibiotic
- Dress the wound
- 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.
