Wound Care

It's the largest organ of our bodies. It weighs about six pounds and holds us together. It's our skin. Skin provides the outer covering for our bodies and protects us from heat, light, injury and infection. (Read about "Skin") Most of the time, when someone gets a cut, it's not a big problem. But that's not always the case. Cuts can become infected. Cuts also may not heal the way they're supposed to. Because of this, it's important to be able to recognize the signs of potential problems and get the right medical care when it's needed.

When you get a wound, the surface of the skin has been compromised in some way. It opens the body up to infection. Your body and your immune system (Read about "The Immune System") immediately go to work to try to close the gap and heal the wound. Most wounds heal easily on their own with just a little care, but if a wound does not heal, it is important to seek medical care. Poorly healing wounds can be the sign there is another problem.

Some of the reasons that a wound doesn't heal are:

• poor circulation
• complications from diabetes (Read about "Diabetes")
• infections

Wounds that are the result of pressure ulcers are also frequently slow to heal. People who have suppressed immune systems often have trouble with wounds.

Any breaking of the skin can result in infections and more so be sure and pay attention and take care of any wound.

Below you will find more information on caring for wounds, from minor cuts to non-healing wounds.

Initial treatment

Here are suggestions from the American Medical Association for a minor cut:

• Rinse the cut thoroughly with water
• Wash with a mild soap and rinse again
• Cover with a sterile bandage or gauze
• Examine the cut and surrounding area daily for signs of potential problems including redness, swelling, tenderness, warmth, or drainage

A more serious cut may require the attention of a doctor. The American Academy of Family Physicians (AAFP) says contact a doctor if the wound is jagged, has dirt in it that won't come out or if the edges gape open.

AAFP also suggests getting medical attention if any of the following happens:

• you start to run a temperature over 100 degrees
• the area around the wound feels numb
• you can't move comfortably
• red streaks form near the wound
• the cut becomes tender or inflamed
• the cut drains a thick, creamy, grayish fluid
• the wound is the result of an animal bite (Read about "Animal & Insect Borne Diseases")

You should also get medical attention for any puncture wound or deep cut if you haven't had a tetanus booster in the last 5 years. In general, if there are any questions as to the danger of a cut, it's better to contact a doctor.

Tetanus

A serious concern with wounds is tetanus, also called lockjaw. It's caused by a toxin made by a certain bacteria. Tetanus bacteria can enter any wound but prefer deep puncture type wounds. The bacteria can be found in dirt, dust or other organic material. (Read about "Microorganisms")

The signs of tetanus include:

• headache
• muscle stiffness in the jaw
• stiffness of the neck
• difficulty swallowing
• muscle spasms
• sweating

Tetanus is extremely rare in the United States but people that get the infection can become seriously ill.

There are vaccines for tetanus. (Read about "Immunizations") Most American children get their first tetanus shot in the combined DTaP (diphtheria-tetanus-pertussis) vaccine. (Read about "Childhood Illnesses") According to the National Institute on Aging (NIA), most adults need a tetanus booster shot every ten years to be protected. If someone has a severe cut or burn and hasn't had a booster shot in the past 5-10 years, NIA also recommends a booster shot as soon as possible.

Wounds can get infected with a number of other bacteria, including Staphylococcus aureus or "staph" (Read about "Staph and MRSA"). Some staph infections are drug resistant. So-called MRSA infections, usually occur after surgery, hospitalizations or other medical treatment. However, there is growing concern about MRSA infections that are developing outside of healthcare facilities. The American Academy of Family Physicians recommends that you contact a healthcare provider if a wound appears to develop an infection and becomes tender or inflamed.

Wounds that don't heal

A doctor should also be alerted if there's a wound or sore that doesn't heal. An estimated three to five million Americans have suffered from a non-healing wound. Examples of this type of wound include:

• diabetic foot ulcers (Read about "Diabetes")
• venous stasis ulcers
• arterial ulcers
• wounds caused by circulatory problems (Read about "Raynaud's Phenomenon")
• pressure sores
• burns (Read about "Burn Prevention")
• non-healing surgical wounds

A wound that doesn't heal is a particular risk for people with diabetes who may have developed nerve damage, known as peripheral neuropathy (Read about "Peripheral Neuropathy"), and circulatory problems in their feet and legs. As a result, injuries to these areas may heal very slowly or not at all; in addition, diabetics may not even be aware of the fact that they have developed a cut or sore on their feet or legs. This can lead to infection and damage to tissue and bones if the infection spreads. (Read about "Cellulitis") In some cases, amputation may be necessary.

For cuts or wounds that don't heal, doctors have special bandaging techniques and ointments that can help a wound heal faster and reduce the risk of permanent damage. Wound care centers can often provide a specialized approach, with a team of internists, vascular surgeons, podiatrists, reconstructive surgeons (Read about "Plastic Surgery"), nurses and other specialists. Treatment options can include:

• hyperbaric oxygen therapy, using a special chamber filled with pure oxygen
• special dressings, which may contain healing medications or fibers within the dressing itself
• nutritional counseling
• infection control
• synthetic skin grafts, to promote skin growth during healing
• outer wraps that provide extra compression to promote healing
• debridement, which involves cleaning out unhealthy tissue, can also help to promote healing

The important thing is to monitor any cuts carefully and seek medical help if the cuts aren't healing as they should.

Related Information:

    Emergency Room