Wound care can take place in various settings, for instance home, doctor or hospital care. Indeed, when at home skin wounds need to be thoroughly cleaned as soon as possible to reduce the risk of infection and scarring and to promote healing. Scrapes and abrasions often do not require any more care than washing the area 4 times daily. However, for for the first 48 hours and keeping the area covered with a sterile bandage.
With this in mind, deeper wounds and bites will require medical attention. For instance, if the wound is large, deep, too painful to clean, or has dirt, debris, or a foreign object in it that you cannot remove, see a health professional. Obviously, wound care at home doctor hospital care are the options of choice when dealing with wounds.
Clean the Wound
• Wash your hands well with soap and water.
• Put on medical gloves before cleaning the wound, if available.
• Remove large pieces of dirt or other debris from the wound with cleaned tweezers. Do not push the tweezers deeply into the wound.
• Clean the wound under running tap water (the more the better) to remove all the dirt, debris, and bacteria from the wound. For example, lukewarm water and mild soap, such as Ivory dishwashing soap, are the best. (Note: If you are cleaning a wound near the eye, do not get soap in the eye.)
Large, Deep, or Dirty Wounds:
You may need to see a health professional for a large, deep, or very dirty wound to determine whether you need stitches or antibiotics. Most wounds that need stitches should be treated within 6 to 8 hours after the injury to reduce the risk of infection. Very dirty wounds may not be stitched to avoid the risk of infection. If you are going to see a health professional immediately, the wound can be cleaned and treated at the medical facility. It is imperative, for instance, to have wound care home, doctor, or hospital care setting to heal.
Stop the Bleeding
• Before you clean the wound, try to stop the bleeding.
• Put on medical gloves, if available, before applying direct pressure to the wound. If gloves are not available, use many layers of clean cloth, plastic bags, or the cleanest material available between your hands and the wound.
• If possible, hold direct pressure on the wound and elevate the injured area.
• However, use your bare hands to apply direct pressure only as a last resort.
• Remove or cut clothing from around the wound. Remove any jewelry from the general area of the wound so if the area swells, the jewelry will not affect blood flow.
• Apply steady direct pressure for a full 15 minutes. Use a clock—15 minutes can seem like a long time. Resist the urge to peek after a few minutes to see whether bleeding has stopped. If blood soaks through the cloth, apply another one without lifting the first. If there is an object in the wound, apply pressure around the object, not directly over it.
When to get Stitches
A quick test to determine whether you need stitches is to wash the wound well and stop the bleeding, then pinch the sides of the wound together. If the edges of the wound come together and it looks better, you may want to consider getting stitches. After all, stitches may be needed, avoid using an antiseptic or antibiotic ointment until after a health professional has examined the wound.
Bandage the Wound
• Thoroughly clean the wound before bandaging.
• Use of an antibiotic ointment has not been shown to affect healing. If you choose to use an antibiotic ointment, such as polymyxin B sulfate (for example, Polysporin) or bacitracin, apply the ointment lightly. The ointment will keep the bandage from sticking to the wound. Be sure to read the product label about skin sensitivity. If a skin rash or itching develops under the bandage, stop using the ointment.
• Apply a clean bandage when it gets wet or soiled to further help prevent infection. If a bandage is stuck to a scab, soak it in warm water to soften the scab and make the bandage easier to remove. If available, use a nonstick dressing.
• If needed, use an adhesive strip called a butterfly bandage to hold the edges of the wound together. You can make one at home or buy them already made. Always put the butterfly bandage across a cut, not lengthwise, to hold the edges together.
• Take the dressing off and leave it off whenever you are sure the wound will not become irritated or dirty.
When to Visit Your Doctor:
• All bites and any cut or laceration greater than 1/2-inch long in which you can see fat or deeper tissues (muscle or bone) will require medical attention.
• Bleeding is brisk or blood spurts with your heartbeat or does not stop after 10 minutes, your doctor should be called.
• If there is still dirt and debris in an abrasion after your best attempt at cleaning the area, you should notify your doctor.
• Any redness extending from the wound after 2 days or yellow drainage from the area should warrant medical attention.
• You should find out from your doctor when you last had a tetanus shot. If the wound was dirty, you should have one if it has been more than 5 years since your last tetanus immunization. You should have this done within 48 hours of the injury.
Most doctors will not stitch a cut or laceration that is more than 8-12 hours old. This is because there is a greater chance of infection after that time. In fact, after 3 hours, the incidence of infection begins to increase. Therefore, do not wait to have the injury repaired. If you are in doubt, call your doctor or go to the nearest hospital’s emergency department. As a consequence, an open wound takes longer to heal and leaves a bigger scar.
Reasons to go to the hospital if you have a wound:
• Obvious life-threatening wounds (Call 911 for emergency services.)
• Any laceration greater than 1/2-inch long that is through all layers of the skin exposing the underlying fat.
• Bleeding is continuing and not stopping
• Blood continues to “spurt” from the wound (Apply pressure and go to the hospital’s emergency department.)
• For instance, if you think that there may be something in the wound such as glass, wood, or rust, for example
• You cannot move your finger or toe in the area of the laceration, or you have lost sensation in the area beyond the laceration
• For any bite wound (human or animal)
• Your physician cannot see you that day