Cleaning the Wound

1
Examine the wound. The first step in treating any injury is to examine it closely. You'll
need to determine the nature and severity of the wound. Take a close look at the injury
and pay attention to the following:[1]

The amount of blood. How rapidly is the person bleeding? Does the blood
come out in a steady flow, or is it pulsing?

Foreign objects in the wound. This might be the cause of the wound itself,
like a fishhook, or a piece of glass.

Dirt or debris in or around the wound.

Evidence of a bone fracture, like a protruding bone, swelling over a bone,

or inability to move a limb. Look for this especially if the person was injured in a fall. [2]

Evidence of internal bleeding, like swelling, large purple areas on the skin,
or abdominal pain.[3]

In the case of animal attacks, look for signs of bites and multiple injuries. If
you live in an area where there are venomous snakes or insects, it may be helpful to
know what those injuries look like.

2
Determine if medical attention is needed. You can often treat minor wounds at home.
But, in the case of a serious wound, the injured person should see a doctor immediately.
Seek medical attention if:

The wound is bleeding a lot, the bleeding is pulsing, and/or it won't stop.

The wound is more than one centimeter deep. This may require stitches.

There is any significant head trauma.[4]

There is evidence of a bone fracture or internal bleeding. [5]

The wound is dirty and the injured person has not had a recent tetanus

vaccination. This is especially important if the wound came from a rusty metal object.
[6]

The person is known to be taking blood thinners. This is especially

important if the person has suffered head trauma.

3
Stop the bleeding. Apply gentle pressure to the wound using a wad of cloth or gauze,
with excess fabric wrapped around the wounded area. Elevate the wounded area above
the person's heart, if possible.
Elevating the wounded area will decrease blood flow to the wound and

decrease bleeding.[7]
If bleeding doesn't stop within 10 to 15 minutes, seek immediate medical

help.

[8]

4
Remove small foreign objects. If there are any objects in the wound that you can
remove (such as a a small rock, splinter, or fishhook), carefully take them out.

Use sanitized tweezers for small objects, if you have them available.

Do not remove large objects from a wound. You can further open the
wound and increase bleeding.[9]

If there is a large amount of debris in the wound, especially if the wound is

large (e.g. a "road rash" injury), seek medical attention. Removing the debris can
require painful scrubbing, and a local anesthetic may be a good idea.

5
Irrigate the wound. Once the bleeding has stopped, the next step is thoroughly cleanse
the area with warm, flowing water. This is arguably the most important step for
promoting speedy recovery.[10] There are several good ways to do this:

Use a bulb syringe (available in most drug stores) filled with warm tap
water or normal saline (you can use a large bottle of saline solution for contact lenses if
you're in a pinch). Squeeze the liquid out onto the wound. Repeat for a volume of
approximately two liters. You won't need to irrigate as much on the face or scalp. These
areas have many blood vessels and will clean the wound naturally through bleeding.

A 60cc syringe with IV catheter tip provides the best volume and pressure
of irrigation. It also provides directed irrigation to get behind skin flaps and other difficult
areas. If you go to a doctor for care, this is most likely what he or she will use.

You can also use running warm tap water. Run at least two liters, the size
of a large plastic soda bottle, over the wound. Continue until all wound areas are free of
debris and all flaps cleaned under.

Wounds from burns should be generously irrigated with cool water to bring

down temperature.[11] In the case of chemical burns irrigation dilutes the chemical and
reduces tissue damage.

6
Bandage the wound. After cleaning the wound, wrap it in a clean bandage. Bandaging
restricts mobility so that wound edges can come together and heal. It also protects from
further injury and infection.

Use a bandage that is slightly larger than the wound itself. [12]

Any commercially available bandage material will work for most wounds.
Gauze is the mainstay, either rolled or in 2x2 or 4x4 options depending on wound size.

Burns, abrasions, or wounds with irregular edges should be covered with a

non-stick or Telfa pad, as dried blood and healing skin can stick to gauze.

Iodine impregnated gauze is best for wounds need to stay open, such as
abscesses or puncture wounds.[13]

Managing the Wound

1.

Reexamine the wound daily. After 48 hours, recheck the wound daily.Carefully remove
the bandage and look for signs of infection or other complications. Contact a doctor if
you see signs of infection.

If the bandage is crusted on to wound and won't come off easily, soak it in
warm water.[14]

While the wound is exposed, assess for signs of infection. These include
redness of the skin around the wound edges or redness progressing up the injured limb.
Look for drainage of pus or that is greenish-yellow in color. [15]

Feel gently with your fingers for warmth in the area, and increased
swelling. These can be warning signs, especially in the presence of redness.

Check the injured person's temperature for fever. Anything of 100.4 or

above is cause for alarm, and you must seek immediate medical attention.

If an infection becomes trapped inside the skin, the wound may need to be
reopened by a doctor. Some infected wounds require antibiotics or even an operation
under general anesthesia. This is especially common in cases where the wound was
not irrigated properly.

2
Irrigate the wound. If the wound is clean, irrigate again to maintain cleanliness. Just
run water over the wound for one minute. Wash any clotted blood off with soap and
water.
Use soap and water to clean the surrounding skin and parts of wound that

are not wide open. Sing the birthday song twice while sudsing and you will have done a
thorough job!

3
Apply an antibiotic. Once is it cleansed, apply a small coating of neosporin or other
topical antibiotic ointment to the wound with a Q-tip. This reduces the chances of
infection.[16]

This is not a substitute for thorough cleaning and irrigation. Apply

sparingly, and if the wound is macerated, let it dry before applying any ointment.

4
Bandage the wound. Place a clean bandage over the wound. Between inspections,
keep the bandage clean and dry.

Repeat the inspection process daily until the wound is healed.

Continue to elevate wound as much as possible, for at least the first few
days. This will minimize pain and swelling.
a