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Wound Care and Management

As we enter the summer season, you may begin to participate in more outdoor activities, whether that be biking on Mud Island or relaxing by the pool. And with these activities comes increased chances of scrapes and cuts. At first, one might not think too much about a simple scraped knee or cut on their pinkie toe, but without proper care and management, what was at first a barely noticeable scrape, can turn into an unsightly wound that could cause other issues such as infection and further skin damage. Although all scrapes and cuts should be treated, the severity of treatment depends on the severity of the wound. In this post, we will be focusing on what are called acute wounds. These are wounds that still require proper care and management but are not severe enough to call for medical attention (think a scraped knee when you fall off your bike). We will be going over the proper initial care of the wound and what you should do when managing the wound until it has fully healed.


1) Wound Debridement - Wounds that have dead tissue or contamination benefit from debridement prior to further wound management. Debridement means cleansing the wound and removing any dead tissue or debris. Bleeding impairs the ability to see what tissue should be removed so if bleeding occurs, it should be stopped before cleaning the area. Bleeding can be managed with gentle pressure using sterile gauze or pads. Once the bleeding stops, debridement can continue. If there is no debris, you can use antibacterial soap and water to cleanse the area.


2) Irrigation - Irrigation with fluid is important for decreasing the bacterial load and removing loose material and should be a part of routine wound debridement. Low-pressure irrigation (ex. spraying normal saline over the scraped knee) can be sufficient to properly clean and irrigate the wound. The addition of dilute iodine or other antiseptic solutions (ex. hydrogen peroxide 3%, isopropyl alcohol 70% ) can be used after cleansing one to three times a day.


3) Antibiotics - All wounds will have bacteria and other microbes in them; however, not all wounds are infected. Thus, antibiotic therapy is not indicated for all wounds and should be reserved for only those wounds that appear infected. There is no evidence to support antibiotic therapy as "prophylaxis" in non-infected wounds or to improve the healing of wounds that have no signs of infection. Signs of infection that might require topical or oral antibiotic therapy include:

Local symptoms

  • Redness

  • Swelling

  • Pain

  • Hot to the touch

  • Drainage

  • Bad smell

  • Wet

  • Gangrene

Systemic symptoms

  • Fever

  • Chills

  • Nausea

  • Low blood pressure

  • High blood sugar.

For wounds that do become infected and require the use of topical antibiotics, follow the directions listed on the packaging of the product for proper use and application. For systemic or severe local infections, do not self-treat and seek medical attention. As always, if you have any concerns please contact your primary care provider.

4) Wound Dressings - After irrigation, apply a bandage or gauze and tape depending on size and severity of the wound. Dressing changes should be frequent enough that the bandage/gauze does not dry out completely, which can be as much as two to three times daily. Dressings are discontinued when all the dead tissue has been removed and the wound has begun to heal and scab over.


The ideal dressing for a given wound would remove excess drainage while maintaining an appropriate level of moisture. Because some dressings may impede some aspects of wound healing, they should be used with caution. Wounds healed with proper dressings heal up to 40% more rapidly than non-covered wounds. In addition to faster wound healing, wounds treated with dressings are associated with less prominent scar formation.





Healing

Once your wound isn’t bleeding any more, and it has been properly cleaned and dressed, the body can begin healing it. First, the body should create a scab over the wound within the first few days after cleaning the wound. This might make the area look inflamed, or a little red and swollen. It might feel a bit warm too. Don’t worry. This means help has arrived, and your immune system is working on healing your wound. You might see clear fluid in or around the area. This means white blood cells are at work defending and rebuilding. Eventually the scab will go away, and you might see a fresh, raised, red scar. The scar will slowly fade in color and look flatter. Even after your wound looks closed and repaired, it’s still healing. It might look pink and stretched or puckered. You may feel itching or tightness over the area.


How long it takes to fully heal a wound depends on how large or deep the cut is. An open wound may take longer to heal than a closed wound/scrape. According to Johns Hopkins Medicine, after about 3 months, most wounds are fully repaired.


Let Harbor Town Pharmacy Help You!

Harbor Town Pharmacy carries several products for treating scrapes and cuts. If there is a specific product you want and we don't have it, we can order it and have it in by the next day. We are here to help you with any questions you have regarding caring for and managing your scrapes and cuts or any other medication questions you have! See the difference a local pharmacy can be today!


Written by Austin Bartmess, PharmD Candidate 2023

Reviewed by Kelsey Newell, PharmD



Sources:
  • Atiyeh BS, Ioannovich J, Al-Amm CA, El-Musa KA. Management of acute and chronic open wounds: the importance of moist environment in optimal wound healing. Curr Pharm Biotechnol 2002; 3:179.

  • John Hopkins Medicine. How wounds heal. (n.d.). hopkinsmedicine.org/health/treatment-tests-and-therapies/how-wounds-heal

  • Wilcox JR, Carter MJ, Covington S. Frequency of debridements and time to heal: a retrospective cohort study of 312 744 wounds. JAMA Dermatol 2013; 149:1050.



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