Monday, April 29, 2013

Acute Wound Care

     One of my athletes came to see me with a small laceration on his hand. It was a border line between needing stitches and being able to close with just a band aid and steri strips. Standard protocol in this situation is for me to stop the bleeding, close and cover the wound, and get the athlete ready for transport so that the doctor can make the final call. 

     This got me thinking about writing a blog entry about acute wound care while out on the water. I cannot count the number of times I have had nicks and cuts while in my kayak or unloading/loading my kayak. As a standard item in my first aid kit I always carry superglue for these situations. It is a cheap, quick fix that works extremely well for on the go situations. The most beneficial characteristic of superglue is that it seals wounds air and water tight. There is one other option that is more expensive and a little harder to get yours hands on, and its called Dermabond. Dermabond is basically a medical grade superglue used in hospitals for wound closure. Either one allows me to stay on the water longer with worrying about the risk of potential infection. 
     You have to remember that while superglue will seal out germs, it will also seal in bacteria as well, so it is very important to clean the wound and let it dry before applying the adhesive. I will always carry alcohol prep pads with my super glue to clean the area around the wound as well as the wound itself. I did a little research before writing this post about official stances on superglue in wound care from the AMA, FDA, and ACEP. I looked at their websites and called each of these organizations and all of them said that there was no official position on this subject. 

     I wanted to share my methods for acute wilderness wound care, but by all means if you do not feel comfortable using household super glue on your wounds, don't. This method works well for me and has for a long time. Every kayak angler should carry a first aid kit for emergency situations and superglue has always been cheap, and convenient for me. 


*****UPDATE*****

     I just talked to a physician from the Wilderness Medical Society. He explained the the difference between a product like dermabond and superglue is the use of acetone in superglue. If too much superglue gets into the wound it can cause a little inflammation of the skin, which in turn can increase the risk of infection. He also told me that he always carries it when backpacking and frequently uses it on himself and his children if needed. It is important to try and pinch the skin closed as much as possible before applying superglue. There is a small chance that it can increase the chance of infection but according to this physician, not covering the wound at all probably increases your chances more. For more information you can visit Wilderness Medical Society for more great resources.
     

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