Wound cleaning is something most people know is needed but few know how to do properly. This is because most people tend to associate wound cleaning with myths or outdated information rather than the best possible practice, resulting in ineffective treatment or extended healing times. Obviously you don’t want to waste time by using treatments that don’t work or make wounds take longer to heal, so let’s look and see what you should do to clean injuries.
Disclaimer: I’m not a doctor, surgeon, or any kind of medical expert and this article represents only my own opinion. Furthermore, this advice is intended solely for situations where doctors and hospitals are unavailable such as after a societal collapse. Always listen to your doctor regarding wound care, and always seek medical attention for potential infections, serious wounds, or other injuries.
Why wounds need cleaning
Before you can delve into the “how”, you need to know why it’s so important to clean wounds. After all, I’m sure you’ve probably been told to “put some dirt on it and walk it off” for more than one injury, so why the importance on cleaning them?
Simply put, cleaning a wound has 2 major goals:
- Minimize the chance of infection. Removing bacteria and other infectious pathogens from the wound helps to reduce the odds of becoming infected. An infected wound can lead to gangrene and necrotic (dead) tissue, sepsis, and eventually death so this is extremely important in a survival situation.
- Speed healing by aiding the natural cleansing/knitting mechanisms. Your body is usually perfectly capable of cleaning minor cuts and scrapes by overwhelming the populations of bacteria and the like with various natural responses, but deeper, larger, or particularly contaminated wounds can sometimes overwhelm these natural processes. By cleaning the wound, you not only help your immune response to keep out infectious bacteria, but you can also remove obstacles such as debris and dead cells that can impede healing. Essentially, you’re cleaning out the “work area” for your body, making it easier and faster to heal once the repair process is started.
Done properly, wound cleaning aids the natural bodily processes and minimizes the chance for complications, which is particularly valuable in a situation where hospital care and a carefree month or so in bed to heal may not be an option.
Proper care and cleaning practices for all wounds
Let me note first and foremost that different wounds need different kinds of care, so please do not try to apply one particular method to all situations and kinds of wounds! Mild soapy water might be suitable for mild abrasions, but it is hardly enough for a deep knife stab. Even when you compare different kinds of serious wounds (a stab vs a large open wound for example) treatment methods and the chemicals used may well differ. Forgetting this fact is one of the primary reasons that people improperly treat wounds in survival situations, so please do not forget it!
With that said, here are some general principles that do apply to most wounds regardless of type or severity:
- Be cautious when removing large pieces of debris or lodged objects. Generally speaking, unless you truly know what you’re doing you could very well cause a lot more damage by removing that chunk of tree branch or knife stuck in your patient. Obviously if it is life-threatening there may be situations where it is safer to remove it than it is to leave it in, but don’t be overly quick in making that assessment.
- Choose the mildest cleanser possible relative to the severity of the wound. Some cleaning solutions (such as soap and water, saline etc) don’t actually kill anything but just wash out harmful debris and bacteria. As such, they tend to be gentler on wounds and better at promoting quick healing since they don’t damage healthy tissue on the edges of the wound. Antiseptics like hydrogen peroxide or alcohol solutions on the other hand actively kill bacteria but tend to be much more indiscriminate in destroying healthy tissues as well which makes them less suitable for delicate or minor wounds.
- Heat cleansing solutions to room temperature unless that would ruin it. This helps to keep the wound from becoming cold and slowing the healing process.
- All the cleaning in the world means little if you don’t cover the wound to protect it from further harm. Sterile bandages, gauze pads, topical antibiotics like Neosporin, whatever you have on hand to protect the wound should be used in accordance with the severity of the wound. Cleaning won’t do much for the wound if it is permitted to become contaminated from the general surroundings and filth you’ll be encountering in a survival situation.
- Always take care to minimize addition of infectious material from your own care. Don’t cut skin from wounds with dirty instruments, don’t use non-sterile bandages unless you absolutely must, and always be sure that your cleaning solution is still clean and usable. Furthermore, if you need to get your head and mouth close to the wound (perhaps for inspection or to check for foul odors) always cover your mouth and nose with a mask to avoid breathing on it.
Cleaning mild wounds and abrasions
These are extremely mild and tend to be innocuous even if they’re not cleaned…but that is not a risk I ever advise you to take. These can be simply cleaned with warm soapy water and covered with a clean bandage until they’re fully healed. If the wound is a puncture wound or a deeper cut, you may also wish to seal it with a bit of neosporin to protect it further.
For deep cuts or puncture wounds
Assuming that no major debris or object remains lodged in the wound, you will need to be careful not to cause harm to the tissues and muscle that are now exposed to the open air. As such, unless there is necrotic tissue or a large amount of debris present milder cleansers such as a sterile saline solution is recommended. To clean the wound, rinse it with a steady stream of saline or other mild cleanser for 5 minutes. Dry the area thoroughly with a sterile pad, then cover with a sterile bandage. When the bandage is changed (daily is commonly recommended though your needs may dictate longer times for practicality’s sake) the wound can be re-cleaned if needed by wiping with a sterile pad soaked in saline parallel to the cut.
For abrasions and open wounds.
If the wound is only mildly dirty (if it isn’t covered in gravel or dirt for example) a mild cleanser is appropriate. If not, you may elect to clean with an antiseptic, though it should be noted that this could cause the wound to take longer to heal. Regardless, apply the solution in a stream across the wound, carefully rinsing out the debris for about 2-3 minutes. If the wound is large or a mild scrubbing action might be needed, soak a sterile pad in the solution of choice and rub gently in larger and larger circles, starting in the center of the wound and continuing until you are about 2 inches outside of it (or 1 inch past wherever your bandage will cover if you use one). Let me stress that rubbing, scrubbing etc should be as gentle as possible to reduce bleeding and to minimize tissue damage that can slow healing or even cause scars.
Recommended chemicals/solutions for cleaning wounds
Here are the solutions typically recommended for use:
- Sterile saline. Saline is isotonic and generally the least toxic sterile solution that is commonly used. As such, it causes minimial damage to healthy or healing tissues while still washing thoroughly without introducing additional bacteria to the wound. It’s only major weakness tends to be with extremely dirty or necrotic tissues, since the sheer volume can be too much for sterile liquid alone to wash away.
- Potable water. Yep, humble water is often recommended in situations where chemical solutions are unavailable. Obviously every effort should be made to ensure that the water is as sterile as possible, and you certainly don’t want to be dumping a gallon of lakewater on a wound, but in a pinch potable water can do very well to help clean a wound with minimal injury to healthy tissue.
- Drinking alcohols. Generally speaking, your average beer, wine etc will not even scratch the bacteria present in a wound. Anything with over 35% alcohol content generally affects bacteria sufficiently to be worth cleaning with, but differing alcohol content affects different bacteria in various ways. Something like Everclear (either 75% or 95% alcohol content compared to the 1-3% most beers contain) can be terribly damaging to some bacteria, but the sheer level of alcohol can actually shield other kinds and make them take longer to die as a result. Generally only recommended as a last resort owing to the variability.
- Providone Iodine. Effective against many kinds of bacteria, but damaging to healing tissues. Also tends to dry out and/or discolor skin, which further inhibits healing and leaves you at risk for additional contamination for longer.
If you follow the advice in this article and apply some common sense, you should be able to carefully and properly clean any wound you come across. Just make sure to keep the needed supplies on hand so that you have all the tools you need for the job!
Do you know of any other methods for cleaning wounds? Let us know in the comments below!
This article first appeared at Prepared For That: Help Your Body Repair Itself: How to Properly Clean Wounds