How To Care for Wounds

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1 How To Care for Wounds For people without diabetes, a cut or a scrape may be a call for a little cleaning, peroxide, and adhesive bandage. They can typically cover it and not worry much about it. Not so for people with diabetes. Any break in the skin is an invitation for infection, which can lead to greater complications. So even minor incidents must be carefully treated and monitored. dlife Expert Columnist Joy Pape has defined minor wounds as: superficial - they happen to the outer layer of your skin, the epidermis. not near the natural openings of your body (eyes, ears, nose, mouth, urethra, vagina, rectum). not heavy bleeders. not larger than the size of a quarter. If you need to know how to treat minor wounds, this is the place to start. People with diabetes can treat wounds with the same level of care as people without diabetes. The answer is false. If you have diabetes, you must be vigilant about any break in the skin. You want to clean and cover your wound. Mild soap and safe, drinkable tap water are great for cleansing any minor wound. Prepackaged cleansing towelettes are good to have in your first aid kit in case clean water is not available. After cleaning the wound, apply antibacterial ointment to aid in the healing, then cover it with an adhesive bandage or gauze and tape. Antibacterial ointment helps prevent scarring by keeping the bandage from sticking to the wound while still maintaining the proper moisture and temperature for the wound to heal. If improvement isn t seen within a day or two, see your doctor. When treating a wound, traditional methods such as hydrogen peroxide or letting a wound breathe work the best. The answer is false. 1

2 The name of the game is preventing infection. Even when treating a minor wound, care must be taken, so cleaning and covering the wound not letting it "breathe" is your best course of action. For cleaning, many over- the- counter medications, such as iodine, alcohol, salicylic acid, and corn- removal agents, are dangerous. Iodine products or hydrogen peroxide should never be applied to wounds because they can kill healthy cells. Normal saline is a safe and effective cleanser for all wounds, as is drinkable tap water.(1) Apply the antibacterial ointment preferably with a cotton swab to prevent infecting the wound and contaminating the ointment tube and cover the wound with an adhesive bandage or gauze and tape. Make sure the gauze is big enough to fully cover the wound. First- aid tape can be used to hold the gauze in place. If you do not want it to adhere to your skin, adhere the tape to the gauze instead making sure the gauze is not too tight against the wound. SOURCE: Agency for Healthcare Research and Quality. Pressure ulcer treatment. Health care protocol. n420. (Accessed 09/27/10) Wounds should be kept as dry as possible. The answer is false. The actual wound should be kept moist, while the area around the wound should be kept as dry as possible, though you still want to take care of the healthy skin by keeping it moisturized. There are special dressings to keep a wound moist, but the peri- wound the area around the wound should be kept dry. Examples of these types of dressings are hydrocolloids, transparent film dressings, foam dressings, and more. If you develop a foot ulcer, seek medical care immediately. The answer is true. Foot ulcers, when not properly treated, are a common cause of lower extremity amputation, so awareness is key. A foot ulcer is not always precipitated by a cut. 2

3 Everyday friction, or rubbing of the foot against something, can aggravate conditions such as corns and calluses, which may not be easily detected if neuropathy (nerve damage) has set in. That friction is helping to literally wear away at the skin, causing a sore or ulcer to develop. When treating a foot ulcer, the first thing you need to do is see your podiatrist or primary care provider immediately. He or she will be trying to prevent infection and promote the fastest healing possible by: encouraging good blood glucose control. taking the pressure off the area, called "off- loading." removing dead skin and tissue, called "debridement." applying medication or dressings to the ulcer. keeping the ulcer clean and bandaged. Walking barefoot is not recommended. Instead people with foot ulcers may be asked to wear special footgear or utilize a wheelchair or crutches off- loading to reduce pressure and irritation to the ulcer area. Minor burns should be covered. The answer is true. Contrary to what your grandmother may have done, blowing on a burn and/or applying butter is not a proper treatment for a burn. Butter can promote infection by introducing bacteria. Leaving a wound to fend for itself does not work either. Determine the type of burn you are dealing with and then take appropriate action. First- degree burns affect only the outer layer of the skin. They cause pain, redness, and swelling but may get better in a day or two. This is minor unless it involves a large portion of the hands, feet, face, groin or buttocks, or a major joint, which requires emergency medical attention. Second- degree burns affect both the outer and underlying layer of skin. They cause pain, redness, swelling, and blistering. If the second- degree burn covers an area more than 2 to 3 inches in diameter, or if it is located on the hands, feet, face, groin, buttocks, or a major joint, treat the burn as a major burn. Third- degree burns extend into deeper tissues. They cause white or blackened, charred skin that may be numb. 3

4 For first- and some second- degree burns, provide the following first aid: 1. If the skin is unbroken, run cool water over the area of the burn or soak it in a cool water bath (not ice water). Keep the area submerged for at least 5 minutes or until the pain subsides. A clean, cold, wet towel will also help reduce pain. 2. Cover the burn with a dry, sterile bandage or clean dressing. 3. Protect the burn from pressure and friction. 4. Over- the- counter ibuprofen or acetaminophen can help relieve pain and swelling. Do NOT give children under 12 aspirin. Once the skin has cooled, moisturizing lotion also can help. Do not: apply ointment, butter, ice, medications, cream, oil spray, or any household remedy to a severe burn. breathe, blow, or cough on the burn. disturb blistered or dead skin as it can lead to infection. remove clothing that is stuck to the skin. give the person anything by mouth, if there is a severe burn. immerse a severe burn in cold water. This can cause shock. place a pillow under the person's head if there is an airways burn. This can close the airways.(1) For third- degree burns, seek medical help immediately. SOURCE: MedlinePlus.Burns. 09/28/10) Properly managing blood sugar is one step in treating any wound. The answer is true. Diabetes affects the immune system and the circulation of your blood. High blood sugars hinder the proper functioning of these systems, which are needed in order to aid in the healing of any wound, so keeping your blood sugars under control is vital. As always, if you are finding that first aid was not sufficient or even that your blood sugars are more difficult to control than usual, consult your doctor. Your first aid kit should contain: a) Gauze 4

5 b) First- Aid Tape c) Antibacterial ointment d) All the above The answer is d, all the above. The American Red Cross itemizes a good first- aid kit (1): 2 absorbent compress dressings (5 x 9 inches) 25 adhesive bandages (assorted sizes) 1 adhesive cloth tape (10 yards x 1 inch) 5 antibiotic ointment packets (approximately 1 gram) 5 antiseptic wipe packets 2 packets of aspirin (81 mg each) 1 blanket (space blanket) 1 breathing barrier (with one- way valve) 1 instant cold compress 2 pair of nonlatex gloves (size: large) 2 hydrocortisone ointment packets (approximately 1 gram each) First- aid scissors 1 roller bandage (3 inches wide) 1 roller bandage (4 inches wide) 5 sterile gauze pads (3 x 3 inches) 5 sterile gauze pads (4 x 4 inches) Oral thermometer (non- mercury/nonglass) 2 triangular bandages Tweezers First aid instruction booklet When stocking your first- aid kit, note the varieties of first- aid tape. Make sure you are not allergic to the tape and consider getting tape that will not stick too much to the skin, if you have sensitive skin. Antibacterial ointment that will perform as many healing functions as possible is a good choice. Remember, no hydrogen peroxide. Instead add prepackaged cleansing towelettes to your first aid kit in case clean water is not available to clean the wound. Taking care of the healthy skin around a wound is very important too, so consider a small tube of fragrance- free lotion. And for pain relief, consider adding aspirin or ibuprophen. As a person with diabetes, you may also want to make sure any kit that may be used for you contains a few basic items for blood sugar emergencies such as glucagon. SOURCE: 5

6 American Red Cross. Anatomy of a First Aid Kit. (Accessed 09/28/10). 6

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