Pressure on small, infected wounds a good idea?

May 21, 2007 8:49 PM

Am I helping or hindering healing, by squeezing out the pus?

My minor cuts and punctures often get infected. While these wounds are healing, I habitually fuss with 'em -- if they're even slightly swollen I squeeze the injury between thumb and finger, like a zit, in order to eliminate the pus. I figure I'm reducing the white blood cell and lymph system's workload, thereby decreasing recovery time.

True or False?

posted by Rash to health & fitness (18 comments total)

Maybe true, but considering you'll be reopening the wound, making it vulnerable to getting dirty and becoming more seriously or re-infected, I'm not sure about the net gain.
posted by puddpunk at 8:58 PM on May 21, 2007

I've had numerous small cuts that haven't healed until I've opened them right up, allowing them to finally scab.
posted by tomble at 9:05 PM on May 21, 2007

The key to answering your question is "helping or hindering, relative to what?" Relative to incubating a massive infection which turns to blood poisoning, or causes septic shock, you're probably helping. But relative to keeping the wound from becoming infected in the first place, you're definitely hindering, and you're running minor but non-zero risks of additional complications, and creating more scar tissue than is probably necessary.

Cleaning a wound, applying a topical antibiotic ointment (Neosporin or equivalent), and a self-adhesive bandage is a simple and cheap enough bit of first aid that you deserve to do this for yourself, regularly. Yes, even you deserve this much care.* You can buy several little cans of self-adhesive bandages and small tubes of ointment for $10 at any drug store. One for the car/truck, one for the bathroom, etc. Then, all that's required is that you think enough of yourself to take 2 minutes to give yourself a little first aid when you need it.

*Well, probably.
posted by paulsc at 9:15 PM on May 21, 2007

False. Squeezing can cause pressure-induced rips in tissue already damaged by the process of infection, and those rips take further time to heal. Opening a small wound to the outside by bursting the top will also often allow extra germs to get in there that would otherwise not have done so.

The best thing you can do for minor cuts and punctures is scrub the hell out of them with soap and warm water and a nailbrush as soon as you get them, then paint on a little Betadine, then leave them the hell alone. That way they won't get infected in the first place.
posted by flabdablet at 9:19 PM on May 21, 2007

Do they still get infected (or stay infected for as long) if you don't fuss with them, at all? Determining that might be one way of answering your question.
posted by treepour at 9:20 PM on May 21, 2007

Yes, I wonder if all of your "fussing" is the reason they get infected so frequently.
posted by rhapsodie at 9:23 PM on May 21, 2007

While the tissue is knitting (healing itself back together), stress on the wound can tear apart delicate bonds. That said, oxygen is needed in order for the wound to heal properly. The best way around all of this is just to dab some neosporin on it and let it ride. It won't get swollen and you might not necessarily be inclined to work it.
posted by rhizome at 9:35 PM on May 21, 2007

look at it under a magnifying glass and you'll be horrified by the damage you're doing. That said, it's hard to leave stuff alone. There's got to be something primal/instinctive about this desire to pick these things apart methinks.
posted by iamkimiam at 9:37 PM on May 21, 2007

I pick at scabs whenever I get them and I've never had any get infected. Maybe you should see a doctor about this. (Or just try disinfecting them when you get them (and when you re-open them) and see if that helps.)
posted by Many bubbles at 9:57 PM on May 21, 2007

If you've got necrotic tissue in there then yes, you're helping. This needs to be removed before the wound will fully heal and the infection resolve. That's how abscesses form, the flesh heals over but the dead core festers from underneath and it eventually breaks open again. If you haven't and it's just pus, then all the stuff about micro-tears and reintroducing infection come into play and you should leave it alone, tempting as it may be to play with. If you follow paulsc's advice then the chances of infection and build up of necrotic tissue will be greatly reduced, and this will become much less of an issue.

FWIW some people just seem to pick up these small infections easily, I know I do. It's not a big deal and you don't need to see a doctor. Just take extra care of any little cuts and scratches soon after they happen and you'll prevent most of it.
posted by shelleycat at 10:07 PM on May 21, 2007

If you are not immunocompromised, your "minor cuts and punctures" should not be getting infected. Wash them with water and keep them clean and dry, and they should be healing on their own with a bandaid.

I would also question what you mean by "infected"--if they are truly infected wounds, then you're having abscesses, and you really shouldn't be having these. If they're red or slightly tender, that is often a sign that simple healing is taking place. Those are signs of inflammation, which are normal after a cut--inflammation recruits cells to remove debris, kill bacteria, and rebuild your skin.

I'm not sure what exactly you're expressing from these wounds, hard to tell. Pus is generally from an abscess, and it is made up of neutrophils--cells that search out and destroy bacteria. Abscesses need to be drained (by a doctor, please!) and packed with gauze so they stay open and heal by secondary intention.

If I had to guess, I would say you're doing more harm than good--probably disrupting the fibroblasts which lay down new tissue.

The best thing you can do for minor cuts and punctures is scrub the hell out of them with soap and warm water and a nailbrush as soon as you get them, then paint on a little Betadine, then leave them the hell alone. That way they won't get infected in the first place.

Wow. No.

Minor cuts and punctures that are not actively bleeding and do not require sutures/staples/medical closure can be thoroughly irrigated well with simple tap water. (The goal of cleaning wounds is to remove foreign bodies and reduce the bacterial load of the wound so that it's to a level that your body can handle. You're just diluting bacteria. Irrigation is best under higher pressure if possible. No soap is necessary, but probably won't hurt that much. Betadine, however, will hurt. It will sting like hell, and it will also inhibit the healing process (while it will kill bacteria inside the cut, it will also kill your own cells, making more debris for your body's macrophages to have to clear). If you go to the ER, you will see that we irrigate with water or normal saline under high pressure, use betadine around the wound (but not in it) for when we're suturing, and then dress the wound with some antibiotic ointment and bandaid/sterile gauze.

Everyone should have a Tetanus booster as well every 5-10 years.

(I am not a doctor and not your doctor. You should see one.)
posted by gramcracker at 10:16 PM on May 21, 2007 [4 favorites has favorites]

Immunocompromised has nothing to do with it. Really minor wounds don't go far enough through the skin to come in contact with the blood supply, so immune cell exposure is limited. Scrapes, grazes and minor burns often get infected for this reason, they break enough of the skin to remove barrier function but doesn't go deep enough to contact white blood cells and activate APCs etc. Some people are more susceptable to this than others, either because of the bacteria they carry on their skin as part of everyday life (we all have them), or poor wound care, or just a slightly overreactive inflammatory response. These low level, almost sub-clinical, infections are normal and totally preventable. Not an indication of faulty immune response or requiring of medical care.

Some people just need to be more careful with small wounds than others. Everyone should still clean and cover wounds correctly regardless as part of general looking after yourselfness.
posted by shelleycat at 11:33 PM on May 21, 2007

On the somewhat rare occasion that I get a sore that I can see has pus under it, and it looks nearly ready to burst, I do what my mom taught me to do... I run a washcloth under water as hot as I can stand it, and hold it against the sore. Repeat as necessary. It helps bring the pus to the surface and it usually opens and drains on its own.

People, sometimes there are infections that need to be drained, especially when they're swollen with pus. Have none of you ever been to the doctor with an infected, say, toenail, and the doctor lanced it? Now, I'm not saying any of us are qualified to determine whether a sore needs to be drained, but doing the above has never hurt me.
posted by IndigoRain at 4:06 AM on May 22, 2007

Well, if you can get pus out of a wound, it's infected. If you want to get the pus out of it - which will make it hurt less and, in my experience, heal faster - don't squeeze it, which forces the pus and bacteria into the surrounding tissue, and tears a tiny ragged exit wound; just poke it with a sterile razor blade or scalpel. Then squeeze it out gently, wash the area with water and anti-bacterial soap, and cover it with Neosporin and a Band-Aid.

IANAD, I just get cut a lot.
posted by nicwolff at 5:24 AM on May 22, 2007

You people (except gramcracker) have a strange idea of "infection."
posted by yesster at 7:07 AM on May 22, 2007

Immunocompromised has nothing to do with it. Really minor wounds don't go far enough through the skin to come in contact with the blood supply, so immune cell exposure is limited. Scrapes, grazes and minor burns often get infected for this reason, they break enough of the skin to remove barrier function but doesn't go deep enough to contact white blood cells and activate APCs etc.

If it is minor enough to only break through the epidermis, then a) that shouldn't be getting infected if you keep in clean and b) the epidermis is dead skin cells anyway.

If it goes down to at least the dermis, which most "minor" wounds probably do, then there's plenty of capillary blood supply to create an inflammatory and immune response. Any disruption of the dermis will cause an immune and inflammatory response, if you're able to mount one. APCs will migrate into the dermis and start doing phagocytosis and antigen presentation. Seriously. Minor cuts should not be getting infected (but I think you're a little confused about what "infected" means).
posted by gramcracker at 9:06 AM on May 22, 2007

I get lots of little scrapes and cuts, but rarely do they become infected. I wash them out, alcohol and a dab of neosporin. Bandaid if needed. You're not doing something right. Quit picking at 'em.

Also, a cut or wound will heal quicker if a scab is NOT allowed to form, but just kept slightly moist and protected. From my own experience and previous mefi discussions, I've learned that allowing a wound to "breathe" does not accelerate healing.
posted by wsg at 11:54 AM on May 22, 2007

By infected I mean red, swollen, and painful to the touch. I thought these were the signs of infection -- if not, what is?

And just today, the doctor (my first visit with a new one) asked when my last tetanus shot was, and gave me one when my answer was at least ten years, maybe twenty. So maybe that's why my many little cuts and scrapes so often get "infected."

Thanks for everybody's info.
posted by Rash at 4:16 PM on May 22, 2007