For small wounds, like a linear small cut or graze the size of a 5 pence piece (or a 1 cent coin), and that has no contaminants or debris inside, just rinse it under some clean water, dry and cover with a band aid or plaster. Change everyday, until healed. You will find most cuts don't need such a dressing and will be fine otherwise. If you have an allergy to band aids/plasters use hypoallergenic ones, or use cotton wool and some surgical tape on top. No special cleaning equipment is needed.
If it has debris, you need to flush the cut. This should definitely be done by clean tap water, or saline solution (0.9%) (irriclens) if you have it. Of a cut this size, its important to not make it any worse and just clean it. If its deep or sore when done, just rinse under very cold tap and cover up using above method.
If the cut is not linear, or the graze is bigger/deeper, it should be covered up, and if a normal band aid will not fit, you should find one of two dressings: Mepore or Melolin. (with the melolin you will need to have surgical tape). These are plain dry absorptive dressings that don't contain any agents and are sterile. These should be applied once the wound is irrigated with clean water or saline solution if available, and any fixed debris removed. If glass, shrapnel or splinters are in the wound, you should either go seek medical advice or remove them carefully with tweezers a steady hand, plenty of light and patience. The dressing should be applied and changed once a day.
If skin (such as a skin flap) has come off the wound or it is very deep, in this case an antiseptic should maybe be used, after irrigating the wound for debris. I recommend: Surgical Spirit BP, Dettol or TCP (follow the instructions of dilution). Chlorhexadine if you have access to it would be the best one of choice. You then need to wait for the solution to dry. Add a gauze swap ontop, then add a dressing (mepore or melolin + tape) using as clean a procedure as possible. Change the gauze swap and the dressing every day. No need to re add antiseptic.
If the wound is big, or caused from a surgical procedure or a boil exploding, I suggest seeking medical advice for treatment.
What to watch for in your wound every day you change your wound. Ask yourself is teh wound:
• Red
• Swollen
• Sore
• Hot
If the answer is YES to ALL this questions, you are recommended to repeat antiseptic technique and seek medical attention for an antibiotic cream, fusidic acid (or in bad wounds oral flucloxacillin). Neosporin (neomycin) may be used, but it is not as widely used and not as effective as fuscidic acid. Dressings containing silver or iodine may also be used, (Tegaderm Alginate and Inadine). The cream should be applied tds if badly infected, but maybe reduced to bd. Before redressing and applying antibiotic cream, clean out any discharge and puss and irrigate with saline ONLY (reminds me of the time I literally collected a mug full of pus from an exploded boil that was cut out and rehealing but got infected. The pus came from everywhere within a foot diameter). If there is an odd smell, blackening of the skin; seek emergency medical attention.
If the cut has been done by a metal device of either unknown origin, or if it is still within the wound eg fish hook or nail, (do not remove it), and seek emergency medical advice. For those cuts that are very deep and profusely bleeding, aim to use clean cotton or linen to absorb blood and apply pressure to the wound to allow it clot. Aim not to get it wet straight away as you break up the platelet plug before fibrinogen has turned into fibrin and bound the clot. if the bleeding continues for about 5 minutes, or significant blood loss (more than 1/4 pint in that period) seek emergency medical advice. You will need to apply excessive pressure above the site of the wound, and on the wound. Wrap with cotton or linens to absorb whilst seeking advice. If you at anytime feel excessive pain, uncomfortable treating the wound by yourself, rebleeding happens, systemically ill a little while after the cut or symptoms worse or are worried seek minor injuries or A&E depending on the situation.
Burns require a different procedure:
Superficial burns (those who just affect the top layer of skin, not too sore, red, warm should be managed under a cold tap for 10 minutes. These burns should be left to air, and moisturiser applied twice a day until healed. Wash hands before applying moisturiser and ensure it is a water based moisturiser. Oil based ones will only make the burn worse and sweat, drying it. Not nice.
Partial thickness burns any larger than a 50pence piece or the size of a quater should be seen by medical personnel. If not treat as the following; run under cold water for 10 minutes, pat dry wounds. Apply either moisturiser (water based fragrance-free) or some burn cream (the best one is Flamazine; or use Neosporin). Apply a non-stick (low adherent) dressing on, preferably a plastic filmed dressing (so Melolin ... NOT MEPORE). Avoid heat, and aim to not get it wet, but moisturise tds or burn cream bd/tds. Change dressing once a day. If it gets infected, see a medical practitioner for antibiotics. If it gets severe, gives a lot of pain or loss of sensation, seek medical advice.
For pain relief, cold but dry ice packs on wound after covering up and some NSAID medication (such as ibuprofen 400mg tds) to be taken in those over 16 (200mg tds for 6 and above)
For full-thickness burns, seek emergency medical advice immediately. Do not apply cold water to the burn. If any clothing has moulded itself to the patient, do not remove. Aim to cool it by running tepid water over it. Apply tepid water over the burn but be careful about temperature drop. Look after the patient, making sure they do not go into respiratory problems, loss of consciousness etc. If this happens place in recovery position without applying pressure to site. Do your DR ABC and Call for ambulance. Call for ambulance is patient has multi-locational wounds that are large. Remove patients clothing and tight fitting garments. Cover patient in warm, clean, dry linens (not cling film)... and leave the rest to us when they get here.
Hope that helps.... and I hope I havent missed anything.
