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Hesperian Health Guides

Wounds

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HealthWiki > New Where There Is No Doctor > First Aid > Wounds


  1. Stop the bleeding with pressure.
  2. Clean the wound thoroughly as soon as you can. The better you clean it, the less likely it is to become infected. For larger wounds, give some kind of pain medicine before you clean and care for the wound. Inject lidocaine around the wound and just below the skin inside it. Or give another pain medicine and allow time for it to work.
  3. Dress or close the wound, or for a small wound, leave it open to heal.

Contents

Clean all wounds

Any wound, big or small, can become infected. Clean every wound well.


Wash your hands well with soap. Then wash the wound with 1 to 4 liters of flowing water. You do not need antiseptics, some of which can slow healing down. If the wound looks dirty, use soapy water and then rinse that off with plain water.

Lift up any flaps of skin to clean underneath. For deep wounds, squirt the inside of the wound with a bulb syringe, letting the water run out.

a flap of skin held up with tweezers while water is squirted on the wound.


Or take the needle off a syringe and squirt water into the wound.

Or just run lots of clean water over and into the wound.

Wash out anything left inside the wound, especially dirt, wood, or other rough material. You may need to use a piece of sterile gauze or clean fabric to clean out the wound, then rinse thoroughly.

Caring for wounds

As the wound heals, make sure it stays clean to prevent infection. If it gets dirty, clean the wound with lots of water. Covering the wound with a bandage, sterile gauze, washed banana leaf, or very clean piece of cloth will help keep it clean. Putting honey on the wound also helps prevent infection. Change the bandage daily, and if it becomes wet or dirty. It is better to have no bandage than one that is dirty or wet.

Watch for signs of infection such as redness, increasing pain, warmth, swelling, or pus at the site of the wound. For any of these signs, clean the wound well. You may need to gently pull open the wound to clean it. Watch that the infection does not spread to other parts of the body.

Closing wounds

A small wound is best left alone to heal. It should not need stitches. The most important thing is to keep wounds clean.

A wound that is more than 12 hours old should be cleaned and left open to heal.

A larger wound that comes together well will heal better if it is closed.

To close a shallow, clean wound, use butterfly bandages, glue, or stitches.

Butterfly bandage

Use a butterfly bandage for a small cut.

how to make a butterfly bandage.
The skin around the wound must be clean and dry for the bandage to stick.

Glue

Super Glue or Krazy Glue (cyanoacrylate, a powerful adhesive) is easier to use than suture and works just as well for most wounds. Use it when you can clearly see how the two sides of the wound should go together. It may not work as well on hands or joints because they move so much. Do not use glue near the eyes or mouth. Super Glue may irritate the skin.

illustration of the above: using glue to close a wound.

Step 1: Make sure the wound is clean and the skin around it is dry.

Step 2: Push the sides of the wound together. Keep fingers well away from the wound so they do not stick to the glue. A helper can use a couple of clean sticks to hold the sides together.

Step 3: Squeeze a line of glue along the closed edges of the wound.

Step 4: Hold the wound closed for 30 seconds. Then add another layer of glue. Wait another 30 seconds or so, and then add a third layer. Each layer should cover a little more of the surrounding skin than the last.

The glue will wear away on its own. By then the wound should be healed.

Stitches (sutures)

A cut will benefit from stitches if it is shallow and long, or if the edges of the skin around the cut do not come together by themselves.

Line up the edges. The edges of the wound should come up slightly above the skin instead of tucking into the wound.

Make the depth and the length of the stitch the same on each side of the wound.

illustration of the below: making a stitch with a curved needle.
Put the stitch through here
not here

Step 1:
Put the stitch through the cut, not under the cut.

If you do not have suture or a curved suturing needle, sharpen a sewing needle. Boil the needle, some silk or nylon thread, and a small pair of pliers for pulling the needle through tough skin.

a stitch that has been tied.


Step 2:
Tie a secure knot.


Step 3:

a cut with 5 stitches.

Make enough stitches to close the whole cut.

A deep wound should get a couple of stitches inside the muscle with dissolvable suture before sewing the skin together. If you cannot do this then do not close the wound.

Leave stitches in place for about one week (10 days for a leg wound). Then cut each stitch and pull it out. If you spend some time sewing clothes, you will find that your skill to suture wounds improves as well.


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