Wound care health education content

There are no black-and-white rules for debridement to prevent infection, moisturizing to promote healing, and reducing scar formation. There are no black-and-white rules such as "cover the wound to heal quickly" or "let it dry to prevent inflammation." It must be dynamically adjusted according to the type of wound and the stage of healing.

Last week, I met a 19-year-old young man in the surgical clinic. He fell off his knee while riding a shared bicycle. The wound, which was as big as his palm, leaked a lot of tissue fluid. When he got home, he heard his mother say, "It will get better if you cover it, but it will heal faster if you let it air for a while." I was stunned and kept my trouser legs rolled up for three days. I blew my knee, and when I came to change the dressing, there was a layer of hard black scab on the surface, which cracked when I bent my leg slightly. There was also yellowish-white exudate under the scab. The wound was supposed to be healed in a week, but it took almost half a month of hard work, and there is a high probability that it will remain pigmented.

Some people will definitely raise objections when it comes to this. I made a small cut on my fingertip with paper a few days ago. I rubbed some iodine on it and left it to dry overnight. There was no problem? This is actually the difference between two common ideas in wound care - the "dry scab healing" used by the older generation and the "moist healing" advocated by the current international mainstream guidelines. There is no absolute right or wrong in itself, but the wounds that are suitable for it are different. For extremely shallow wounds with almost no bleeding or exudation, the method of drying and scabbing is completely sufficient and saves trouble. ； However, if the wound is larger than the size of a fingernail, has obvious exudate, or is a scald wound, wet healing can reduce the damage to new granulations, heal at least one-third faster, and also reduce the probability of scarring.

The first mistake many people make when dealing with wounds is to use disinfectant randomly. No matter what kind of wound comes up, they pour hydrogen peroxide or spray 75% alcohol. They hiss in pain and gasp, thinking "the more painful it is, the more effective it is." To be honest, except for the initial flushing and disinfection of extremely contaminated wounds with hydrogen peroxide, subsequent routine dressing changes do not require these irritating disinfectants. It is enough to rinse the wound exudate with warm saline. I usually change dressings for patients, and when I see a patient who has been applying alcohol at home for three or four days, as soon as I lift the dressing, I can see that the new epithelium around the wound has been burned and turned white. This situation will take at least two or three days to heal. There are also those who apply toothpaste, soy sauce, incense ash, and homemade aloe vera gel to the wound. The most exaggerated old man I have ever seen was that he had his foot burned and applied half a bottle of miso. The entire wound was smelly when he came in. When he was cleaning it, he hit the table in pain. It was originally a shallow second-degree burn, but it became infected to a deep second-degree burn, and he had to stay in the hospital for a week.

There's another question that's been asked a lot - can wounds be exposed to water? There's really no such thing as "don't touch it." For a fresh wound, you cannot directly wash it with tap water. However, if you stick it firmly with a sterile waterproof dressing, it is perfectly fine to take a bath. Just wipe the water around the dressing clean after washing. It is not like not taking a shower for ten and a half months because of a small wound. The whole body will be smelly and it will easily breed other bacteria. If it has reached the late stage of healing and the scab has softened and there is no fresh exudate, it is okay to take a shower directly. After washing, just take a clean cotton towel and gently dry it with water. It is better than covering the scab every day and not daring to wash it, leaving a pile of dead skin and bacteria on the surrounding skin.

Many people think that the wound is healed once the scab falls off. This is actually a big misunderstanding. Especially for people whose wounds are on the face, joints, or who have scars themselves, the 3 to 6 months after the scabs fall off are the period of high incidence of scar hyperplasia. Don't believe the rumors that "vitamin E can remove scars". Only regular silicone scar removal products have been clinically proven to be effective. Apply them every day and use sunscreen. Don't always pick and touch the hyperplasia with your hands. Eat less spicy and fishy thorns. Food irritation, if you find that the area where the wound has grown is red, itchy, and bulging, go to the hospital as soon as possible to get a scar injection. It costs tens of dollars. It is much more cost-effective and less painful than waiting for the scar to grow to a few millimeters thick before undergoing surgical removal.

In fact, there are really not so many hard-and-fast rules for wound care. Everyone's skin condition, wound depth, and degree of contamination are different. If someone uses a convenient method to apply it to you, you may get into trouble. If you are really not sure how to treat your wound, you can spend a few bucks to get a surgical number from a community hospital and ask the doctor to take a look at it. It is much more reliable than searching online for a long time and fussing with yourself. If it really breaks and leaves a scar, it will be too late to regret it.