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Stop germs from taking over

Overprotective moms of the world are right. Germs are everywhere. So when the sidewalk scrapes, the stove burns, or the hammer nails you, a zillion germs see an opportunity to infect. So call in the germ busters. A good first-aid kit always contains antiseptics and antibiotics as the first line of defense against infection. Antiseptics are effective cleansers and are defined as "antimicrobials" or "germicides" because they kill bacteria and other microorganisms. First-aid antibiotics are used in preventing infections in minor cuts, scrapes, and burns. So treat that wound with a little TLC and a good slathering of ointment.

Preventing Microbe Mayhem

When injuries occur, antiseptic and antibiotic creams, ointments, and sprays may be used to protect the wound from microbial contamination. Antiseptics are used primarily to kill the germs on intact skin around a wound. Topical antibiotics are used primarily to fight or prevent an infection in a small superficial wound. It is generally not necessary to apply both an antiseptic and an antibiotic.

Antiseptics should only be applied to intact skin.
Antibiotics should only be applied to superficial wounds.
Many antibiotic and antiseptic products also contain topical pain-relieving agents.
When choosing an antibiotic, it's usually best to select a combination product that can fight more than one type of bacteria. Such broad-based antibiotics are usually mixtures of such active ingredients as neomycin, polymyxin B, and zinc bacitracin.

Topical antibiotics

Used in first-aid products, these agents fall into two classes: polypeptide antibiotics (which include bacitracin and polymixin b sulfate) and aminoglycosides (neomycin). These topical medications are usually found in combination to prevent infection in minor cuts, wounds, scrapes, and burns. Combinations of antibiotics work best because they are able to kill a broad spectrum of bacteria to help prevent infection.

Antiseptics

Approved to disinfect intact skin. Many antiseptics are available for use without a prescription; common ones include alcohol, isopropyl alcohol, iodine, povidone-iodine, and hydrogen-peroxide. To avoid interference with the body's natural healing process, it is recommended that these products only be used externally.

Ingredient		Description
Topical Antibiotics
Bacitracin	?	A polypeptide that prevents bacterial cell wall production, it is effective against gram positive bacteria. Allergy is reported in 2% of individuals using this antibiotic. Formulation of bacitracin as a zinc salt appears to enhance its antibacterial effect.
Neomycin	?	Neomycin prevents protein production in bacteria (gram negative and gram positive), but has a 3.5% to 6% reported frequency of allergy. It is often incorporated into antibiotic combinations to avoid developing resistant strains.
Polymyxin B	?	Like bacitracin, polymixin B interferes with bacterial cell wall production. It has an extremely low incidence of allergy, lower than the other two antibiotics. It is effective against gram-negative bacteria.
Antiseptics
Ingredient		Description
Alcohol	?	Alcohol is the common name for ethanol. In concentrations of 20% to 70% (48% to 95% by volume) it has antimicrobial activity. Allergic reactions and other side effects are rare. It is relatively nontoxic in small quantities, but unsafe if applied externally to large, open wounds.
Isopropanol	?	Another alcohol, it is found in concentrations from 100% to 70% (50% to 91.3% by volume). It has a slighter better antimicrobial effect than ethanol. It is highly toxic when ingested, but it is an effective antiseptic when swabbed on the skin. It works more slowly and less effectively against viruses and fungi.
Iodine	?	Iodine in 2% iodine and 2.4% sodium iodide is an effective antimicrobial agent. Use of iodine in alcohol mixtures is more irritating to the skin.
Povidone-Iodine	?	This compound is a complex of iodine with povidone. Effective in solutions that contain between 9% to 12% iodine.
Hydrogen Peroxide	?	Hydrogen peroxide is a safe and effective antiseptic that inhibits the growth of a large variety of bacteria.
Phenolic Compounds	?	At low concentrations phenol has antiseptic properties and relieves itching and pain. At concentrations over 1%, phenol starts to irritate skin.
Hexylresorcinol	?	At 0.1% hexylresorcinol is safer and less toxic than phenol as an antiseptic for inhibiting bacterial growth. However, it may be irritating to skin.
Quaternary Ammonium Compounds	?	These compounds (including benzalkonium chloride, benzethonium chloride, and methylbenzethonium chloride) have antimicrobial and surfactant properties. Check directions for specific products since they may need to be diluted before being applied to skin. They are very strong antiseptics. However, they can be irritating to skin.

FDA-Approved Uses

Antiseptic and antibiotics

First aid to help decrease the risk of infection, the chance of bacterial contamination, and the chance of skin infection in minor scrapes, cuts, and burns

Iodine

For preparation of skin prior to surgery

Helps reduce bacteria that can cause skin infection

Alcohol

For preparation of skin prior to surgery or injection

Helps reduce bacteria that can cause skin infection

Products labeled for healthcare handwash

Help reduce bacteria that potentially can cause disease

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. Be careful not to prick yourself.
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 diluted. Antiseptics may be used up to three times per day on the intact skin around the wound.
Only five substances have been classified by the FDA as safe and effective when uses as first-aid and pre-operative antiseptics:
- Iodine tincture (USP)
- Povidone-iodine complex (5% to 10%)
- Iodine topical solution (60% to 90%)
- Alcohol (60% to 95%)
- Isopropyl alcohol (50% to 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 commonly available antibiotics were among the various agents deemed safe and effective by the FDA:
- Bacitracin
- Neomycin
- 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 eight hours after the injury occurs to clean the wound thoroughly.
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.
With clean hands, open the bandage packet. Don't touch the gauze pad.
Secure one side of the strip before removing the backing from the other.
Press down firmly and then attempt all normal movements you'll be making. Make sure that the bandage doesn't pop up, wrinkle, or bunch during any of these.
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