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Wounds care, what to do when we get hurt

Even if it is something usual, sometimes it is not easy to know what to do to heal a wound. I am writing this article to enlighten some concepts in order to help you to take care of it.

First of all, we need to define some related terms that we often use: what do asepsis, antisepsis and disinfection mean?

Asepsis is the process to avoid any pathogenic germs to spread into a place free of them (for instance, by washing our hands). Destruction of pathogenic germs that may cause infection in living tissues is called antiseptis, but in objects or surface (like floor) it is called disinfection. For it, we use antiseptics and disinfectants.

Most used and commonest antiseptics that we can find in our first aid boxes are: 70% ethyl alcohol, povidone-iodine (Betadine®), clorhexidine gluconate or digluconate in aqueous or alcoholic solution (Cristalmina®, Diaseptyl®), silver sulfadiazine (Silvederma®), silver nitrate or Mercromina®.

  • Alcohol is very used, often to 70% (recommended concentration) or even to bigger contents, being an antiseptical good option whenever skin is a whole (without any wound), for instance, before an injection, an analytic… The problem with alcohol is that it is not useful with blood or pus. Furthermore, it hurts and can enhance infection, because it produces a scab and under it germs can prolife.
  • Povidone-iodine provides a antimicrobial function (is a huge bactericide) and creates a moist area that helps healing. But, it also damages wound cells (what we call cytotoxicity) and so, it brings a delay for cicatrization. We may have absorption risk, so we do not advice its use with babys and toddlers. It is very helpful with fresh wounds that do not have blood or pus (it loses its power with them), and also like antiseptic before an operation. Besides, it is necessary to use it 4 times at day to obtain the maximum antimicrobial effect.
  • Clorhexidine is a wide range antiseptic (it fights a huge variety of germs). It is used in different concentrations, between o,5 and 4%, in aqueous or alcoholic state. It is not irritating but, like povidone-iodine, it becomes inactive with organic materials (blood, pus…). There is not any systemic absorption risk. It reaches its maximum effect in 20 seconds and its effect lasts about 6 hours (a very important difference with Betadine, which does not have any residual action). It is very important to avoid ears or eyes contact, because it may damage stratum corneum. It is one of the best options to heal wounds.
  • Hydrogen peroxide is used betweem 0,5 and 29% concentrations and have a big bactericide activity, and that can be even bigger with acider pH and higher temperatures. Again, it also becomes inactive with organic materials, and also with air and light. It has a hemostatic action (it helps stop the little bleeding of a wound). It can help us cleansing a wound, but it is necessary to use also another antiseptic.
  • Mercromina® has a low bactericide power, that is inactivated by blood. Moreover, it may produce contact dermatitis and systemic absorption. So, it is the worst option.
  • Silver sulfadiazine is a very used antiseptic for 2nd and 3rd degree burns treatment. It acts against bacteria and fungus. As a benefit opposite to silver nitrate, it does not stain clothes. We may have some systemic absorption risk, particularly when we use it on large areas, so it is better not to use it in babes younger than 2 months. A possible reaction with its use is photosensitivity (a bigger sunburn risk).

Some people are prones to develop wound infections. It is the case of diabetics (who have bigger glucose levels in blood), because they have difficulties to heal wounds, so they can easier become infected.

Finally, we would like to insist that antibiotics, topic or systemic, should be taken only when an infection is going on; typical signs of infection are: heat, erythema (redness around the wound), pain, pus-filled, fever, shivers or stink. Antibiotics may not be taken to prevent an infection nor to help healing (they give not better results than common antiseptics). Every time we suppose an infection, we must go to our doctor or dermathologist to analyze the wound and decide proper treatments.

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