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Practicing first aid the old-fashioned way
Gauze is a common choice for those who prefer dressing a wound the good, old-fashioned way, cutting gauze and tape themselves. However, you should be aware that ideas about wound treatment have changed, and now medical professionals are advocating synthetic dressings rather than cotton gauze. Why? It's now believed that giving the wound a moist environment helps speed-up healing and reduce scarring. Gauze, made of cotton and/or polyester, tends to dry out the wound by soaking up excess fluids. However, don't rule out gauze completely: if you have a wound whose dressing needs to be changed frequently or which has an excessive amount of fluid, gauze may be just the thing. It should also do perfectly well for small wounds and slight abrasions.
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Treating a Wound
Sterile gauze is used to clean or dress wounds, not only to protect them from the environment, but also to soak up fluid or pus. However, contrary to popular belief, while gauze should soak up excess fluid, it shouldn't dry the wound. Gauze dressings, just like bandages, should provide the wound with a moist, clean environment.
Contrary to previous practice, extensive research has confirmed that treating a wound by leaving it open to air or covering it with gauze may actually hinder recovery and increase the chance of infection and scarring. Healthcare professionals now advocate maintaining a moist, clean environment for the wound as an ideal way to promote healing.
Oozing wounds are a sign of serious damage. Consult the advice of a healthcare provider if your wound has been oozing for more than 24 hours.
Gauze offers the following important properties that aid in healing wounds:
- Absorbs excess fluids flowing from the wound site
- Provides and maintains a moist environment.
- Allows oxygen to circulate and reach the wound
- Blocks out bacteria
- Provides thermal protection for the wound
- Does not shed or disintegrate
- Upon removal, does not inflict any trauma upon the wound or surrounding tissues
Regular vs. Synthetic
Cotton gauze has a tendency to dry out the wound more than the new synthetic materials. If you must use gauze, purchase products made with "surgical grade" cotton, which is less likely to break down and leave bits of cotton in or around the wound.
Because wounds need a moist environment in order to heal, try synthetic products, which are less likely to dry out the wound than traditional cotton gauze dressings.
Other Features to Look For
- Gauze comes in many shapes and sizes: it can be pre-cut into sponges or sold in long, rolled-up sheets.
- You can purchase elasticized gauze, but you should only use it if your doctor has shown you how to apply it. Be careful not to wrap too tightly and cut off the important circulation of fluids to the wound.
- For particularly severe wounds there is a gauze-like product coated with a petroleum-based substance, which serves as a barrier between the wound and the dressing to ensure that the dressing doesn't stick to the wound.
- For more serious wounds that require frequent cleaning and dressing, consider purchasing a higher-quality gauze.
- How are the edges of the gauze pad kept together? Are the edges smooth or rough?
- Some gauze comes in sterile packaging while other comes in non-sterile, usually bulk packaging. Determine which is best for you.
- Gauze should be able to protect wounds but allow for a certain amount of air circulation. Gauze which seems too tightly woven may not suit your purposes.
- How likely is the gauze to fray or present loose edges? The higher the quality the less likely the gauze is to degrade despite constant handling and exposure to adhesives.
- Some gauze can be ordered according to your own specifications. This can be particularly useful if you need dressings for a long period of time or for awkwardly-situated injuries.
- Try to balance quality with price. Proper wound dressings are an essential part of the complete healing of a wound. They can also reduce the amount of scarring.
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Uses of Gauze
- Gauze is used as a dressing for wounds, particularly those too large or deep for regular bandages.
How Does Gauze Work?
- Cotton gauze is cotton with threads of elastic woven into it.
- Applied to the wound, it is designed to soak up fluid without sticking to the wound.
- The mesh on the gauze is designed to drain excess fluids away from the wound, but it should also maintain a moist environment.
- Gauze with a petroleum coating serves as a buffer between the wound and the gauze, creating a non-stick dressing.
- Gauze of this type is usually reserved for serious wounds and abrasions.
Assessing the Damage
- Abrasions are wounds resulting from friction or rubbing type injuries. They are not deep and only extend to the top level of the dermis (the second layer of skin).
- Punctures are the result of sharp objects jabbing into and piercing the skin. They typically break through the epidermis (topmost layer of skin) into the dermis (the second layer of skin). Sometimes, punctures penetrate deeper than the dermis, a very dangerous situation. These should definitely be examined by a physician for debris and depth. Also, consult a physician if the puncture was caused by a rusty object because you may need a tetanus shot.
- Lacerations are the cuts you get from sharp objects such as knives. Like punctures, lacerations can penetrate many layers of tissue and should be evaluated by a physician.
Treating Minor Cuts and Scrapes
- Your first priority is to stop the bleeding if you have a cut. If possible, raise the wound above heart level to reduce pain and bleeding. This can be easily accomplished if you lay down.
- You can also stop bleeding by applying pressure to the wound with your fingers.
- Next, you need to clean out the wound.
- The point of cleaning the wound is not just to clean the skin around the wound but to clean inside the wound.
- Even if it hurts, you need to irrigate the wound with soap and water or just water.
- This does not mean just letting a light stream of water trickle over the injury.
- Water must be of significant pressure to flush all the dirt out of the wound.
- One of the best ways to get adequate pressure is to fill a 10cc, 18 gauge syringe with water or saline solution and point it at the wound and spray.
- Don't prick yourself! (OUCH!)
- If you have an abrasion and you have small pebbles under your skin, consult a doctor. These can get trapped under the skin as the wound closes.
- Antiseptics should be used inside the wound only if they are very dilute. Antiseptics may be used on the intact skin around the wound up to three times per day.
- Only five substances have been classified by the FDA as safe and effective as first-aid and pre-operative antiseptics:
- Iodine tincture (USP)
- Povidone-iodine complex (5% to 10%)
- Iodine topical solution (2% to 7%)
- Alcohol (60% to 95%)
- Isopropyl alcohol (50-91.3%)
- Are you surprised that you didn't find hydrogen peroxide on the list? Though it is one of the most widely used at-home first-aid antiseptics, hydrogen peroxide is one of the weakest antiseptics on the market. It can cause tissue damage because of the fizzing and should never be poured into abscesses.
- Even saline solution, or nine grams of salt per one liter of water, will do an adequate job as an antiseptic.
- A topical antibiotic can be applied if the wound is not a deep puncture.
- The following antibiotics were deemed safe and effective by the FDA:
- Bacitracin
- Neomycin
- Chlortetracycline hydrochloride
- Combination products containing oxytetracycline hydrochloride
- Polymyxin B sulfate
- Usually, applying both an antiseptic and an antibiotic is not necessary; one will suffice.
- The most important thing is to clean the wound thoroughly. You have until 8 hours after the injury occurs to clean the wound thoroughly.
- Make sure the skin that the adhesive will be sticking to is dry. Otherwise the adhesive won't stick properly!
- Cover the wound with a dressing that will keep it moist, while allowing oxygen exchange. A topical antibiotic can be applied if the wound is not a deep puncture.
Applying a Bandage
- Make sure that the skin is completely dry and all cleansers have been thoroughly rinsed.
- You might consider shaving the area to reduce pain when you have to change the dressing and remove adhesive tape.
- If shaving is impossible or undesirable, consider using paper first-aid tape as a barrier between your skin and the adhesive tape.
- If your dressing will require frequent changing, using paper first-aid tape can be helpful in avoiding the pain of removing adhesive tape and possible irritation from adhesives.
- Hold the gauze in place and tape around the edges of the gauze.
- Don't tape over the gauze that sits on top of the wound. You want to avoid any chance of the gauze sticking to the wound
- Never apply a bandage too tightly. This can hinder the healing of the wound.
- Do not change the dressing often. Frequent changes can slow the healing process by removing new layers of skin. Change it only if it is dirty.
- Check to see that the wound is healing properly. In particular, check for infection. A noxious smell and worsening pain are signs of infection, but initial redness and swelling are not. Other signs of infection are crusty, oozing lesions and fever.
- Consult a physician if you suspect infection or if the wound occurred in a dirty area. Do not risk infection.
- Bandages should be changed:
- When the gauze pad is saturated with fluid from the wound.
- If the skin has become dirty.
- After excessive sweating.
- After showering or if the bandage has become wet.
- If unpleasant odors are coming from the gauze pad.
When It's Time to Call the Doctor
- Don't even try to treat these wounds by yourself.
- Deep punctures or lacerations.
- Wounds that do not heal.
- Infected wounds.
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Dressing a Wound With Gauze
- Make sure the gauze does not dry out the wound. This will slow down the healing process and could cause scars
- Gauze can inflict trauma on the wound when it is removed, so be careful.
- Since gauze doesn't adhere to the skin on its own, you'll need what is called a "secondary dressing" to keep the gauze in place.
When the Injury Is Serious
- If you have been punctured by a rusty object, seek the advice of a doctor as you will need a tetanus shot.
- Puncture wounds that are deep need to be treated by a doctor -- bacteria and dirt can be impossible to remove at home and can cause infection.
- What is considered a deep puncture wound? Use common sense. A deep wound on the bottom of the foot should absolutely be seen by a doctor, while a one-third-inch-deep puncture in your buttocks is less serious.
- Seek the advice of a doctor if you have an abrasion that affects a large portion of your body or if pebbles and dirt are trapped under the skin.
- If the wound is near an artery, it is best to seek the advice of a doctor.
- If you cannot stop the bleeding, seek the advice of a doctor.
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Websites, Organizations & Manufacturers
Sources & Further Reading
Books
- 1. American Medical Association.The American Medical Association: Guide to your family's symptoms. Washington, D.C.: American Pharmaceutical Association 1992.
- 2. Fauci, Anthony S. et al. Eds. Harrison's Principles of Internal Medicine, 14th ed. New York: MacGraw Hill 1998.
Find more books on health and wellness at  barnesandnoble.com.
Articles
- 1. Rahman, Shireen."Sportin' slips: how to prevent and care for sports injuries". Diabetes Forecast; Vol. 48 1/1/1995.
- 2. Schwade, Steve."Bandage wrap-up". Prevention; Vol. 46 6/1/1994.
- 3. Accerrano, Anthony."First aid for wounds". Sports Afield; Vol. 211 1/1/1994.
- 4. Tilton, Buck."Medical cover-ups". Backpacker; Vol. 23 8/1/1995.
- 5. Leibowitz, Ed. "Hot spot bandages try to keep everyone covered". Newsday; 1993.
- 6. Weiss, Eric A. "How to repair your skin: What to do on those occasions when a bandage just isn't enough". Backpacker; Vol. 23 10/1/1995.
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