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Scraping away at wound-care myths

Old adages can hurt more than help

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I'm nursing a fairly serious and painful scrape after a trip-and-fall accident left me knee-first on the dusty ground of my condo's parking garage.

I could blame the moderately high wedge-heeled boots I wore the evening of the mishap, but the reality is, since childhood, I have always been a bit prone to falling. (I need to improve my balance.)

So I admit, it's not my first time with such an injury.

Several years ago, I spent three weeks caring for two nasty facial wounds thanks to another trip-and-fall accident that landed me face-first on a sidewalk. Carrying several grocery bags at the time, my hands weren't free to break my fall, so I kissed the pavement instead.

What surprised me then was the conflicting advice I received about how to care for my scrapes. The opposing advice came from emergency room staff and from various walk-in clinics.

At one clinic, a doctor told his nurse to re-bandage my wounds after he had examined me. That nurse advised me not to cover them and to let the fresh air dry them out.

I quickly found out the advice from the nurse was bad.

My latest wound is healing well with the help my general practitioner provided, combined with my own diligence. (Wounds require attentive care so they don't lead to serious consequences such as infections.)

Other nuggets of advice I've received in the past involved one stranger asking me with an air of authority whether my wound was itchy. It was.

"That's a sign it's healing," he said.

Not true. My itchiness was actually an allergic reaction to the bandage and the topical antibiotic ointment I was using, as I later found out from a dermatologist who was instrumental in helping my facial wounds heal without infection or scars.

Do you know how to handle knee scrapes and other such wounds? Or are you setting yourself up for scarring and infection?

Here are some common wound-care myths busted:

 

MYTH 1: Use peroxide or rubbing alcohol to clean your wound

REALITY:

WHILE it is important to clean your wound as soon as possible in order to prevent infection, using peroxide or alcohol is a bad idea, say most medical experts. Such chemicals can be effective in minimizing germs, but can actually harm skin cells and impair the healing process.

Instead, clean your wound right away under running tap water or under a running shower. Use a mild liquid soap if you have it. You can also use a pressurized bottle of sterile saline -- available at most pharmacies -- to clean your wound if you don't have access to a shower or clean tap water.

If your flesh is embedded with debris, as mine was, see a doctor immediately. You may be given a tetanus shot (I was). This helps prevent the bacteria found in dirt and soil from making you sick. It's essential to get the dirt and debris out of a scrape -- as one emergency room doctor once told me -- so it won't leave behind a permanent "tattoo" on your skin. Your doctor or nurse may freeze the area before cleaning it, if you are in extreme pain.

 

MYTH 2: Keep the wound dry

REALITY:

IT may go against common household lore, but clinical studies prove keeping your wound clean, moist and covered helps it heal faster. Many doctors and pharmacists recommend using an over-the-counter antibiotic ointment to moisten the wound. (Use only a thin layer applied with sterile gauze or freshly washed hands). If you are allergic to the ointment, get a prescription antibiotic ointment. (These are less allergenic than over-the-counter formulations). When your wound has closed up a bit and topical antibiotics are no longer necessary, some experts say using clean petroleum jelly on the wound (preferably from a tube) can keep your wound comfortable.

Leaving my latest wound uncovered would have been especially risky, since it was vulnerable to infection. My doctor gave me a 10-day supply of adhesive gauze and told me to clean and change my dressing three times daily. Applying prescription antibiotic ointment prevented the wound from sticking to the bandage (which could have re-injured the area).

 

MYTH 3: A scab is a sign of healing

REALITY:

THE goal in caring for a wound is to prevent scab formation, say modern doctors. That's because a scab -- or hardened fluid and debris encrusting your wound -- will interfere with the healing process and could eventually lead to scarring. A broken scab can also lead to infection. To avoid scabbing, keep your wound moist with an appropriate cream or ointment. To get rid of the scab that had formed during my facial injury several years ago, my dermatologist recommended placing wet gauze or a cloth compress on the wound for five minutes every few hours. He told me not to tug or rub the skin, since doing so could harm the healing tissue and cause scarring. I didn't have to go through this process with my current injury since I prevented a scab from forming -- starting from Day 1.

 

MYTH 4: Itchiness is a sign of healing

REALITY:

NOT so. Itchiness can mean you are allergic to the bandage, bandage adhesive or antibiotic ointment. It can also mean you have an infection. Stay in tune with what's going on your body and see a doctor if you think your wound is in trouble.

 

MYTH 5: Put the bandage on and forget about it

REALITY:

THE purpose of wearing a bandage is to keep the wound clean and to absorb the fluid that oozes from it. Leaving a bandage on for too long can lead to infection and prevents you from monitoring your injury properly.

My wound oozed a lot of light yellow fluid that soaked through the bandage, so my doctor told me to clean my wound and change my dressing three times a day. This was a bit inconvenient, but well worth the effort.

Be on the lookout for signs of infection, such as bad odours emanating from the wound, red streaks and fluid that's yellow or green. Such symptoms require immediate care from a doctor. Extreme pain is not unusual with a wound in the first several days, but if the pain gets worse or spreads, contact your doctor.

Mine asked me to email him daily descriptions of my wound during the first critical days of the injury. I sent him photos of my wound as well.

 

Have an interesting story idea you'd like Shamona to write about? Contact her at shamona.harnett@freepress.mb.ca.

Republished from the Winnipeg Free Press print edition November 4, 2013 D1

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