By: Dr. Pierre Ghassibi – Jan. 2022
Greetings all.
It is always important to see a health care provider when it comes to the breach of our skin protective function. Let me here review the basic mechanism or principle of healing of small wounds and superficial burns. (Deep and contaminated cases need professional attention) .
In general, what heals wounds and burns are our white blood cells that are recruited to the injured area of the body and do their handy man repair. The most important action that we can take is to wash off any contamination by dirt and infectious organisms like bacteria , viruses, and fungi, but mostly bacteria. We know that adding antiseptics, alcohol, betadyne and the like can cause more local tissue injury and do more damage. The best defenses are healthy tissues and antiseptics can kill the healthy tissues or worsen damaged ones. Antibiotics are often needed for deep or contaminated injuries. Add here that human and animal bites are quite dangerous and always need medical attention. Human and animal bites can introduce bacteria, but also the organisms that cause Rabies and Tetanus. These latter virus and bacteria are real killers once they start the infection. We have to treat them before they start their infectious damaging job. Mind you that people with diseases that lower immunity and people on medications that lower immunity tend to get more serious infections and need to see a medical provider as soon as possible for anything more that superficial, or if the injury seems not to heal or if it is getting painful with exudate or bad odor, or if it looks like it is spreading. Bad injuries on the face, eyes, ears, genitals, hands, and feet need to be seen by a clinician. These can affect function.
For less severe problems, the best initial action ought to be washing the burn or wound with lots of water and tap water is good enough. Putting different kinds of creams, antiseptics, antibiotics, is not necessary and could cause more harm. In the case of burns, immediately letting the body part stay under running room temperature water decreases the pain as long as the water is running and this is much more effective that pain killers. Of course, however, we cannot keep the patient at the faucet for many hours.
Covering the injury with gauze and a dressing can protect it from environmental contamination, unless it is very superficial. In cases of abrasions and burns, as we know, the gauze can adhere to the wound and get very painful to remove for cleaning the next day. Therefore, we use special non adherent , non-sticky gauze. Now, if the dressing gets wet or dirty, it is better to change it, that is, removing it, then washing the wound and re dressing it.
Deeper, large burns or open wounds need medical and possibly surgical attention. The doctors will decide on removing contaminations, dead tissues and use special medications to promote healing.
What bridges two sides of a laceration is natural, body produced, repair type of glue, not our sutures. Surgical sutures work by approximating the gap if there is one. A cut that has no gap may not need sutures. Sutures anyhow are highways for bacteria from the outside to the depth of the laceration. Follow the medical provider’s advice regarding the need for suturing or stapling. We are also using surgical glue for small cuts.
Healing takes a week or two at least. Any white , blue, or black discoloration, severe pain, bad odor, inability to move a limb or digit, mean serious developments and the need for immediate care, usually in the emergency room. By immediate, I mean immediate and not many hours later.
Of course, more important is to prevent injuries and I think they happen more often when we are multitasking. I try not to walk while on the phone, not to do laundry while I am cooking dinner, not to change the radio station while driving, not to admire a nice building while walking at the same time; I need to see where I am stepping.
Sincerely,
P. Ghassibi, md – ghassibi@hotmail.com ◊