Summer is the season for enjoying time outdoors! Unfortunately with summer activities comes accidents and injuries, such as skin abrasions, lacerations, and burns. My first year as a PA I worked at an urgent care and I was shocked at the amount of patients who came in that summer with skin wounds! It was nothing compared to what we see doing in dermatology, but it sure did prepare me for how to educate patients on proper wound care. Dealing with an injury for yourself or a loved one can be daunting and stressful… Rule #1: stay calm. Rule #2: follow these wound care tips and you will handle it like a pro!
Wound Care 101:
- Always wash your hands with soap and water prior to touching a wound.
- Initial wound care for minor superficial wounds:
- Irrigate the wound by rinsing with cool to lukewarm water for 2-3 minutes, followed by gently cleansing with a mild unscented soap.
- If there is bleeding, apply firm direct pressure for 5-10 minutes or until the bleeding stops.
- Apply a topical petroleum ointment such as Vaseline or Aquaphor.
- Cover the wound with a bandage and keep the area dry for ~24 hours.
- Daily wound care:
- Gently clean the wound once daily with a mild soap and pat dry.
- Apply ointment and bandage once to twice daily until fully healed.
- For best healing, keep the wound moist with ointment at all times and covered with a bandage. For sensitive skin use gauze and paper tape.
- Aggressive scrubbing or using brushes to clean the wound.
- Cleaning with rubbing alcohol, hydrogen peroxide, or iodine.
- Exposure to bodies of water (pools, hot tubs, lakes, oceans, etc.) until fully healed.
- Use of Neosporin/polysporin ointment – these have a higher incidence of allergic contact dermatitis and can cause irritation and disrupt healing.
Seek medical care if:
- You are unable to control bleeding.
- The wound is large (>½ inch long) or deep (extending through the top layer of the skin).
- The wound is likely to cause significant scarring if not sutured.
- The wound crosses an area of increased skin tension (overlying joints) or that spans an important structure (eyebrow, lip, eyelid, ear).
- Tetanus vaccine prophylaxis is needed:
- Non-contaminated wounds: if ≥ 10 years since last vaccine dose.
- Contaminated wounds: if ≥ 5 years since last vaccine dose.
- Wounds at risk of infection may need antibiotics:
- Wounds contaminated with foreign debris: dirt, feces, soil, saliva, contaminated water (fish tank, lake, pool, etc).
- Puncture wounds.
- Nail bed injuries or avulsions.
- Wounds resulting from missiles, crushing, burns, or frostbite.
- Dog, cat, or human bite wounds.
- Signs of infection:
- Worsening or spreading pain.
- Increased discharge, foul odor, or pus.
- Spreading redness or red streaking of skin near the wound site.
- Skin swelling and warmth to touch.
- Fever (>100.4°F), malaise, or sweats/chills.
- Other emergent symptoms to monitor for: numbness, skin color changes (white, black), or decreased movement/stiffness.
It is recommended that you seek medical care promptly. Delayed wound repair increases risk of infection and poor healing. Make sure to get sutures removed in the recommended timeline. Wounds are the most vulnerable to re-opening in the days following suture removal. Avoid excessive tension or force to the area to prevent injury.