What's the latest on minor wound care?
May 30, 2012 9:24 AM Subscribe
Years ago, when I scraped my knee my mother put neosporin on it and covered it with a bandaid. Today we have many new wound care products. But are they any better than the old neosporin and bandaid?
I fell and badly scraped my knee on Sunday night. I iced it and put a pressure wrap on for about an hour, then wore tights to help with compression while sleeping. Monday it was better, still sore, and starting to scab but still oozing. I put neosporin and covered with bandaids (3, overlapping, as I didn't have any large bandages). Today it's too wet, clearly the wound needs air. But I don't want the wound oozing into my jeans. So what do I use to cover the wound, let it form a dry scab, keep it clean, keep it from oozing into my jeans?
I fell and badly scraped my knee on Sunday night. I iced it and put a pressure wrap on for about an hour, then wore tights to help with compression while sleeping. Monday it was better, still sore, and starting to scab but still oozing. I put neosporin and covered with bandaids (3, overlapping, as I didn't have any large bandages). Today it's too wet, clearly the wound needs air. But I don't want the wound oozing into my jeans. So what do I use to cover the wound, let it form a dry scab, keep it clean, keep it from oozing into my jeans?
You could try a hydrocolloid bandage, which didn't exist when I was a kid in the 80's and therefore seem alien and strange to me. But they're now common enough that your drugstore probably sells them under their own generic brand right next to the name-brand bandages.
According to the Wikipedia entry on Hydrocolloid dressings, they don't "dry" a scab because they create a particular type of moist environment to prevent scarring. They will prevent jean ooze though, pretty much like regular gauze.
posted by bcwinters at 9:32 AM on May 30, 2012
According to the Wikipedia entry on Hydrocolloid dressings, they don't "dry" a scab because they create a particular type of moist environment to prevent scarring. They will prevent jean ooze though, pretty much like regular gauze.
posted by bcwinters at 9:32 AM on May 30, 2012
Yes! Hydrocolloid dressings! Like bcwinters I'm old enough that these were totally foreign to me. One of my friends had one on her leg a few weeks ago and I thought she must have been seriously injured and gone to the hospital to receive such a legit looking dressing. Those things are awesome. Technology!
posted by telegraph at 9:35 AM on May 30, 2012
posted by telegraph at 9:35 AM on May 30, 2012
I always had problems with gauze because the weave often isn't "tight" the way it is with good-quality bandaids, so it gets stuck in wet wounds. I think the trick is to find a "low-adhesion" gauze? But I've also just cut up larger bandaids to completely cover a large wound because higher-quality bandaids have a tight weave.
I was under the impression that you don't necessarily want to let wounds 'air out' - in my limited experience (my own large scrapes) dry scabbing tends to lead to worse scarring.
posted by muddgirl at 9:41 AM on May 30, 2012
I was under the impression that you don't necessarily want to let wounds 'air out' - in my limited experience (my own large scrapes) dry scabbing tends to lead to worse scarring.
posted by muddgirl at 9:41 AM on May 30, 2012
Many dermatologists now urge their patients to use Polysporin, rather than Neosporin.
Developing a contact allergy to the neomycin in neosporin is very common, especially during granulation, if the wound is continually trapped by a Band-Aid.
posted by Danf at 9:51 AM on May 30, 2012
Developing a contact allergy to the neomycin in neosporin is very common, especially during granulation, if the wound is continually trapped by a Band-Aid.
posted by Danf at 9:51 AM on May 30, 2012
I was given a silicone bandage thing after surgery and it healed me ridiculously fast. It's just a strip of silicone to put on under a bandaid. They're expensive, but I think you can get them on amazon. My dr couldn't even explain how it works. But it does - this coming from someone who doesn't heal; I had stitches for a month.
posted by crankyrogalsky at 9:59 AM on May 30, 2012
posted by crankyrogalsky at 9:59 AM on May 30, 2012
I use liquid bandages. You spray it on and it hardens into a plastic-looking seal over the wound. No idea if they give you cancer or something, but it keeps the wound clean and uncontaminated, the one I use has an antibiotic in the spray, and it flakes off naturally or you can clean it off by applying more then wiping it away.
posted by Ghostride The Whip at 10:39 AM on May 30, 2012
posted by Ghostride The Whip at 10:39 AM on May 30, 2012
Clean and protect is still the best thing to do for most non-severe wounds and probably always be, but there are definitely many more ways to protect these days than there were when I was a kid. The two big ones are Tegaderm film and the hydrocolloid bandages already mentioned, and there's also liquid bandages.
I do not understand why the hydrocolloid bandages work so well, but oh man, they do. Or at least they seem to; I haven't done any scientifically-sound studies or anything. They're comfortable to wear, provide cushioning against incidental light bumps and friction, don't hurt coming off, and somehow seem to heal my scrapes and boo-boos faster than anything.
Tegaderm film transparent, breathable, adhesive dressings that stick to the skin but not the wound. They've been around for awhile but only recently widely available to the general public. I think their original use was in a surgical context, but they make great all-purpose wound protectors. They're thin, easy to apply, water-resistant and stay on through many washings, and let the wound breathe while keeping it protected from dirt, microbes, etc. You can get them with or without gauze pads in the middle.
Liquid bandage is a liquid sealant you apply by brushing or spraying the liquid over minor cuts and scrapes. It keeps the wound covered and protected, but dries flexible (so it's great for small wounds on the hands), and often contains a minor pain reliever, too (even though it can still sting like hell the first second or so you apply it). I like this for minor wounds because it lasts longer than a bandaid, doesn't get dirty or wet or bunched-up or fall off, and doesn't scream "Hey I have a boo-boo you should ask me about it!" like bandaids or other bandages do.
I keep all three of these in my first-aid kits as well as bandaids, and pretty much the only time I ever use a traditional band-aid is when someone else asks me for one.
As for the various 'sporins and other antibacterial treatments, the only time I ever put anything else on the wound between cleaning and bandaging is when I'm out and about and can't clean it properly, or I want to quickly dull the pain of a particularly nasty scrape (I carry an antibacterial ointment spray that has a pain reliever in it). Doctors and Red Cross instructors alike have told me repeatedly that antibacterial ointment is generally not necessary unless there's concern about infection.
posted by rhiannonstone at 10:49 AM on May 30, 2012 [1 favorite]
I do not understand why the hydrocolloid bandages work so well, but oh man, they do. Or at least they seem to; I haven't done any scientifically-sound studies or anything. They're comfortable to wear, provide cushioning against incidental light bumps and friction, don't hurt coming off, and somehow seem to heal my scrapes and boo-boos faster than anything.
Tegaderm film transparent, breathable, adhesive dressings that stick to the skin but not the wound. They've been around for awhile but only recently widely available to the general public. I think their original use was in a surgical context, but they make great all-purpose wound protectors. They're thin, easy to apply, water-resistant and stay on through many washings, and let the wound breathe while keeping it protected from dirt, microbes, etc. You can get them with or without gauze pads in the middle.
Liquid bandage is a liquid sealant you apply by brushing or spraying the liquid over minor cuts and scrapes. It keeps the wound covered and protected, but dries flexible (so it's great for small wounds on the hands), and often contains a minor pain reliever, too (even though it can still sting like hell the first second or so you apply it). I like this for minor wounds because it lasts longer than a bandaid, doesn't get dirty or wet or bunched-up or fall off, and doesn't scream "Hey I have a boo-boo you should ask me about it!" like bandaids or other bandages do.
I keep all three of these in my first-aid kits as well as bandaids, and pretty much the only time I ever use a traditional band-aid is when someone else asks me for one.
As for the various 'sporins and other antibacterial treatments, the only time I ever put anything else on the wound between cleaning and bandaging is when I'm out and about and can't clean it properly, or I want to quickly dull the pain of a particularly nasty scrape (I carry an antibacterial ointment spray that has a pain reliever in it). Doctors and Red Cross instructors alike have told me repeatedly that antibacterial ointment is generally not necessary unless there's concern about infection.
posted by rhiannonstone at 10:49 AM on May 30, 2012 [1 favorite]
Hydrocolloid dressings are miraculous things! I've never seen anything heal wounds faster, cleaner, or with less scarring. For a smallish wound (under quarter sized?), the Band-Aid Blister Care bandages are the easiest to find option.
posted by mostlymartha at 10:59 AM on May 30, 2012
posted by mostlymartha at 10:59 AM on May 30, 2012
Years ago, when I scraped my knee my mother put neosporin on it and covered it with a bandaid.
That's pretty modern. When I scraped my knee, my mother would wash it with soap and let it dry. If I got an infected scrape or cut, she would put soap and sugar on it. Neosporin hadn't been invented yet. (When she was young, penicillin still hadn't been discovered.)
Neosporin contains three over-the-counter antibiotics: bacitracin, polymyxin B, and neomycin.
Neosporin's successor, Polysporin, contains just two of those antibiotics: bacitracin and polymyxin B. If you buy it in Canada, you can get it with a different third antibiotic, gramicidin.
But the latest on caring for minor scrapes like yours is also the earliest: clean the wound with soap and water and let it heal without overdoing (or doing at all) the antibiotics. (I'm assuming you are a healthy person with a healthy immune system.) Wash it and change the dressing every day. Let it heal. If it's oozing through the bandage, try a thicker dressing that will absorb the moisture.
posted by pracowity at 11:29 AM on May 30, 2012
That's pretty modern. When I scraped my knee, my mother would wash it with soap and let it dry. If I got an infected scrape or cut, she would put soap and sugar on it. Neosporin hadn't been invented yet. (When she was young, penicillin still hadn't been discovered.)
Neosporin contains three over-the-counter antibiotics: bacitracin, polymyxin B, and neomycin.
Neosporin's successor, Polysporin, contains just two of those antibiotics: bacitracin and polymyxin B. If you buy it in Canada, you can get it with a different third antibiotic, gramicidin.
But the latest on caring for minor scrapes like yours is also the earliest: clean the wound with soap and water and let it heal without overdoing (or doing at all) the antibiotics. (I'm assuming you are a healthy person with a healthy immune system.) Wash it and change the dressing every day. Let it heal. If it's oozing through the bandage, try a thicker dressing that will absorb the moisture.
posted by pracowity at 11:29 AM on May 30, 2012
When my husband crashed his bike a couple years ago I did some research on what the general consensus was on caring for his scrapes and road rash. It seemed that cleaning the wound and using Tegaderm film or Hydrocolloid bandages was the thing to do. I specifically remember that keeping the wound moist keeps it from forming a scab, which is actually a good thing and reduces scarring.
posted by thejanna at 11:37 AM on May 30, 2012
posted by thejanna at 11:37 AM on May 30, 2012
Those hydrocolloid bandages are like some star trek shit, for sure. And not that expensive! I hadn't seen them before a few months ago, and it kind of freaked me out... totally seems like 'replacement skin in a bag' or something, but works wonders.
posted by FatherDagon at 12:27 PM on May 30, 2012
posted by FatherDagon at 12:27 PM on May 30, 2012
Doctors and Red Cross instructors alike have told me repeatedly that antibacterial ointment is generally not necessary unless there's concern about infection.
Neosporin/Polysporin aren't even available OTC in Britain, where antiseptics (Savlon, Dettol, Germolene) and not antibiotics are still the home standard for cleaning cuts and scrapes. Hydrocolloid and alginate are the latest and greatest for dressings, and silver-infused dressings are growing more common to deal with wounds where there's a risk of infection.
posted by holgate at 1:08 PM on May 30, 2012
Neosporin/Polysporin aren't even available OTC in Britain, where antiseptics (Savlon, Dettol, Germolene) and not antibiotics are still the home standard for cleaning cuts and scrapes. Hydrocolloid and alginate are the latest and greatest for dressings, and silver-infused dressings are growing more common to deal with wounds where there's a risk of infection.
posted by holgate at 1:08 PM on May 30, 2012
Geez, I feel like the most retro slacker mom ever, but when my kid came into the house sobbing last weekend because she'd fallen and scraped her knee, I spritzed it with Bactine, then put Polysporin and a Band-Aid on it. We changed the Band-Aid daily (because they were cheapo not-Band-Aids and kept falling off) and sometimes the scab underneath was a bit gooshy. After about 5 days, it had healed enough that she could go without the bandage and just be scabby.
posted by looli at 1:32 PM on May 30, 2012
posted by looli at 1:32 PM on May 30, 2012
I race bicycles. Crashes happen, often with bad road rash. Most racers I know agree the Hydrocolloid dressings (aka Tegaderm) are the best option for healing quickly and minimizing scarring. Expensive though...
posted by sarah_pdx at 1:47 PM on May 30, 2012
posted by sarah_pdx at 1:47 PM on May 30, 2012
When I was a youth, I got some serious road rash from a bike crash. It wasn't healing up very well. Then I spend a day at the beach with some friends and the hours in the water cleaned it up right nice.
Since then, I've been a fan of keeping the wound moist, at least until it closes up. My usual procedure is to clean it out with peroxide and then dress it with neosporin and a bandage. Then remove the bandage to shower, and then re-do it. Once it's closed up I'll only keep a band-aid on it to prevent it from getting reinjured. Otherwise I let it stay open.
My uneducated guess regarding the silicone is that it acts like a scab as far as the body is concerned. It sees no air and goes about repairing itself underneath. The bonus is that unlike scabs or other bandages, the silicone won't stick to the wound when you remove it. It sounds like that's what the hydrocolloid ones do too- form an artificial scab that allows the skin to repair itself.
posted by gjc at 2:21 PM on May 30, 2012
Since then, I've been a fan of keeping the wound moist, at least until it closes up. My usual procedure is to clean it out with peroxide and then dress it with neosporin and a bandage. Then remove the bandage to shower, and then re-do it. Once it's closed up I'll only keep a band-aid on it to prevent it from getting reinjured. Otherwise I let it stay open.
My uneducated guess regarding the silicone is that it acts like a scab as far as the body is concerned. It sees no air and goes about repairing itself underneath. The bonus is that unlike scabs or other bandages, the silicone won't stick to the wound when you remove it. It sounds like that's what the hydrocolloid ones do too- form an artificial scab that allows the skin to repair itself.
posted by gjc at 2:21 PM on May 30, 2012
Honey has been shown to promote healing faster, with fewer possible negative side effects, than antibiotic ointments in recent medical studies.
posted by IAmBroom at 3:59 PM on May 30, 2012
posted by IAmBroom at 3:59 PM on May 30, 2012
Funny that this should come up. I was looking into this for my nursing skills assessment the other day, and this paper was one I found interesting, looking at dry dressings and hydrocolloid and postop wound healing times:
Effect of Three Wound Dressings on Infection, Healing Comfort, and Cost in Patients With Sternotomy Wounds (Full text free)
Dry dressings were found to have about the same effect as hydrocolloid upon healing times, and were often found to be more comfortable in a postoperative setting, due to movement. And far cheaper!
Conclusions: In the context of no additional benefit for the prevention of wound infection or the rate of wound healing for any of the three dressing products examined, dry absorbent dressings are the most comfortable and cost-effective products for sternotomy wounds following cardiac surgery.
posted by owlrigh at 4:53 PM on May 30, 2012 [1 favorite]
Effect of Three Wound Dressings on Infection, Healing Comfort, and Cost in Patients With Sternotomy Wounds (Full text free)
Dry dressings were found to have about the same effect as hydrocolloid upon healing times, and were often found to be more comfortable in a postoperative setting, due to movement. And far cheaper!
Conclusions: In the context of no additional benefit for the prevention of wound infection or the rate of wound healing for any of the three dressing products examined, dry absorbent dressings are the most comfortable and cost-effective products for sternotomy wounds following cardiac surgery.
posted by owlrigh at 4:53 PM on May 30, 2012 [1 favorite]
Not all Tegaderm = hydrocolloid
3M Tegaderm Hydrocolloid Dressing
3M Tegaderm Transparent Film Dressing
...cool technologies, definitely. (Try a little hydrocolloid over a bad pimple...)
One thing I have that my mother didn't is Band-Aid Hurt-Free Antiseptic Wash -- cleans it out, painlessly.
posted by kmennie at 5:56 PM on May 30, 2012
3M Tegaderm Hydrocolloid Dressing
3M Tegaderm Transparent Film Dressing
...cool technologies, definitely. (Try a little hydrocolloid over a bad pimple...)
One thing I have that my mother didn't is Band-Aid Hurt-Free Antiseptic Wash -- cleans it out, painlessly.
posted by kmennie at 5:56 PM on May 30, 2012
I can see how dry dressings would be more comfortable with movement, but what about during dressing changes, when scabby areas that have been oozing tend to adhere to the dressing, and pulling the dressing off then unroofs the scabs? A sternotomy scar is different than a scraped knee - I'd want something non adherent.
posted by treehorn+bunny at 11:25 PM on May 30, 2012
posted by treehorn+bunny at 11:25 PM on May 30, 2012
gjc: " My usual procedure is to clean it out with peroxide and then dress it with neosporin and a bandage."
I believe the latest info is not to use peroxide, as it can also kill healthy cells needed to help the wound heal.
posted by IndigoRain at 8:19 AM on May 31, 2012 [1 favorite]
I believe the latest info is not to use peroxide, as it can also kill healthy cells needed to help the wound heal.
posted by IndigoRain at 8:19 AM on May 31, 2012 [1 favorite]
Response by poster: Wow, thanks for all the useful information!
To clarify, what I have is road-rash, it's only on the skin and no "closure" is needed for this wound. I'm not worried about infection, I had the neomyacin at hand so I used it - more to help keep the wound from sticking to the bandage than anything else. (I rarely reach for antibiotics and hand sanitizers, I'm not the type who is constantly trying to "fight off germs".) I'm not worried about scaring - I have plenty of scars and if I get one more it won't bother me - although I really don't expect a scar from this one.
I just need the wound protected so it doesn't get dirty, or ooze into my clothing. I'm attracted to the idea of Hydrocolloid dressing, because I can buy a single product and have it "adapt" to any wound covering needs. I don't run a daycare center, have children, or get injured myself often, and don't see the point in stocking up in dozens of different bandaging supplies so I can cover all different sizes of wounds, when a liquid covering product can do the adapting for me! I'm going to give that a try. I'll pick a "best answer" after I see how this works for me.
posted by jcdill at 10:50 AM on May 31, 2012
To clarify, what I have is road-rash, it's only on the skin and no "closure" is needed for this wound. I'm not worried about infection, I had the neomyacin at hand so I used it - more to help keep the wound from sticking to the bandage than anything else. (I rarely reach for antibiotics and hand sanitizers, I'm not the type who is constantly trying to "fight off germs".) I'm not worried about scaring - I have plenty of scars and if I get one more it won't bother me - although I really don't expect a scar from this one.
I just need the wound protected so it doesn't get dirty, or ooze into my clothing. I'm attracted to the idea of Hydrocolloid dressing, because I can buy a single product and have it "adapt" to any wound covering needs. I don't run a daycare center, have children, or get injured myself often, and don't see the point in stocking up in dozens of different bandaging supplies so I can cover all different sizes of wounds, when a liquid covering product can do the adapting for me! I'm going to give that a try. I'll pick a "best answer" after I see how this works for me.
posted by jcdill at 10:50 AM on May 31, 2012
I heartily recommend hemostatic gauze. You don't need to buy it in the crazy big package. It's sold to stop nose bleeds but I used it on a severe surface cut.
It's not gauze in the normal sense. The material turns into a sticky gel where it contacts blood. So if you have a bloody abrasion you put this on and it essentially forms a pliable scab in a few minutes.
posted by chairface at 6:28 PM on May 31, 2012
It's not gauze in the normal sense. The material turns into a sticky gel where it contacts blood. So if you have a bloody abrasion you put this on and it essentially forms a pliable scab in a few minutes.
posted by chairface at 6:28 PM on May 31, 2012
treehorn+bunny, there are non-adhesive, dry bandages. They're absorbent, but kind of plasticky. I had surgery a couple years ago, and that's what I used. Later I used silicone, but my surgeon was adamant that it couldn't be used until the wounds were fully closed.
posted by looli at 7:27 PM on May 31, 2012
posted by looli at 7:27 PM on May 31, 2012
IndigoRain: "I believe the latest info is not to use peroxide, as it can also kill healthy cells needed to help the wound heal."
Actually, I believe the bigger reason is the risk of embolism. While not much of a problem with scrapes, it has actually occurred in treatments of cuts.
posted by IAmBroom at 1:38 PM on June 1, 2012
Actually, I believe the bigger reason is the risk of embolism. While not much of a problem with scrapes, it has actually occurred in treatments of cuts.
posted by IAmBroom at 1:38 PM on June 1, 2012
This thread is closed to new comments.
posted by phunniemee at 9:29 AM on May 30, 2012