When I see the way some wounds are dressed here it makes me shudder. It wasn’t long ago that the only dressing available here was a roll of gauze and a bottle of bright red mercurochrome.
Thankfully the mercurochrome is off the shelves. As the name suggests it does contain mercury and this is why many countries banned the antiseptic solution. Even today I see open wounds dressed with gauze, that adheres to the lesion, ripping the wound open every time the dressing is changed….ouch!
Even some supposedly reputable clinics have no idea how to dress a wound in such a way to promote maximal healing. Another common mistake is to bomb the wound with every antiseptic under the sun. Everything from undiluted dettol, bleach, hydrogen peroxide, alcohol, betadine etc etc.
Basically all this does is burn the tissue and kill off any cells that are attempting to heal. The best way to clean and flush a fresh wound is with sterile water (aqua), saline (sterile salty water if you have it), or if the wound is dirty, a tablespoon of betadine in a bottle of aqua will do the trick. You can pat the wound try with sterile gauze (kassa sterile).
If there is a need for antibiotic cream Fucidin or Bactroban are the best.
HOW TO DRESS A WOUND
Sterile gauze (Kassa Sterile) – Gauze should never be applied and left directly on the wound. This is used for cleaning wounds or to pad the dressing out is there is any oozing. If this is used as a contact dressing it will take off the top layer of healing tissues when it is removed.
If this has been used and you are having difficulty removing the dressing, moisten the gauze with sterile water (aqua is sterile) then remove the dressing.
Non Stick Dressing Pads – If the wound is closed and the edges of the wound close together, a non-stick dressing can be applied and adhered with dressing tape (Ultrafix). Some non-stick dressings already have an adhesive. These only need to be changed once a day, usually after a shower as they are not waterproof. They come in a variety of sizes so choose the one most suited to your wound.
Sofra-Tulle – This oily gauze has an antibiotic cream already applied. This is ideal for burns, or burn-like wounds where the top layers of skin have been injured (gravel injuries following a bike accident for example).
Personally I would only change the Sofra-Tulle once every 3 days or so, depending on the condition of the dressing and the wound. Plain sterile gauze can be used behind the dressing to soak up any ooze, and can be changed as often as necessary. When you need to change the dressing you may need to moisten the pad with sterile water so as it comes away easily.
Opsite – Opsite is a clear thin plastic dressing that is generally used after surgery but can also be used on neat wounds that do not have a lot of ooze. The beauty of these is that they are waterproof and you will be able to shower. As this dressing should only be used for clean, neat wounds they only need to be changed every 3 days or less, depending on the amount of ooze.
DuoDERM – DuoDerm dressing pads and gel are magic for wounds that have a lot of ooze, such as ulcers or wide lesions that are not joined neatly. The pad or gel will soak up the ooze and basically hold on to it until the next dressing change. It saves a lot of mess and really does improve healing time.
Steri-Strips or Butterfly closures – These are basically strips of sticky fabric that you can use to pull the edges of a wound together. Be aware that these can only be used if the cut is only a few layers of skin deep. If the cut is deep or gaping it will need stitches. These will need to be left in place for at least 3 days for the edges of the skin to join back together.
The problem with these is that in warm climates they tend to come adrift due to perspiration. A good tip is to apply a drop of super glue to the strip either side of the wound. (Not to used in the eye area). Super glue actually has the same formula as medical glue and is much cheaper. In my clinic I would also apply Friars Balsam around the wound which is a sticky resin like solution, however is difficult to find here.
HAIR – Yes hair! Here is a good tip for all you mums & dads who might have to deal with deep cuts on the scalp. You can actually tie the wound together with strands of hair from either side of the cut. Make sure you flush out the wound first to check how deep it really is. It may need real stitches. Also if there has been a decent blow to the head, you may need observation for head injury.
I hope this has given you all some good tips on home care for your family. All the above dressings, and creams are available here at your local pharmacy (I like Kimia Farma), except for the SteriStrips & Butterfly closures.
Kim Patra is a qualified Midwife & Nurse Practioner who has been living and working in Bali for over 30 years. She now runs her own Private Practice & Mothers & Babies center at her Community Health Care office in Sanur.
Kim is happy to discuss any health concerns that you have and may be contacted via email at balikim2000@gmail.com, or office phone 085105-775666 or https://www.facebook.com/CHC Bali
Copyright © 2017 Kim Patra
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