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# Wounds | |
## Wound care steps: | |
* Stop the bleeding with pressure. | |
* Clean the wound thoroughly as soon as you can. The better you | |
clean it, the less likely it is to become infected. For larger | |
wounds, give some kind of pain medicine before you clean and care | |
for the wound. Inject lidocaine around the wound and just below | |
the skin inside it. Or give another pain medicine and allow time | |
for it to work. | |
* Dress or close the wound, or for a small wound, leave it open to | |
heal. | |
bleeding | |
lidocaine | |
## Clean all wounds | |
> Any wound, big or small, can become infected. Clean every wound | |
> well. | |
Wash your hands well with soap. Then wash the wound with 1 to 4 | |
liters of flowing water. You do not need antiseptics, some of which | |
can slow healing down. If the wound looks dirty, use soapy water and | |
then rinse that off with plain water. | |
Lift up any flaps of skin to clean underneath. For deep wounds, | |
squirt the inside of the wound with a bulb syringe, letting the water | |
run out. | |
Bulb syringe | |
Or take the needle off a syringe and squirt water into the wound. | |
Or just run lots of clean water over and into the wound. | |
Wash out anything left inside the wound, especially dirt, wood, or | |
other rough material. You may need to use a piece of sterile gauze | |
or clean fabric to clean out the wound, then rinse thoroughly. | |
## Caring for wounds | |
As the wound heals, make sure it stays clean to prevent infection. | |
If it gets dirty, clean the wound with lots of water. Covering the | |
wound with a bandage, sterile gauze, washed banana leaf, or very | |
clean piece of cloth will help keep it clean. Putting honey on the | |
wound also helps prevent infection. Change the bandage daily, and if | |
it becomes wet or dirty. It is better to have no bandage than one | |
that is dirty or wet. | |
Watch for signs of infection such as increasing redness, pain, heat, | |
swelling, bad smell or pus at the site of the wound. For any of | |
these signs, clean the wound well. | |
You may need to gently pull open the wound to clean it. Watch that | |
the infection does not spread to other parts of the body. | |
sepsis | |
## Closing wounds | |
A small wound is best left alone to heal. It should not need | |
stitches. The most important thing is to keep wounds clean. | |
A wound that is more than 12 hours old should be cleaned and left | |
open to heal. | |
A larger wound that comes together well will heal better if it is | |
closed. | |
To close a shallow, clean wound, use butterfly bandages, glue, or | |
stitches. | |
Butterfly bandage | |
Use a butterfly bandage for a small cut. The skin around the wound | |
must be clean and dry for the bandage to stick. | |
Butterfly bandage | |
Glue | |
Super Glue or Krazy Glue (cyanoacrylate, a powerful adhesive) is | |
easier to use than suture and works just as well for most wounds. | |
Use it when you can clearly see how the two sides of the wound should | |
go together. It may not work as well on hands or joints because they | |
move so much. Do not use glue near the eyes or mouth. Super Glue | |
may irritate the skin. | |
Super Glue | |
* Make sure the wound is clean and the skin around it is dry. | |
* Push the sides of the wound together. Keep fingers well away | |
from the wound so they do not stick to the glue. A helper can use | |
a couple of clean sticks to hold the sides together. | |
* Squeeze a line of glue along the closed edges of the wound. | |
* Hold the wound closed for 30 seconds. Then add another layer of | |
glue. Wait another 30 seconds or so, and then add a third layer. | |
Each layer should cover a little more of the surrounding skin than | |
the last. | |
The glue will wear away on its own. By then the wound should be | |
healed. | |
Stitches (sutures) | |
A cut will benefit from stitches if it is shallow and long, or if the | |
edges of the skin around the cut do not come together by themselves. | |
Line up the edges. The edges of the wound should come up slightly | |
above the skin instead of tucking into the wound. | |
Make the depth and the length of the stitch the same on each side of | |
the wound. | |
If you do not have suture or a curved suturing needle, sharpen a | |
sewing needle. Boil the needle, some silk or nylon thread, and a | |
small pair of pliers for pulling the needle through tough skin. | |
1. Put the stitch through the cut, not under the cut. | |
Stitch through the cut | |
2. Tie a secure knot. | |
Tie a secure knot | |
3. Make enough stitches to close the whole cut. | |
Make enough stitches | |
A deep wound should get a couple of stitches inside the muscle with | |
dissolvable suture before sewing the skin together. If you cannot do | |
this then do not close the wound. | |
deep wounds | |
Leave stitches in place for about one week (10 days for a leg or | |
joint wound). Then cut each stitch and pull it out. If you spend | |
some time sewing clothes, you will find that your skill to suture | |
wounds improves as well. | |
How to tie a strong knot: | |
Tying a strong knot | |
* First tie a simple knot and pull skin together. | |
* Tie a second simple knot over the first one. | |
* Tie a third simple knot over the second one. | |
* Tie a fourth simple knot over the third one. | |
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> 1919 Addison St Ste 304, Berkeley, CA, 94704, 1.510.845.1447, | |
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