The basic methods of treating a cut or small wound is known to most adults. However, there are still many misconceptions and errors made during this process. Properly treating a cut can prevent an infection from setting in. Sometimes these infections can lead to complications which may be fatal if left untreated. However, basic wound care to treating a cut and preventing an infection is not difficult. For smaller wounds it can be done at home without the need for immediate medical care.
Skin: The First Line of Defense
The outermost layers of the skin are composed of dead skin cells filled with a protein known as keratin. The tight junctions in-between ensure that it is a continuous layer that is relatively hardy, waterproof yet flexible. It protects living tissue within the body. Although the skin has these properties it is easily injured and broken. This exposes the delicate underlying tissue to the physical and chemical insults from the environment and can also allow microbes to enter the body where it may cause an infection.
Although the skin is the first line of defense it is not entirely dependent on its physical properties. There are a host of other protective mechanisms that lie just under the outermost layers. This largely depends on the action of immune cells and chemicals to neutralize any microbes before it causes and infection. As with the skin, this immune defense is not infallible and can fail at times. Microbes may then infect the skin, extend into the deeper tissue or even spread throughout the body.
Environmental and Skin Infectious Agents
Skin infections are mainly due to bacteria, fungi or viruses. Some of these microbes live naturally on the skin and play an important role in health and wellbeing. It is referred to as the skin flora. These microbes do not attempt to penetrate the skin surface and its population is usually kept in check on the skin surface by a host of factors. Even many bacteria and fungi in the environment do not and cannot penetrate the skin and will normally not pose a risk to health.
However, when there is a break in the skin an infection can set in. Sometimes it is one or more species of the skin flora that may cause the infection. At other times it is microbes within the environment like in the air, in inanimate objects or even in water that will take the opportunity to infect the broken skin. Therefore it is important that any cut or sore on the skin is properly cared for to prevent these infections. While the body has defenses to protect itself until a small cut heals this is not always enough to prevent an infection.
Preparation to Tend to a Wound
Whether it is a tiny cut, a large gaping wound or sore of varying size and depth, wound care starts even before attending to the wound. First the necessary items should be sourced such as dressings, antimicrobial ointments or antiseptic solutions. Then the hands need to be thoroughly cleaned immediately before the wound is to be attended to. Remember that any bleeding must be stopped before the would is treated.
Cleaning the Hands
- Wash the hands thoroughly from the wrist down or preferably higher like midway from the forearm.
- Use clean water, preferably warm running water, to wash the hands along with antibacterial soap for at least 20 seconds.
- Rinse thoroughly to ensure that all of the antibacterial soap has been removed.
- Do not touch any objects unnecessarily as germs on these surfaces will be transferred back to the hands.
- Wear clean surgical gloves if available or cleanse the hand again with a hand sanitizer if any object is inadvertently touched.
This degree of cleansing may not seem necessary but with large wounds and in people with weakened immune defenses it is vital. Failure to do so could lead to complications like cellulitis and progress to septicemia which may be fatal.
Infection Prevention Wound Care
Large wounds, wounds that are very painful, bleeding from wounds that cannot be stopped, deep wounds or wounds where foreign objects cannot be removed should NOT be treated at home. It has to be attended to by a medical professional. Smaller wounds like cuts may be managed at home at least for a short period of time. First and foremost infection needs to be prevented in order for the wound to heal properly and to avoid complications that can be fatal.
Follow the following steps after cleaning the hands thoroughly.
1. Wash the wound
Allow clean water to run over the wound for a few minutes. Ideally it should be rinsed for 5 to 10 minutes. This will wash away any debris and even many microbes that are already in the wound. It should be rinsed under a faucet using cold water. Do not open the faucet fully. The high pressure could injure the area further. Do not rub or attempt to wash the area with your hand if running water is available.
2. Remove debris
Any debris that has not been rinsed off may have to be removed manually. Tweezers are a better option that using the fingers or fingernails. Ensure that the tweezer has been thoroughly clean either with an antiseptic solution. If such a solution is not available then the tip of the tweezers can be thoroughly heated over an open flamed. Make sure it cools down before using on the wound. Do not push in too deep.
3. Rinse again and stop bleeding
Rinse the wound again with water after removing debris with tweezers. Let the water run again for a few minutes. Stop any bleeding that may be persisting or restarted. Direct pressure is the best way to stop the bleeding. However, if the bleeding is not subsiding then professional medical attention is necessary.
4. Disinfect and dress
Once the bleeding stops an antiseptic solution should be applied to the area. This should be extended to the intact skin around the wound as bacteria from surrounding skin can travel to the wound to infect it later. Once the antiseptic solution dries, an antimicrobial ointment should be applied liberally to the wound and surrounding skin.
An appropriate dressing can then be placed over the wound to protect it from the environment. Do not apply the dressing too tight. Do not bandage it tightly afterwards. Smaller cuts should not be dressed after it has been cleaned and the bleeding has stopped. Allowing the wound to dry in the open air may be a better option but an antimicrobial cream should be applied repeatedly.
Even if the wound seems to be effectively treated in the interim, it is advisable to follow up with a doctor as soon as possible. Antibiotics may be necessary as well as stitches for a larger wound.