Stages of treatment for open wounds
A wound is any violation of the integrity of tissues resulting from the mechanical action of certain external objects. The degree of damage to body tissues depends on the size, shape, weight of the injured object, and the strength and speed with which this action is performed. According to this, wounds can be cut, chopped, stabbed, bruised, crushed, lacerated, bitten and gunshot.
Cut, chop, and stab wounds cause less tissue destruction than other types, as these are wounds with a small area of damage. Torn, bruised, bitten and crushed wounds have a large area of damage. Gunshot wounds can have different damage zones. Random wounds are always infected.
Treatment of open wounds is reduced to restoring the integrity of the skin. The cells of the dermis have the ability to divide and regenerate. However, their full recovery is possible only with timely and high-quality cleaning of the damaged area.
- Stages of treatment for open wounds
- Primary wound treatment
- Deep wound care
- How to treat a weeping wound?
- Treatment of an open purulent wound
- Ointments and creams for treating wounds at home
Stages of treatment for open wounds
Any open wound requires 3 stages to heal:
- Primary self-cleaning.
- Granulation tissue restoration.
Bleeding develops immediately after the injury. The vessels are sharply narrowed, due to which a blood clot forms and it stops. After that, the vessels expand, the permeability of their walls increases, which leads to the formation of edema in the affected area.
This reaction of the body helps the soft tissues to cleanse themselves, without the use of any disinfectants.
The second stage is accompanied by increased tissue edema. The skin turns red. A significant number of leukocytes accumulate in the damaged area.
Granulation tissue restoration
Granulation tissue repair can begin against the background of existing inflammation. This is totally normal. The granulation process covers the entire wound surface, including its edges and surrounding tissues.
Then the granulation tissue is transformed into connective fibers. The process ends with the formation of a scar.
The wound can heal with primary and secondary intention. If a small area was injured, the divorced edges are located close to each other, and the inflammation is insignificant, then the tension will be primary. In all other cases, healing is characterized by secondary intention.
The features of the treatment of an open wound directly depend on how intense the inflammatory reaction is and how much the tissues were injured. An important condition is the stimulation and control of all stages of their recovery.
Primary wound treatment
Primary wound treatment is imperative. If the incision is small and was obtained in everyday life, all dirt must be removed from it. To do this, you can use the pointed tip of a sterile bandage, or tweezers (it must be treated with an alcohol-containing liquid).
When the contamination from the wound has been removed, it must be rinsed with an antiseptic solution. You can use 3% hydrogen peroxide, iodinol, chlorhexidine, etc. Hydrogen peroxide helps to push out the smallest contaminants, since after applying it to the wound, bubbles form. In parallel, it destroys pathogenic flora. If medicines are not at hand, then you can use a 2% solution of soda, a solution of concentrated salt, vodka or chamomile infusion. It must be understood that microbes will always be present in the wound, unless the incision was made with a sterile instrument.
Household wounds are susceptible to infection. Sometimes microbes begin to multiply even in postoperative wounds. Therefore, after injury, the damaged area must be closed. To do this, it is bandaged or sealed with a plaster. Only small scratches and shallow cuts can be left open.
Deep wound care
If you get a deep wound, you need to seek medical attention. Cuts larger than 2 cm will take a long time to heal on their own. They are painful, uncomfortable, and often complicated by suppuration. Therefore, it is highly recommended to visit a specialist.
You cannot try to heal wounds on your own, which are accompanied by severe pain. In this case, you need to make sure that the nerve has not been damaged. Medical attention is required if there is a bleeding wound.
Sometimes the cut is sutured. This will allow the tissue to heal faster. The doctor will treat the affected area, trim the torn edges, stop bleeding, and apply stitches. In some cases, the wound is sutured later, after the acute inflammation has subsided. The dressing should be changed daily.
In the first 7 days, a wet-drying dressing is used. Antiseptic drugs are placed in it. Then gauze dressings are recommended. They must be impregnated with agents to kill germs and to accelerate tissue regeneration. These can be drugs such as: Levomekol ointment, Levosin, Methyluracil.
If necessary, your doctor will prescribe broad-spectrum antibiotics for oral administration.
How to treat a weeping wound?
If a lot of fluid is released from the wound, then its treatment is slightly different. Abundant discharge is not a pathological sign. On the contrary, they stimulate healing, as they help cleanse the injured surface. However, excess exudate requires special measures, since it impairs blood microcirculation in the affected area.
Change sterile dressings more often if the wound is weeping. To disinfect surfaces, it is necessary to use a solution of Furacilin or sodium hydrochloride. You can irrigate the wound with Miramistin or Okomistin.
It is possible to reduce the amount of separated liquid by using a 10% sodium chloride solution. Change the bandage every 4 hours.
For disinfection, antibacterial ointments are used: Streptocide, Mafenid, Streptonitol, Fuzidin. They are placed under a sterile bandage. Alternatively, you can apply the ointment to a tampon and use it to treat the wound surface.
Xeroform or Baneocin powder is used to dry the wound. These drugs kill germs and also help reduce inflammation.
Treatment of an open purulent wound
A purulent open wound is the hardest to repair. It is important to stop the process of reproduction of pyogenic bacteria and prevent damage to healthy tissues. To do this, every time you change the dressing, you need to clean the wound surface, removing pus from it. Drainage can be used for this purpose. It allows you to ensure a constant outflow of purulent masses.
It is imperative that during dressing the wound is treated with antibiotics, for example, Dimexidum. You can remove dead tissue and pus with Trypsin or Chymotrypsin powder. The selected agent is diluted with Novocaine or sodium chloride, soaked in sterile wipes with the resulting composition and injected into a festering wound. The bandage is left on for 1-2 days. It is possible to apply powders directly to the wound if it is wide and deep.
A purulent wound requires the mandatory oral administration of antibiotics. Sometimes they are injected.
Features of the treatment of a festering open wound:
- After removing the pus from the wound, Levosin ointment is injected into it. It has antimicrobial and analgesic effects.
- Dressings that are applied to a purulent wound are lubricated with Levomekol ointment or Syntomycin.
- If purulent inflammation develops due to reproduction of Staphylococcus aureus in the wound, it is recommended to treat the wound with Baneocin.
- Anaerobic infections respond better to Nitacid.
- Experts call Dioxidine Ointment a universal drug. It is fatal to most of the bacterial flora. Pseudomonas aeruginosa and even germs that provoke gangrene are sensitive to it.
It is possible to treat the wound surface with ointments containing polyethylene oxide. In the past, products containing petroleum jelly or lanolin were used, but modern surgery refuses them.
- Vishnevsky's ointment helps to quickly reduce tissue edema, improves their nutrition by activating blood flow. Apply the drug to wounds 1-2 times a day.
If a person with an open and festering wound is admitted to the hospital, then he is shown therapy aimed at removing intoxication from the body and increasing immune forces. Ultrasound therapy and liquid nitrogen treatment help speed up the process of tissue repair.
Ointments and creams for treating wounds at home
When the wound is shallow, you can deal with it at home.
For the fastest tissue regeneration, you can use such means as:
Salicylic ointment with antibacterial effect. It is applied to the wound after pretreatment with hydrogen peroxide. Cover the affected area with a sterile bandage. Alternatively, you can use Ichthyol ointment.
Streptocide. If there are tablets at hand, then they are crushed into powder and sprinkled on the affected area. Some people treat wounds with BF glue. However, it should not be applied to a contaminated wound surface. First you need to disinfect it with streptocide.
Balm Lifeguard. It forms a thin film on the wound. Therefore, before applying the balm, the damaged area must be treated with hydrogen peroxide.
Solcoseryl. This ointment is applied to an open, dry wound. If the damaged surface gets wet, then the drug is used in the form of a jelly.
Heparin ointment, Troxevasin ointment, Dolobene gel. The listed drugs are applied to the skin if a hematoma has formed on it. These medications help get rid of bruising and reduce tissue swelling.
Eplan cream. The basis of the drug is polyethylene glycol. It will allow you to qualitatively disinfect the wound surfaces. Therefore, the risk of infection entering the wound is reduced.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".