Wellness: Injuries and Emergencies

Know When a Bandage Will Suffice

Bandages are a matter-of-fact part of everyday life, an easy treatment for minor wounds.

The first pre-packaged bandage was available in the 1920s from Johnson & Johnson. According to the company, a cotton buyer in the purchasing department of the New Brunswick, N.J., company was frustrated when his wife repeatedly sliced her fingertips while working in the kitchen.

He placed a bit of cotton on the sticky side of a thin strip of adhesive tape and covered the whole length with something he could pull off when he took it home. Thus were born Band-Aids, the brand name the company used for the find and the name that has become synonymous with bandage.

Today, we can choose pre-packaged bandages in a staggering assortment of sizes and colors, including transparent versions or those to fit your skin tone. Shapes include those formed like small dogs to fit over fingertips and knuckles without creating pleats that catch on clothing or work surfaces.

There are extra-wide adhesive strips with gauze pads large enough to cover the back of your hand or your kneecap.

How to handle a cut

Are all these pre-packaged wound coverings the best thing for treatment of cuts and everyday injuries? Can we safely smear a scrape with first-aid ointment and expect it to heal, untended, in a few days?

The American Academy of Family Physicians (AAFP) and other experts say yes to the bandages, no to the ointment, and no to loving neglect of any wound.

All breaks in the skin should be covered to protect against infection, the AAFP says.

The first and best thing to do with a wound is wash it with soap and cool water. If it's bleeding, apply pressure to it with a clean piece of cloth or gauze, and elevate it above the heart.

The next step is to look at the wound. If bright red blood is spurting out at intervals linked to your heartbeat, you are bleeding from an artery. This is serious and needs immediate medical attention to stop the bleeding.

Some minor wounds may remain uncovered if they won't get dirty or rub against clothing. Adhesive bandages protect against dirt and irritation from rubbing. Many wounds, such as large scrapes, heal faster and with less scarring when kept moist with occlusive bandages. Most wounds heal well without antibiotic creams or ointments. Never apply a cream or ointment to a burn without checking with your health care provider first.

To stop heavy bleeding, don't use a tourniquet. Instead, use a dry sterile bandage, apply pressure and elevate the wound area. Pressure and elevation will stop the blood flow. A tourniquet, however, will stop all circulation and will cause more trauma to the surrounding area.

All dressings should be changed twice a day. Bandages should be changed even if it means pulling off a part of a scab that's forming. Try to keep the area dry.

Any wound that is on the face, jagged, very dirty, becomes tender or red, develops pus, or is accompanied by a fever or the appearance of red lines coming from the injured area is infected and must be treated by a doctor. Any human or animal bite should be seen by a health care provider.

To stitch or not to stitch

The need for stitches depends on the depth and location of a wound. Wounds that gape open, that are over joints, or that are particularly deep will require sutures for the best cosmetic or future functional results. Cuts on non-fleshy areas, like fingertips and parts of the face, often are not suitable for stitches, but can be kept closed with light adhesive strips.

Gaping cuts require stitches. If you're uncertain whether a wound should be stitched, go to a health care provider. If stitches are required, the wound should be closed within a few hours to decrease the chance of infection.

If a wound is very dirty, or if you fall on gravel or wood splinters, you should go to a health care provider to have it cleaned. The alternative may be long-term infection and serious complications if even a sliver of a foreign object remains in the body. Make sure your tetanus vaccination is up to date.

Also, puncture wounds can push particles of dirt deep into the body. If you haven't had a tetanus shot in five years, get one if you have suffered a puncture wound or a scrape or cut from any item that is dirty.

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