Cleaning and Disinfecting Wounds
All too often a small cut or abrasion turns into a much more serious matter because of poor cleaning and disinfecting leading to infection and inflammation, which, if left untreated, can even lead to fatal systemic conditions like septicaemia. The skin normally acts as a protective barrier against any bacteria and other pathogens lurking on your body but the minute that defence is breached, bacteria start entering the wound and multiplying exponentially.
So it is a good idea to have a sound knowledge of how to clean and disinfect any cuts, puncture wounds or abrasions.
First…Before touching the wound, make sure that you have scrubbed your hands thoroughly with soap and warm water (refer to the article “Clean Hands” for the correct way to wash hands effectively), and ideally dry them on disposable paper towels.
Also make sure that you have collected all the equipment and materials you need and that you have sterilised everything effectively using either steam, boiling water or (most conveniently) alcohol wipes - or are using freshly-opened materials such as bandages and dressings. Especially if you will be touching a wound on another person and will be in contact with bodily fluids such as blood, it may be a good idea to put on latex gloves after washing your hands to prevent the spread of infection.
Next…If it is a small cut or abrasion, flushing the area with soap and running water, or a saline solution should suffice. Alternatively, you could use the many commercially available antiseptic or alcohol wipes. For larger, deeper wounds, it may be wiser to use a proper disinfectant – such as a dilute solution of iodine and water or chlorhexidine gluconate (e.g. as in “Savlon”).
If things are urgent and you do not have a disinfectant solution handy, you can make up an "emergency" disinfectant with salt dissolved in boiled water (sterile saline solution). Never use neat alcohol or neat iodine on an open wound – these are both too powerful and may damage the tissues. However, you can use them to clean and disinfect the skin around the injury.
Then…All open wounds are contaminated so using sterile tweezers pick out any debris embedded in the wound to discourage the further growth of bacteria. This is particularly important when you have abrasion wounds, such as the skin scrapes that occur when you fall from a bicycle or something similar, as any debris left in the wound can cause painful infection as well as an unwanted tattoo left under the skin, if it isn’t thoroughly cleaned. If you find that you cannot effectively remove all particles from a wound yourself, it is best to seek medical help.
Once you have cleared the area, you can irrigate the wound again with your disinfectant, using a sterile eyedropper if necessary, to reach all areas of the wound. You can follow this with an anti-microbial or anti-septic cream, ointment or spray. This must be done immediately after cleaning the area as the body will quickly form a seal over the wound, which the antiseptic won’t be able to penetrate.
Finally…You may place a bandage or dressing over the wound to keep it clean and prevent further debris from entering the vulnerable area. However, make sure it is not airtight as sealed wounds are more likely to become infected. Contrary to popular belief, a moist wound is actually not an infection risk, as long as it is not oozing pus and fluids – a slightly moist wound is actually more likely to heal quickly, compared to a dry, hard scab. Change the bandages or dressings regularly so that the wound does not become too moist or too dry and you may need to further irrigate with disinfectant each time you change the dressing.
Resist the temptation to touch or pick at the wound as it is healing, particularly when your hands have not been thoroughly washed. As the wound heals and the skin reforms, it is natural to experience itching and irritation but it is vital that you allow the injury to heal of its own accord, as picking at it even at this later stage can still introduce infection or even lead to permanent scarring.
NOTE: for serious puncture wounds, such as dog bites, it is important to seek medical help and possible receive a dose of antibiotics.