What Doctors Don't Tell YouTaking care of a wound or cut is largely a matter of common sense. When self-treating, consider these options to help support the body’s own efficient healing process.
* Stop the bleeding. The sooner you can cover the wound and slow down the blood flow, the easier the injury will be to deal with. To stop the bleeding, apply pressure that is firm and even – too much will cut off the circulation. Don’t keep checking to see if the blood has stopped; you might disturb the clotting/healing process. If there’s a lot of blood seeping through the padding you’re using, don’t remove the padding – cover it with another cloth or pad and continue to apply pressure.
Sometimes minor cuts – especially those on the head and face – bleed much more than you might expect since the number of blood vessels is greater in these areas of the body than in others. Once you have controlled the blood flow, examine the wound to determine what action is necessary.
* Keep it clean. To prevent infection, make sure that anything that touches the scrape or cut – such as hands and dressings – is as clean as possible. From time to time during the healing process, be sure to clean the wound with a gentle saline solution. You can make one at home by dissolving two teaspoons of salt into a litre of boiling water and allowing this to cool.
* In case of infection, try treating with natural antimicrobials. A good first choice is Echinacea angustifolia, which fights infection as well as promotes healing (Br J Phytother, 1998; 5: 97-104; Med Klin, 1984; 79: 580-3). Others include calendula, tea tree and lavender (Phytomed, 1996; 3: 11-8; Austr J Pharm, 1988; 69: 276-8). Pure honey may also be beneficial. Poorly healing wounds may benefit from being bathed in an infusion of camomile (Zeitschr Hautkr, 1987; 1262: 1267-71).
* Boost your protein intake. Skin is made of protein, and extra is required when you are injured. This is especially true for those undergoing an operation since surgery increases both calorie and protein needs by 20-50 per cent. Without enough protein, recovery may be delayed and the risk of infection is increased.
* Supplement. Studies show that a poor diet can retard wound healing (Am J Med, 1986; 81: 670). WDDTY panellist Dr Melvyn Werbach suggests in his book Nutritional Influences on Illness (Thorsons, 1989) that many nutrients have a role to play in wound healing. Vitamin A helps to form scar tissue, vitamin B1 deficiency can interfere with collagen synthesis and vitamin B5 accelerates the healing process. Vitamin C promotes the formation of collagen and elastin, and a deficiency can slow the healing process. Vitamin E aids in the healing of skin grafts, and zinc stimulates wound healing. Essential fatty acid deficiencies are associated with poor wound healing.
* If you have stitches. You can usually wash an area that has been stitched after one to three days. Washing off dirt and the crust that forms around the stitches helps reduce scarring. If the wound drains clear yellow fluid, you may need to cover it. Be sure to dry the site well after washing. Ointments, rather than creams or lotions, will keep a heavy scab from forming and may help reduce the size of the scar.
* Healing scars. Moist dressings should result in fewer and less noticeable scars. However, if you do have scars, silicone sheeting may be one way to help. Studies show that silicone sheets can moderately improve the appearance of hypertrophic and keloid scars resulting from surgical procedures or trauma (J Dermatol Surg Oncol, 1993; 19: 912-6). They are most effective on fresh scars (Cutis, 1995; 56: 65-7; Dermatol Surg, 1996; 22: 955-9), but should not be used until the cut has closed. Similarly, glycerine-based gel sheeting can be just as effective and less expensive (Adv Wound Care, 1998; 11: 40-3). Simply keeping scars moist for a longer period may be of the greatest benefit. Topical vitamin E oil may also help.
* Know when to call your practitioner. Cuts that require medical attention include those that: are deep (how deep is usually more important than how long); expose any red muscle tissue or yellowish fat tissue; stay open if you let go of the sides of the cut; or are sited on a joint or in an area where healing might be difficult (stitching might be needed to keep the wound closed). If medical attention is required, discuss the pros and cons of different types of dressings with your doctor. For instance, alginates are best used on wounds that are leaking lots of fluid, while hydrogels and hydrocolloids boost moisture in dry wounds. Selecting the right dressing can substantially boost healing.
Daniel Redwood DC
Tom Ferguson MD
