Wound Care

Abrasions The primary objective is to remove the foreign materials from the wound and excise the devitalized tissue and control arterial or venous bleeding.

Clean wound with soap, water, or poloxamer 180 (Shur-Clens) Use non sterile gauze sponges in a circular motion Working from the middle to the outer border of the wound. Discard Sponges every 10 revolutions. If foreign matter is in the wound, hydrogen peroxide may Be used to further clean the wound. (Hydrogen peroxide will also flush the normal epithelial cells from the wound) Use Betadine to clean around the border of the wound. Flush the wound with clean or sterile saline. Dry the wound with sterile gauze pads. Apply Bioclusive or a hydro colloid type dressing (DuoDerm, etc.). Cover with stretch gauze if needed. The wound will build up tissue exudate under the dressing, this is normal. You should always look for signs of infection ie: redness, sour smell, pus, cellulitis. Clean the wound with water or poloxamer 180 only at this time, applying Betadine, peroxide, or other cleaning agents will damage the new tissue cells. Re apply sterile dressing. Repeat until wound is healed. Note that antibiotic ointments are not needed. This type of wound care is a radical departure from the old norms but has been met with great success.

DuoDerm application over a deep medial tibial abrasion.

Lacerations Clean with soap, water, and poloxamer 180. Flush with sterile water - saline solution. Apply direct pressure to stop the bleeding. Evaluate whether the wound needs suturing to close or if sterile skin closures be used. Wrap in pressure dressing using sterile materials and refer to your physician.

Burns Clean with soap, water and Shur Clens (poloxamer 180) Flush with sterile water - saline solution For Grade 1 and Grade 2 burns, apply DuoDerm or a similar product. Do not put anything over Grade 3 burns

Burn Grade 2 burn Shur Clens and other products

4 day old burn. Notice the red center of the wound 4 day old burn. Notice the red center of the wound. This is healthy tissue with good circulation. The whitish area is dead skin around the blister from the burn. This was later trimmed away. This is a 10 day old, 2nd degree burn that is completely healed. Some sort of soft tissue protection is needed for daily strenuous physical activities but not for ADL's.

This "turf burn" will be followed every other day and will not be treated with a hydrocolloid type dressing. This patient tends to have folliculitis with occlusive dressings. No DuoDerm has been applied. Notice the continued weeping of the wound. 4 days old.

Minimal Arm protection is used by this patient. The forearm abrasion is virtually healed after one week of hydro-colloid (Duo-Derm )treatment

These burns were the result of a tackle on the turf These burns were the result of a tackle on the turf. (new Astro) The soft tissue trauma from the burn makes knee examination difficult. This wound has progressed rapidly over a 4 day period. Knee abrasion is healed.