Proper wound care is very important in the treatment of many things. Wounds that are not cared for properly can lead to cellulitis (bacterial skin infection), which can then lead to sepsis, which is life threatening.
An open wound is anything that breaks the skin, e.g., cuts, scrapes, abrasions, punctures.
Control bleeding with well-aimed, direct pressure.
Clean.
Cover with a sterile dressing.
Immobilize high-risk wounds if possible.
Change the bandage and clean the wound regularly.
Monitor for infection and treat as needed.
Any open wound must be cleaned in order to minimize the chance of infection.
Use a combination of the following depending on the situation:
Remove all foreign materials as best as you can.
Wash the wound and the surrounding skin with soap and water. Lightly scrub.
Irrigate the wound with at least 100 ml (ideally 1000 ml) of the cleanest water available, and make a final wash with water of drinking quality. Hot water (not scolding) is best.
If there is foreign material that cannot be irrigated, or there isn’t enough water, rinse the wound out with antiseptic, e.g., Betadine.
If clean water or antiseptics are not available, consider:
Ø Maggots: they will keep a wound open and clean until better treatment can be given. Make sure they do not devour good tissues.
Ø Urine: assuming you do not have a UTI, your urine will be relatively sterile and can be used to clean a wound, but is not an antiseptic.
Cover the wound with a sterile dressing. Any adhesive should not actually touch the wound.
If needed/possible, close it with sutures/stables etc.
If in the wilderness and/or a survival situation, it is best not to close a wound. The scar will be bigger, but there is less chance of infection.
Change dressings at least twice a day. If bandage is saturated, additional changes may be required.
Clean the wound with clean drinking water (preferably with no chemicals) every time you change the dressing.
If you see bleeding while changing the dressing, just apply pressure until it stops.
A wet to dry dressing may not be needed for minor wounds, but can be very beneficial for larger ones.
Soak a bandage in sterilized (boiled) water and wring the water out.
Apply it directly onto the wound.
On top of that, place a dry bandage.
Secure it in place.
During the healing process you may see blackish material on the edge of the wound. Remove it.
You can scrub it out, or you may need to trim it off.
An impaling object is when an item punctures the skin and is still inside, protruding from the patient, e.g., a knife.
Treatment for Impaling Objects
Remove all impaling objects unless doing so would cause further harm.
Exceptions include impaling objects in the globe of the eye or when removal would result in severe pain or bleeding.
After removal, clean and treat as an open wound; Must Read - Open Wounds, Skin Infections and Sepsis - Open Wounds.
Any wound is susceptible to infection, especially if not cared for properly.
If an infected wound is not treated, it can lead to sepsis and, consequently, death.
Symptoms of Local Skin Infection
These symptoms are present at the site of the infection:
Bad odor.
Discomfort/pain.
Heat on touch.
Pus and/or a cloudy fluid.
Redness.
Swelling.
Tenderness.
Treatment for a Local Skin Infection
Rest and elevate the infected limb.
Drain the puss, incise if needed; Diagnoses and Treatments – Integumentary System – Abscesses.
Irrigate.
Warm water soaks can be soothing.
Consider immobilization of limb.
Pharmaceuticals:
Note: the body can sometimes resolve the infection on its own, even more so if it is cleaned well.
Antibiotic: amoxicillin/clavulanate 500 mg every 12 hours for 7 days, or for 3 days following resolution of acute inflammation or 875 mg every 12 hours for 7 days or until 3 days following resolution for severe cases.
Antibiotic: ciprofloxacin 500 mg every 12 hours for 7 days or until 3 days following resolution or 750 mg every 12 hours for 7 days or until 3 days following resolution for serious cases.
Antibiotics, other: amoxicillin, ampicillin, cephalexin, levofloxacin, metronidazole.
Alternative/Natural Remedies:
Plantain leaves: poultice.
Tannin: compresses or direct application.
Honey: topical application.
Symptoms of Systemic Infection (Sepsis)
Blistering.
Fatigue.
Fever and Chills.
Malaise (general sick feeling).
Muscle ache.
Pain.
Red streak.
Treatment for Systemic Infection (Sepsis)
Same treatment as local skin infection.
Consider surgical draining. Advanced medical care will be needed.
Pharmaceuticals:
Antibiotic: ampicillin.