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On Call: How to Deal With Wounds

Thu, 07/15/2021 - 06:20

The summer brings with it not only the joyful opportunity to spend time with friends and family or explore the outdoors, but also an associated increase in minor wounds and lacerations that can come along with time spent working in the yard, fishing on a boat, or spending time on a favorite hobby like as woodworking. 

People's approach to wounds both minor and significant is often based on what their parents may have done years or even decades ago, and not all of those approaches are necessarily the best in terms of avoiding infection and promoting healing.

First and foremost, it's important to determine if the wound is significant enough to warrant a trip to a doctor's office or the hospital. This is obviously a nuanced decision process, but in general, I advise patients that if they can easily control bleeding and pain and the wound is not in an area of concern or, in the case of a laceration, very deep, then it can probably be managed at home, at least initially. 

The first step is to clean the wound if it is dirty. In the office, we often use normal saline to clean wounds, but several studies have shown that irrigating wounds copiously with tap water can be an acceptable alternative without an accompanying increase in infection. After that is done, firm pressure should be applied with a clean bandage or gauze for 10 to 15 minutes until bleeding has stopped. If you can't control the bleeding in this fashion, you should seek medical attention at your doctor's office or the nearest urgent care or emergency room. 

Do not use hydrogen peroxide or alcohol in this setting to clean the wound unless directed otherwise by a physician. While those may have been commonplace once upon a time, we know now that hydrogen peroxide, for example, may actually impede local wound healing and should be avoided. 

Otherwise, if bleeding can be easily stopped, pain is not severe, and the wound is clean and shallow, a Band-Aid or simple bandage can be applied. If these are not the case, or if you have any questions about whether or not you might require sutures, seek medical care. 

With regard to specific wounds, remember that animal bites in particular likely need to be evaluated by your physician as they can often lead to infection. Contrary to popular belief, dogs' mouths are not sterile environments in terms of bacteria. Rinsing the wound immediately as above, putting gauze on top, applying pressure, and calling your doctor are probably your best bet in this situation as well.

If, as is common in this area, the wound is due to a fish hook through the finger, do not attempt to remove the hook by pulling it back out the way it came in if you do not know if the hook is barbed or not. This can cause more damage. Generally, this is a case where the wound should be evaluated by a medical professional, because they may require antibiotics based on their location and the risk of infection after removal of the hook. 

Obviously, these suggestions represent vague approaches to what can often be more complicated scenarios. In general, if you have a question about how to handle a wound, you should always call your doctor and ask. The last thing anyone wants is a poorly healing or infected wound ruining what should otherwise be a great summer.

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