Wound care measures

Effective hemostasis, thorough debridement, and matching the wound state to choose the healing environment, among which "dry scabbing" and "wet healing" have no absolute advantages and disadvantages, and should be comprehensively selected according to the wound location, pollution degree and personal life scene.

We usually cut our hands when cooking, rub our knees when riding a bicycle, and scald a small blister with boiling water. Many people's first reaction is either to lift their arms for a long time or to find iodophor to pour on the wound, but it is not necessary. Let's talk about hemostasis first. For most superficial wounds with a diameter of less than 2cm and a small amount of bleeding, directly find a clean sterile gauze or even a clean T-shirt that is not stained with oil and press it on the wound, which can basically stop in 3-5 minutes. Early nursing guidelines would suggest lifting the injured part to a position higher than the heart. In recent years, evidence-based research has confirmed that the hemostatic gain of this operation for small wounds is almost negligible, and it is enough to give priority to local compression. However, if the bleeding is splashing and can't be stopped after pressing for 10 minutes, don't hesitate to press the wound and go to the hospital. There is a high probability that you will hurt a thicker blood vessel and you can't handle it yourself.

Don't take this step lightly. Last week, I met a little girl in the clinic. She cut a 1cm hole in mango, sprinkled some powder in amoxicillin capsules and covered it for three days. When she came, there was pus all over her scab, which made her cry. The core of debridement is to clean the silt, foreign bodies and inactivated tissues in the wound, and give priority to sterile normal saline at room temperature. If you don't have it at home, it's no problem to wash it directly with flowing cold boiled water or even municipal tap water. There is a controversy in the industry here: the traditional disinfection school thinks that the pathogenic bacteria on the wound surface must be killed with iodophor and hydrogen peroxide to avoid infection; However, in recent years, the schools that promote wet healing suggest that common disinfection agents will kill newborn granulation cells at the wound indiscriminately, so long as the debridement is thorough enough and the follow-up protection is done well, disinfection agents can be completely unnecessary. My own clinical experience is that if the wound is particularly polluted-such as falling in the mud, stained with pet saliva, or my immunity is relatively low, I can flush it with diluted iodophor mixed with 1:1 physiological saline. If it is just a small cut with a clean kitchen knife or a shallow blister with boiling water, just rinse it. There is really no need to disinfect it specially.

As for "whether it's better to dry or wrap", I have compiled an adaptation table commonly used in clinic. Just look at it according to your own situation:

Last year, a young man who fell on an electric bike came to change his dressing, and his whole knee was bruised in a large area. Before he fell, he was all scabbed in the air, and it took him twenty days to get well, and he left a large dark scar. At that time, he was advised to use hydrocolloid dressing (a common dressing for wet healing), which healed ten days in advance and finally left almost no marks. However, there is also a retired aunt, who is also bruised on her knee. She goes to the vegetable market to buy food every day with a wet dressing. After sweating for more than two days, she becomes red, swollen and painful. Later, she changed to exposed dry care and recovered after more than a week. To put it bluntly, there is really no absolute good plan, and the one that suits your own life scene is right.

Finally, mention a few pits that people often step on: Don't sprinkle toothpaste, cigarette ash, Yunnan Baiyao powder, oral antibiotic powder and other messy things on the wound, which will only block the export of exudate, but instead cover the bacteria inside and cause infection; Unless you have diabetes, low immunity from taking hormones for a long time, or signs of infection such as redness, fever and pus have appeared in the wound, ordinary superficial wounds do not need to take antibiotics at all, but eating indiscriminately will increase the risk of drug resistance; If the wound is on the face and joints, don't scratch the scab. The newly grown new tissue is very fragile, and the probability of scarring is several times. Sun protection should be done before healing, otherwise the pigmentation will not disappear for half a year.

When you are really not sure, just go to the community hospital and look for a nurse. It is more useful to spend a few dollars on medicine than to search for ten remedies online.