Monday Medical: Why wound care?
September 11, 2017
Most of the time, small cuts and sores heal on their own.
But for some people, especially those who are bedridden or dealing with chronic swelling, diabetes or an otherwise compromised immune system, a simple cut can quickly develop into something more serious.
"We want to make sure that people don't ignore these small wounds and think, 'Oh, it will just heal on its own,'" said Michelle Lage, a physical therapist with the UCHealth SportsMed clinic in Steamboat Springs.
The skin is the largest organ in the human body. With seven layers, it serves as a barrier to the germs of the outside world.
Small wounds usually only break through the first or second layer of skin. But those cuts can expose the remaining layers, making it easier for infection to eat down to the subcutaneous tissue underneath.
With proper wound care, serious infection can be avoided. Below, Lage gives her recommendations for preventing and caring for wounds.
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- Do daily skin checks: The first and most important step of wound care is to find small wounds quickly.
"It's important for patients to be self-aware and to do skin checks every single day," Lage said. "For some people, the smallest crack could become very dangerous."
Pay special attention to the feet, where small cracks can develop between toes and on the soles.
Skin checks can be challenging, especially for people who are bedridden or cannot see their lower extremities.
"It's important to make it a routine," Lage said. "If someone is unable to do it for themselves, they can position mirrors on the floor or have a family member do it for them. But they need to do it every day."
- Prevent wounds from forming: One critical step in keeping wounds at bay is to use shoes that fit well.
"Especially for diabetics, proper fitting footwear that's in good condition is key," Lage said.
And, people who are confined to a wheelchair or bed should avoid pressure spots. If their full body weight pushes blood out from an area, that section of skin may quickly die, sometimes in as little as a few hours.
- Treat small wounds immediately: The faster a wound is properly treated, the less likely it is to become infected. Good treatment is surprisingly simple: Clean the wound with water, and keep it moist and covered.
"Moist wound healing is very important, even for a small cut," Lage said. "We used to think it was good to let it scab over, but that's actually not the best way to heal. Keeping a small wound moist will help it heal faster."
- Seek help if the wound doesn't heal: For wounds that don't get better in a couple of weeks, it's important to see a physician, who may recommend other treatments, including wound care from a physical therapist trained in the field.
When Lage first sees a patient, she evaluates the wound and determines a course of treatment. Dead tissue, which can be a breeding ground for bacteria and infection, needs to be cut or scraped away, then the wound is kept moist and covered.
"Keeping the wound moist with proper dressing will help the good tissue take over so it will heal," Lage said.
A therapist might also help reduce swelling with the use of Ace wraps and compression garments.
Though removing dead tissue can be painful, patients often find relief comes quickly once the infection is controlled and swelling lessens.
The bottom line? For some people, even small cuts should be taken seriously and addressed right away.
"Giving immediate attention to an area that's open is always the best route," Lage said.