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When it comes to wound care, live and learn

(Content courtesy of BAND-AID.)

Perhaps you can relate to some of the things I’ve said to patients, family members and friends over the years about postop wounds.

“Let’s just keep that wound open to air and let it breathe.”

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Janice Petrella Lynch, RN

“That’s great, look at that nice dry scab. That means it is on its way to healing. You’re doing a great job!”

“Let’s try some alcohol or hydrogen peroxide on that open wound. That will clean it out well and should do the trick.”

“I’m glad you are going to the beach. The sun will do that wound some good.”

Do any of these recommendations sound familiar to you?

If you are nodding your head right now, I must tell you they are all just old wives tales.

Based on clinical research and best practices, here are the facts that have changed my tune when talking about postop wounds.

• Clean, moist and covered wounds heal faster, have less chance of infection and reduce the incidence of scabbing and scarring.

• When a scab dries out, the healing process takes longer and scarring is more possible. It should be kept clean, moist and covered.

• Irritants like hydrogen peroxide and alcohol may delay the healing process. Wounds should be gently cleaned and dried with sterile products before applying a dressing.

• Keeping a postop wound out of the sun is important since ultraviolet rays slow the healing process and can discolor the skin.

Our patients, family members and friends depend on us for accurate suggestions and practical solutions when it comes to their health and well-being – and especially when it comes to wound care.

I try to live and learn each and every day, and these are lessons I won’t soon forget.

Resources for nurses

Resource sheet: Print and share

Pamphlet: Wound care pocket guide for nurses

By | 2015-12-17T15:18:22-05:00 December 17th, 2015|Categories: Education|3 Comments
Janice Petrella Lynch, MSN, RN
Janice Petrella Lynch, MSN, RN, is director of the Help & Resource Center at The Marfan Foundation. Also a nursing educator, she has held faculty positions at Wagner College, Skidmore College, Molloy College and Adelphi University. She is a member of the New York Organization of Nurse Leders and the Greater New York Nassau-Suffolk Organization of Nurse Executives.

3 Comments

  1. Avatar
    Dr. Linda Benskin January 21, 2016 at 5:09 pm - Reply

    Wounds need clean care, but sterile care is not necessary, since the skin is never sterile anyway.
    1) Clean initially by flushing the wound with saline or clean water. Don’t try to kill the germs! Even soap also kills live tissue and thus increases infection in the long term. You do not need to kill the germs: just remove them with a strong spray of saline. Rubbing the wound to clean it causes microtears in the cells, which increases infection.
    2. Dry the surrounding skin, but leave the wound bed wet. Moisture is needed to allow the WBCs and new cells to migrate freely across the wound surface.
    3. Apply an occlusive dressing. Occlusion keeps the wound wet so the body can keep it free of germs as it uses enzymes to break down the dead tissue. It also decreases pain and inflammation, and decreases scarring.
    4. Apply compression if edema is limiting circulation, and be sure to offload to prevent further damage. The body has an amazing ability to heal – we just need to support it instead of getting in its way!

  2. Avatar
    Harm Smit January 21, 2016 at 5:51 pm - Reply

    shortcuts.

    Therefore, it is really unwise to turn to commonalities, or in your case replace commonalities with other commonalities which are also not generally applicable. What you offer is contrary to being helpful. (just check Cochrane)

    Our patients, family members and friends depend on us for accurate suggestions and practical solutions when it comes to their health and well-being – and especially when it comes to wound care.

    Sometimes you do not have a choice to use gentle solutions in a derailed wound.

    The only thing we know is that debriding a wound is helpful.

    Therefore, the last thing we need is to replace one commonality with another while ignoring the complexity of everyday wound care.

    Here are my remarks,
    “That’s great, look at that nice dry scab. That means it is on its way to healing. You’re doing a great job!”
    > never remove a dry scab on a heal unless…

    “Let’s try some alcohol or hydrogen peroxide on that open wound. That will clean it out well and should do the trick.”
    > you may sometimes even have to use eusol to solve a tricky wound…

    “I’m glad you are going to the beach. The sun will do that wound some good.
    > Yes, because the movement will increase your metabolism (vO2max) and salt water will clean the wound and the UV will kill some bacteria…

    If moist wounds heal faster; why is there no evidence beyond Bloom, Winter and Hinman. Or why does Cochrane find no effect of any intervention without exception.

    All in all, the last thing we need is commonalities. Let’s appreciate wound care is complex and wonder why we have not seen any major progress since 1963.

  3. Avatar
    Jill Troughton April 29, 2020 at 6:54 am - Reply

    Great Tips! Thank you for sharing the tips for wound care. This information was really helpful.
    Keep posting!

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