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	Before you kiss it to make it better ... If you've spent any time in a drug store lately, you know you have options: Smurfs, Bugs Bunny, Power Rangers. You can choose bandages made of flexible fabric or sticky plastic, some already treated with antiseptic. There are those that fit over fingers and elbows, teeny-tiny ones, and huge fits-over-your-whole-arm varieties. Bandages are high-tech; they're a fashion statement; they're fun. And they actually have tremendous positive impact on how a wound heals.



	Treating a Wound It is generally agreed that it is better to apply a bandage to a minor wound than to allow it to scab over. We used to think that scabs protected wounds from infection. However, in order for skin cells to regrow over the wound, the environment must be moist, not dry, so the cells can move easily. Treat even your most trivial wound with great care. It may not hurt, but who wants a scar? A Sticky Situation For small cuts and wounds, an adhesive bandage provides the protection that the injury needs to begin healing. Studies show that wounds that are kept protected and slightly moist will heal faster than those left untreated. The many varieties of adhesive bandages available today allow you to choose the style and size of bandage that best fits your injury. When applying an adhesive bandage, follow these steps to make sure your wound is properly taken care of: Clean the wound thoroughly with mild soap and water. Allow the skin to dry completely. Apply a small amount of antibiotic ointment to the injury; doing so may help it heal faster. Open the adhesive bandage carefully to maintain sterility. Do not touch the gauze pad. Expose the pad and place it over the injury; then remove the coverings from the adhesive ends. Smooth the adhesive ends onto your skin. Change the bandage if it becomes wet, dirty, or loses its adhesion. Bandage Features Vary Greatly Different bandages are good for different purposes -- some are better for joints while others are adhesive even when wet. Bandages vary in size, shape, adhesive, and material. Pick a bandage with a gauze pad slightly larger than the wound itself. If you are prone to having allergic reactions to adhesives, choose a bandage with hypoallergenic adhesive. Almost all gauze pads have nonstick coatings and absorb fluids. Some gauze pads come with antibiotic properties -- the pads are usually colored yellow to indicate the presence of medication. An important characteristic is the positioning of the gauze pad: gauze that runs all the way to the edges does not protect the wound as well because there will be a gap on both sides. Adhesive material bordering all edges of the gauze protects the wound better. There is a variety of different patterns and designs available, though it's not been proven that having cartoon figures on a bandage speeds up or aids the healing process! A new development: bandages that reflect different skin tones. What About the Different Materials? Plastic Cheap Sticks well even when wet Not very flexible or breathable Fabric More expensive Sticks well even when wet Very flexible and breathable Great for joints Foam Most expensive Does not stick as well when wet Comfortable Stretchy



	Bandage Your Wounds Bandages are used to protect wounds, provide a moist environment for cell regrowth, and prevent scars. How Bandages Work Bandages draw out excess fluid from the wound to prevent the collection and drying of pus and blood. They also protect the wound from the external environment and prevent the entrance of bacteria. Bandages should be used to maintain a moist environment for the wound so that cell regrowth is not impeded by dried scabs. Assessing the Damage Abrasions are wounds resulting from friction. They are not deep and only extend to the top level of the dermis (the second layer of skin). Punctures are the result of sharp objects jabbing into and piercing the skin. They typically break through the epidermis (topmost layer of skin) into the dermis (the second layer of skin). Sometimes, punctures penetrate deeper than the dermis, which can be very dangerous. Deep puncture wounds should definitely be examined by a physician for debris and depth of injury. Also, consult a physician if the puncture was caused by a rusty object -- you may need a tetanus shot. Lacerations are cuts from such sharp objects as knives. Like punctures, lacerations can penetrate many layers of tissue and should be evaluated by a physician. Treating Minor Cuts and Scrapes Your first priority is to stop the bleeding if you have a cut. If possible, raise the wound above heart level to reduce pain and bleeding. This can be easily accomplished if you lie down. You can also stop bleeding by applying pressure to the wound with your fingers. Next, clean the wound, both inside and around it. Even if it hurts, irrigate the wound with soap and water or just water. This does not mean just letting a light stream of water trickle over the injury: water must be of significant pressure to flush all the dirt out of the wound. If one is available, fill a 10cc, 18 gauge syringe with water or saline solution, point it at the wound and spray. Just don't prick yourself. If you have an abrasion accompanied by small pebbles under the skin, consult a doctor. These can get trapped under the skin as the wound closes. Only very diluted antiseptics should be used inside the wound. Antiseptics may be used on the intact skin around the wound up to three times per day. Only five substances have been classified by the FDA as safe and effective when used as first-aid and preoperative antiseptics: Iodine tincture (USP) Povidone-iodine complex (5% to 10%) Iodine topical solution (2% to 7%) Alcohol (60% to 95%) Isopropyl alcohol (50% to 91.3%) Are you surprised that you didn't find hydrogen peroxide on the list? Though it is one of the most widely used at-home first aid antiseptics, hydrogen peroxide is one of the weakest antiseptics on the market. It can cause tissue damage because of the fizzing and should never be poured into abscesses. Even saline solution (nine grams of salt per liter of water) will do an adequate job as an antiseptic. A topical antibiotic can be applied if the wound is not a deep puncture. The following antibiotics were deemed safe and effective by the FDA: Bacitracin Neomycin Chlortetracycline hydrochloride Combination products containing oxytetracycline hydrochloride Polymyxin B sulfate Usually, applying both an antiseptic and an antibiotic is not necessary; one will suffice. The most important thing is to clean the wound thoroughly. You have until eight hours after the injury occurs to clean the wound thoroughly. Make sure to apply the adhesive to dry skin so it will stick properly. Cover the wound with a dressing that will keep it moist while allowing oxygen exchange. A topical antibiotic can be applied if the wound is not a deep puncture. Applying a Bandage Make sure the skin is completely dry and all cleansers have been thoroughly rinsed. You might consider shaving the area to reduce pain when you have to change the dressing and remove adhesive tape. If shaving is impossible or undesirable, consider using paper first-aid tape as a barrier between your skin and the adhesive tape. If your dressing will require frequent changing, using paper first-aid tape can be helpful in avoiding the pain of removing adhesive tape and possible irritation from adhesives. With clean hands, open the bandage packet without touching the gauze pad. Secure one side of the strip before removing the backing from the other. Press down firmly and then attempt all normal movements you'll be making. Make sure that the bandage doesn't pop up, wrinkle, or bunch during any of these. Never apply a bandage too tightly. This can hinder the healing of the wound. Do not change the dressing often. Frequent changes can slow the healing process by removing new layers of skin. Change it only if it is dirty. Check to see that the wound is healing properly. In particular, check for infection. A noxious smell and worsening pain are signs of infection, but initial redness and swelling are not. Other signs of infection are crusty, oozing lesions and fever. Consult a physician if you suspect infection, or if the wound occurred in a dirty area. Do not risk infection. Bandages should be changed: When the gauze pad is saturated with fluid from the wound If the skin has become dirty After excessive sweating After showering or if the bandage has become wet If unpleasant odors are coming from the gauze pad Wounds Only a Doctor Should Treat Deep punctures or lacerations Wounds that do not heal Infected wounds



	When the Injury Is Serious If you have been punctured by a rusty object, seek the advice of a doctor. You'll need a tetanus shot. Deep puncture wounds need to be treated by a doctor. Bacteria and dirt can be impossible to remove at home and can cause infection. What is considered a deep puncture wound? Use common sense. A deep wound on the bottom of the foot should absolutely be seen by a doctor, while a one-third-inch-deep puncture in your buttocks is less serious. Seek the advice of a doctor if you have an abrasion that affects a large portion of your body or if pebbles and dirt are trapped under the skin. If the wound is near an artery, it is best to seek the advice of a doctor. If you cannot stop the bleeding, seek the advice of a doctor.



	Websites, Organizations & Manufacturers Johnson and Johnson Parasol EMT Comprehensive First Aid Information Parasol EMT External Bleeding Information First Aid Sources & Further Reading Books 1. Covington, TR et al. Handbook of Nonprescription Drugs, Eleventh Ed. American Pharmaceutical Assoc. Washington, DC 1996. 2. American Medical Association.The American Medical Association: Guide to your family's symptoms. Washington, D.C.: American Pharmaceutical Association 1992. 3. Fauci, Anthony S. et al. Eds. Harrison's Principles of Internal Medicine, 14th ed. New York: MacGraw Hill 1998. Find more books on health and wellness at barnesandnoble.com. Articles 1. Rahman, Shireen."Sportin' slips: how to prevent and care for sports injuries." Diabetes Forecast; Vol. 48 1/1/1995. 2. Schwade, Steve."Bandage wrap-up." Prevention; Vol. 46 6/1/1994. 3. Accerrano, Anthony."First aid for wounds." Sports Afield; Vol. 211 1/1/1994. 4. Tilton, Buck."Medical cover-ups." Backpacker; Vol. 23 8/1/1995. 5. Leibowitz, Ed. "Hot spot bandages try to keep everyone covered." Newsday; 1993. 6. Weiss, Eric A. "How to repair your skin: What to do on those occasions when a bandage just isn't enough." Backpacker; Vol. 23 10/1/1995.

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