Soft Tissue Injuries #2 Long-Term Wound Care

Control of Bleeding:

Direct pressure
Digital pressure 
Elevation
Pressure dressing

Prevention of Infection – Wound Cleaning:

Hemostasis: 
Apply direct pressure or use a pressure dressing to control bleeding for about 30 minutes.
Supplies:
Sterile cleaning solution:
Can be made by adding Betadine, Povidone, or iodine (any iodine solution) to water and allowing it to stand for 30 minutes. 
Thorough wound cleaning you will require 3 – 4 liters (quarts) of sterile (dilute iodine) water solution for irrigation. 
Wound irrigation:
Is best accomplished with a directed stream of the sterile water under force, such as can be produced by squirting water out of syringe. 
Wound Debridement:
All foreign material must be removed, most can be by gently lifted out with forceps or by rinsing it out with the sterile water.
The Rinsing Process:
Once the visible debris in the wound has been removed, begin the rinsing process. 
First rinse with a dilute soap solution or dilute iodine solution, 5 – 6 times, and then a final rinse with clear sterile water or with the dilute iodine solution. 
The iodine solution has to be less than 2% iodine; if the iodine concentration is too high, it can be toxic to the healthy tissues. 
Once the wound has been irrigated well, apply sterile dressings and a bandage. 
Dressings should be changed every 12 hours and the wound site evaluated for signs of infection.

What are these compounds – Iodine, Betadine, Povidone?

Iodine: Is a chemical element, atomic number 53.
Betadine: Betadine is a commercially available 10% solution of Povidone-iodine in water
Povidone iodine: Povidone iodine is a water-soluble complex of iodine and polyvinylpyrrolidone, it contains a 2% concentration of iodine

 For more detailed information on wilderness and long-term management of Soft Tissue Injuries see the Jan/Feb 2006 and the March/April 2006 issues of the Wilderness Medicine Newsletter.

This blog is powered by the Wilderness Medicine Newsletter, now celebrating 20 years of publication. The WMN is published and distributed online six times each year by TMC Books, and subscriptions cost as little as $10 per year. To find out more, or to subscribe online, click here.

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