Cleaning a wound in a non-sterile environment?

Diamondback 2/2

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Okay a “Dooms day” question here for the medically stupid.

How would some of you medical professionals advise someone with limited medical training to clean a wound to avoid infection? My question comes from the idea that normal medical services are not available and wound care is necessary with limited household items.


Scenario:

Your city has suffered a catastrophic event causing emergency services to fail. You have been basically cut off from the normal amenities or abilities to get standard medical supplies. You have a member of your family who has sustained a leg wound (6-inch laceration on the upper thigh) the wound is not fatal and the bleeding has been controlled.

Fill in the blank….

Action:

Condition: Laceration wound with bleeding controlled, only household products available to clean wound.

Standard: Clean the wound to avoid infection.
 

txpj007

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its gonna burn like a mother...but just good old anti-bacterial soap. also you would want to use gravity to flush it out. so say if it was a vertical laceration you would want to flush or pour water on it from the top down. so all the bad shit flows out the bottom. if it was a horizontal lac then the same principal would apply. roll to one side and wash in one direction.

you trying out for a game show or something?
 

Polar Bear

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Pee on it works for ear infections too....So I have heard but I am not letting anyone pee on me
 

Nasty

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Very worst case..lots and lots of water, but as the PJ said, soap and water would be better.
 

x SF med

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Ok... Assuming this is not a clean knife wound, but rather a traumatic laceration without clean edges, and intrusion of particulate and possible other foreign matter. Basing on a 6" long x 1-2" deep thigh laceration with no arterial, venous, ligament or tendon involvement - based on the above- time is not critical, this is a semi-secured area .

a. Stuff:

1. What is the availability of potable water? What is the availability of any water? If potable water is plentiful boil it for 2 minutes, just for safety's sake, cool it to just about body temp. If the water is suspect - filter through cloth (multiple layers) to remove sediment, then boil vigorously for a minimum of 8 minutes, and cool to just above body temp. (unless you're like me and keep a couple of bottles of sterile water in your med kit) make sure you have at least 1.5 gallon of water.

2. Got a turkey baster? got a Garlic injector? Got a soft toothbrush? tweezers? long needles? got a good sized bowl or two? Boil them separately from the water to be used for the actual cleaning.

3.. How well stocked is your home? (I personally keep betadine around, but that's me) No accdess to betadine or one of the other surgical scrubs or iodiform antiseptics... Dishwashing detergent, antibacterial soap, any soap you have on hand...

4. Towels, washcloths, clean rags...

5. More bandages, and preparation to control bleeding again - a good cleaning WILL restart bleeding.

b. Procedure:
*****THOUROUGHLY WASH YOUR HANDS - TWICE - NO, MAKE THAT THREE TIMES - UNDER YOUR NAILS, UP TO YOUR ELBOWS -REALLY CLEAN - AND GLOVE UP IF YOU HAVE THEM.*****

1. gather clean materials, one towel underneath the area to be scrubbed - you need to create a clean (not sterile) field to work.
2. fill one bowl with clean water, fill one bowl with clean soapy water, keep remainder available. If you are using betadine in the water, 1 oz betadine to a quart of water should be sufficient - if you are worried about the cleanliness of the water go to 2 oz/qt. If all you have is soap - a good sudsy mixture is all you need - about 1-2 tbsp per qt of water
3. with a clean soapy washcloth(not too wet) wash surface area- at least 6" out from the wound edges - to keep from reintroducing junk into the wound. Do not put this back into your clean soapy water
4. with a clean damp washcloth, rinse/wipe any soapy water from your clean field.
5, Really Inspect the wound, look for debris, and matter, anything that looks like it's not just plain meat (because there's no other involvement at the moment does not mean you're not close) - that's the first stuff that needs to be removed.
5.a. Remember that turkey baster or garlic injector? fill it with either the plain clean water or the clean soapy water - irrigate, put some force into the water stream, to help dislodge junk using gravity to help flush the wound.
5.b. repeat step 5.a.
6. there are a few large pieces of junk still in the wound, nothing shiny (tendons,ligaments, bones), pulsing or veiny looking - it's a deep meat cut.... using your tweezers or sharp needles pick those large pieces out - can't get them? dunk the soft toothbrush in the clean soapy water and gently scrub them loose.

note- the above and below will restart bleeding - this is good, helps flush the wound - we won't try to recontrol immediately, unless it becomes a major torrent.

7. still got your toothbrush? good, lightly scrub the entire wound. Grab your turkey baster and fill with clean water - irrigate
8. Irrigate some more
9. irrigate a little more
10. dry the area.
11. inspect the wound - what do the edges look like - clean, jagged, what? this is going to get you to the bandaging.

recontrol bleeding at this time - the wound should be clean.

wound closure/Bandaging - depends on your materials - based on the description of the wound - sutures would be optimum closure - but I think butterfly closures / steristrips would be easier/faster/less traumatic to both parties involved. (Assuming fairly clean edges to the wound) -starting at the top of the wound one sticky side of the butterfly 'wings' on one side of the wound and pull that to the other edge of the wound, keep the edges together, no puckering or overlap - hold together, place other sticky side on the other side of the wound - repeat every inch or closer if you can - make more butterflies from surgical tape if you can. When finished - spay with nu-skin if you have it. the bleeding should be controlled - so wrap loosely to protect the wound if the person doesn't have to move for a while - if you have to move out, bandage snugly but not tightly.

Check the wound on a regular basis - 2x a day minimum, to see if any signs of infection appear.

This was probably more than you wanted, but hey, you asked.
 

HoosierAnnie

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DaTroll hit the nail on the head. Just thought I'd throw in this lil bit of medical triviata. If you are in need of setting up a "as close to sterile as possible" field outside a health care feacility, raid the nearest newspaper box. Due to the heat use in the process of printing the papers, the inner pages, until touched, are damned near sterile.
 

pardus

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raid the nearest newspaper box. Due to the heat use in the process of printing the papers, the inner pages, until touched, are damned near sterile.

That is bloody interesting right there!

Great break down xSF!

I've learnt a lot tonight thanks to the Troll and now Annie.



I was going to say use half a can of beer to flush the wound, drink the other half, repeat until you don't give a shit if you live or die. :D
 

txpj007

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xSF --- x100---i took the still eatin breakfast, got a lot of shit to do today approach to my answer. good shit, you blew me out of the water.
 

x SF med

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Common sense is your best guide in these situations... stuff that you don't think about can be used in many situations... like Annie's newspaper... roll it nice and tight and you have a field expedient baton to beat the shit out of your enemy.... rolled newspaper can also be used as the stabilizer for a broken bone... unroll it and tear it up.... toilet paper... crumple it a little (before or after use as toilet paper) and you have a fire starter (waste not, want not)....

Hmmm... idea for a new thread... creative uses for houshold items in a SHTF situation...

Thanks for the kind words... but, I'm still a bastige...
 

Diamondback 2/2

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Thans X-SF! and everyone else!

I had the thought in my mind that i have all this trama kit and know how to keep someone alive somewhat but know jackshit about long term care. Big issue being small wounds becoming big problems due to infection...
 

medic1

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Should have bleach or iodine in the house, can use to make the water potable as well as cleaning the wound [dilute of course!!].....
 

Brooklynben

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X SF Med nailed it. Some other options might be;
Fill an unused 'baggie" or zip-loc bag with water, snip one corner and you have fairly sterile method to stream water to irrigate wounds. Squeeze the bag for more powerful irrigation.

UV light has all sorts of antiseptic properties. I've had some luck (after cleaning) letting fresh wounds get about 15 minutes of direct sunlight (obviously, when time and conditions permit). The down side here is that too much sunlight can overly dry and damage the connective tissues at the edges of the wound. I have a couple of gizmo's I keep in my kit which put out very specific UV frequencies in light - work great on all sorts of things. People often use hydrogen peroxide or mercurochrome on wounds - I avoid these astringents as they're VERY tough on the connective tissues of wounds. Ex SF Med's advice of using soap and water is the best I know of right now.

I know this may sound strange, but if the wound can't be closed tightly and has exposed dermal or subcutaneous tissue, you can pack it with white granulated sugar. Sugar is completely antibiotic and you simply clean and re-apply when the packing/bandage turns to syrup. This method has been used for years and I can supply the medical references if needed. In the same way; honey dipped bandages are outstanding treatment for burns.

If you're interested in this stuff, there's a couple of good books; "Ditch Medicine" and "Where There's No Doctor" are very good starters.
 

LibraryLady

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... I know this may sound strange, but if the wound can't be closed tightly and has exposed dermal or subcutaneous tissue, you can pack it with white granulated sugar. Sugar is completely antibiotic and you simply clean and re-apply when the packing/bandage turns to syrup. This method has been used for years and I can supply the medical references if needed. In the same way; honey dipped bandages are outstanding treatment for burns...

Not strange at all, BB. Sugar and honey are time-honored wound remedies in the veterinary world. They do a real good job of minimizing the scarring also.

LL
 

Starbuck

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This is a great thread - I'm going to mention some of this stuff next time I teach a cadet survival class! :)

Also, I've never tried this, but one of my instructors told us that you could make a poultice with plantago (common lawn weed) to control bleeding, as long as the person didn't have a history of blood clots or anything. You could use horsetail plant (I think) to make it heal faster and bouncing bet/soapwort to make a substitute for soap.

Does anyone know if these things really work?
 

pardus

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I know of a certain type of moss, that I only know by sight that contains penicillium the pre thingy to penicillin and has been used for thousands of years by our ancestors.
I've also been taught by an SF medic that moss can be used quite effectively to stuff a wound to stop bleeding.

I have to ask you, why the hell would you care if someone has a history of blood clots when thinking about stopping them bleeding out?
They will die in 2 - 5 minutes if you dont use the thing that might cause reversible clots. :uhh:

Then again, I'm the most junior douche medic you can get lol

This is a great thread - I'm going to mention some of this stuff next time I teach a cadet survival class! :)

Also, I've never tried this, but one of my instructors told us that you could make a poultice with plantago (common lawn weed) to control bleeding, as long as the person didn't have a history of blood clots or anything. You could use horsetail plant (I think) to make it heal faster and bouncing bet/soapwort to make a substitute for soap.

Does anyone know if these things really work?
 
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