WOUND HEALING

 

T he decision of whether to stitch up a wound is seldom without debate. What procedure should be followed, when, and why would you choose to close a wound? As a general rule, start with the least invasive techniques first. These are tapes, glues, staples, and sutures.

 

Duct-taped butterfly closure made on the fly

There are numerous ways to stitch up a laceration. It makes sense to employ the least complicated and invasive technique possible. Steri-Strips and butterfly closures, sticky bandages that adhere on either side of the incision to bring it together, are the simplest to use. They can be removed without puncturing the skin and eventually disappear on their own. A butterfly closure can be created even with duct tape.

Cyanoacrylate, a unique adhesive marketed under the brand name DERMABONDTM, is the second least intrusive procedure. This medical-grade adhesive was created especially for application to the skin. Simply apply a tiny layer of glue over the laceration while holding the skin's borders together. Keep in position until dry. As the skin heals, it will naturally peel off.

Some have suggested using Super GlueTM, a common household product significantly less expensive, to close wounds. This product is not intended for use on the skin and has somewhat different chemical properties. Some people may have skin irritation, and reactions resembling burns have been noted.

Whether you use a small amount of Super Glue on the inside of your forearm and wait 24 hours, you can check to see if you have an allergic reaction.

Skin staplers are another way of closure. They should be removed after about seven days since they function by "pinching" the skin together. To round out the edges of the skin and approximate them for the person doing the stapling, you will need two toothed tweezers (also known as "Adson forceps"). Therefore, having a helper is best during stapling. The one holding the tweezers, not the one stapling, is the one with the greatest talent.

The best way to remove staples is with a special staple remover tool. Although generally available, stapling equipment is probably not as economical as alternative approaches.

The most intrusive way to close a lesion or cut is by using sutures. It is the one that demands the most talent because one person may complete it. Ask yourself why you can't use a less intrusive technique rather than suturing before you decide to do so. It's doubtful you'll ever be able to refill such supplies in a long-term survival situation.

 

When to Apply for First Aid

What are you hoping to achieve by closing a wound with stitches? You should have clear objectives: You bandage wounds to speed healing and fix the flaw in your body's armor. A wound that is accurately located also scars less.

Unfortunately, this is where things become tricky. Closing a wound that has to stay open might cause more harm than good and even endanger the patient's life. Closing a wound is not a decision that is made lightly and requires much thought.

The most crucial factor is whether you are working on a clean or unclean wound. In a survival situation, the majority of your wounds will be filthy. If you attempt to treat an unclean wound, you introduce bacteria and dirt into the body. The infected wound will quickly develop redness, swelling, and heat. Pus may build up inside an abscess if it does.

The patient's life could be in jeopardy if the infection spreads to the bloodstream. You can clean the inside of the wound frequently and watch it heal if you leave it open. Additionally, it allows inflammatory fluid to leave the body. Open wounds begin to heal from the inside out. Although the scar is less attractive, it is typically the safest choice.

Whether or not to stitch up a wound also depends on whether it is a simple laceration (a straight, thin cut on the skin) or an avulsion (areas of skin torn out, hanging flaps). The incision should be left exposed if the skin's edges are too wide apart to be sewn together without putting too much strain on them. If the wound has been exposed to air for more than eight hours, it should remain since bacteria have had plenty of time to colonize it.

If the wound is long, deep, or gaped open loosely, you should close it if you are convinced that it is clean. Any kind of animal or human bite is an exception.

Stitches are more likely needed for lacerations close to moving elements, such as the knee joint. Remember that you should stitch up deep wounds in layers to avoid any potential "dead space." Dead spaces are areas of air containing germs in a closed wound that could cause a serious infection.

If in doubt, wait 72 hours before dressing a wound to be sure no infection symptoms appear. Delay in the closure is the term used to describe this. Some wounds can only be partially dressed, leaving a tiny gap to prevent inflammatory fluid from building up. This can be accomplished by inserting drains made of thin lengths of latex, nitrile, or even gauze into the incision. Of course, you should cover the exposed region with a dressing.

Antibiotics should be administered to many wounds that need to be stitched up to reduce the risk of infection. Natural medicines like raw, unprocessed honey or freshly crushed garlic may be helpful in a harsh environment.

If possible, utilize absorbable material, such as chromic catgut or VICRYL, as deep-layer sutures are never removed from the body. The body will seal off the sutures if nonabsorbable materials like silk, nylon, or prolene must be used, and they may even form a nodule called a "granuloma." Although it could be unsettling, this has little bearing on a patient's health.

Sutures over a joint should be removed in 14–21 days; skin sutures should be removed in 7 days (5 days if on the face). Over a joint, like the knee, stitches should be placed closely together. Sutures spaced at least half an inch apart are appropriate in other places. Making room for the fluid to drain from the wound is acceptable.

 

Commonly fractured blister

A friction blister will likely happen to anyone who has gone trekking or purchased the incorrect footwear. It can undoubtedly result in more issues than is typical for a soft-tissue injury, although being quite minor. The terrain has caused more than one hike to end abruptly because the footwear could not manage it. Never undervalue the value of a well-fitting pair of shoes.

Your new boots should fit snugly across your entire foot:

       The broadest area of the shoe should easily accommodate the ball of your foot.

       There should be approximately a half-inch gap between your toes and the tip of your shoe.

       The shoe upper should be flexible enough to prevent irritation of your instep.

       When you walk, your heel shouldn't jump up and down.

Additional factors are crucial: Thick VibramTM or other strong material should be used for the soles. By providing extra support and providing protection against snakebites, high-cut boots will aid in the prevention of ankle sprains.

Never purchase very tight shoes and anticipate them to stretch. They might, but it will be quite uncomfortable for you to get them there. Even though you might be accustomed to purchasing shoes online, you should try them out for a bit before making a decision. Purchase one or two extra pairs of shoes while they are still in stock unless you can count shoemaking as one of your survival talents.

When chopping wood, heavier boots, such as those with steel toes, are ideal since you can keep all ten of your toes. However, they are hefty. Remember that one extra pound in your boot equals five extra pounds on your back. Waterproof materials with flexible uppers, like Gore-TexTM, are a wise investment in humid environments.

Your choice of socks affects how well your feet are doing. Even in the height of summer, most hikers continue to wear the same pair of socks all day.

Wet feet cause more friction and blisters, which is why sweaty feet are unhappy feet.

Have extra pairs of socks in your backpack at all times, and change your socks frequently. For added protection, consider wearing a thinner, second pair of socks (sock liners) under your heavier hiking socks. Using cornstarch or foot powders like Gold Bond, your feet can stay dry.

 

Blisters

A blister starting to form will appear as a sore, red region where friction is present. Before it becomes worse, cover it with moleskin or SpencoTM 2nd SkinTM. You can use gauze, a Band-Aid, or even duct tape if you don't have any on hand. Padding is necessary for this situation to reduce friction in the area.

Most individuals want to pop their blisters, but doing so on smaller ones could result in infection. However, large blisters are distinct. Observe these steps:

  1. Use a disinfectant to clean the area. Iodine or alcohol are particularly helpful.
  2. Use alcohol to disinfect a needle or heat it to a red-hot temperature.
  3. Puncture the blister's side. The liquids can now drain, thanks to this. This will help with some of the discomforts and start the healing process.
  4. Preserve any loose skin and protect the blister by covering it.
  5. If you can, use an antibiotic cream.
  6. Cut a hole in the center of a piece of moleskin or Spenco 2nd Skin that is somewhat larger than the blister.
  7. Apply the moleskin with the blister in the center of the flap.
  8. Use a gauze pad or other bandage to cover.
  9. Try to get some rest.

Make sure the bandage prevents friction to the region if you absolutely must continue walking. Remember that bandages commonly slip off, so periodically check to ensure it's still there. To keep the bandage clean, change it periodically.

Blisters can be treated at home using a variety of methods:

       Applying a saltwater-soaked cloth as a cold compress to the blister.

       Apply a 10% tannic acid solution to the blister two to three times each day.

       To clean a broken blister, apply a few drops of ListerineTM antiseptic. For this purpose, garlic oil is also quite beneficial.

       Apply zinc oxide ointment, vitamin E oil, or aloe vera on the blister.

       Apply witch hazel three times daily on the blister to dry it out and relieve pain.

Tea tree oil can stop infections.

 

Splinters

A person may encounter one or more splinters from being in the woods or working with wood. Simply slit the skin around the splinter until you can grab the end with a pair of tiny forceps or tweezers. A magnifying lens will be necessary to make this operation simpler.

Use a scalpel (number 11 or 15 blades) to cut the epidermis if you can see the entire length of the splinter. Just enough of a cut should be made to expose the wooden fragment's tip. Then, with the aid of your tweezers, grip the splinter's tip and remove it by pulling in the direction it entered the skin. Remember to carefully wash the area both before and after the treatment.

Except for those under the skin for longer than 2-3 days, it's unlikely that a simple splinter will result in a serious infection. If an infection develops, redness or swelling in the area will become evident. If you want to avoid issues later, you can think about taking antibiotics in this situation.

 

Fishhooks

You will eventually end up with a fishhook embedded in you, possibly your hand, even if you are an experienced fisherman. Start by thoroughly washing the area with an antibacterial since the hook likely has worm guts.

Your hook most likely has a barb on one end. If it's difficult to slip out, the problem is probably with the barb. Try to pry the hook out along the shank's curvature by pressing down on the skin where the barb is located.

If not, you might need to push the fishhook more into the skin until the barbed end emerges again. Now that the barbed end has been separated from the shank, you can cut the wire with a wire cutter. After that, remove the shank by pulling on the source. Rewash the area once more, then bandage it. Keep a close eye out for infection symptoms over time.

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