What should patients be told about the treatment of mild injuries, burns, and chronic wounds? Wounds, abrasions, and cuts are forms of skin damage we are particularly prone to during daily housework. Once injured, patients usually turn to pharmacists as their first port of call. A wound is defined as damage to skin continuity, and occasionally also to […]

What should patients be told about the treatment of mild injuries, burns, and chronic wounds?

Wounds, abrasions, and cuts are forms of skin damage we are particularly prone to during daily housework. Once injured, patients usually turn to pharmacists as their first port of call.

A wound is defined as damage to skin continuity, and occasionally also to the tissue and/or organs beneath. Wounds are caused by mechanical, chemical, and/or physical trauma, such as contact with a sharp implement, or hot water, hot air, or chemical burn. Notably, such injuries may tie in with varying severity of patient health impact – something we need to take account of during treatment.

Wounds caused by mild trauma

In case of such injuries, cleaning the wound properly is vital, as the surface of human skin teems with bacteria which pose a threat of infection once skin is broken. To avoid infection, we should advise the patient to clean the wound with soapy water, hydrogen peroxide, or disinfectant. Then, zinc hyaluronate-containing gel or balm should be applied. Zinc hyaluronate is a compound of hyaluronic acid – a natural skin ingredient responsible for skin integrity and regeneration. Furthermore, the use of zinc hyaluronate-containing gel or balm will also prevent microorganisms from accessing damaged skin surface, and create an adequate micro-environment required for swift wound healing. In case of particularly soiled wounds, the patient should be referred to a physician for wound cleaning and potential tetanus booster shot; their doctor will also decide whether the patient requires general antibiotic therapy.

Burns

Severe (second- and third-degree) burns, with erythema accompanied by numerous serum blisters and skin necrosis, require definite medical intervention. Trauma requiring medical treatment includes burns to the genital area or face – especially near the eyes – or respiratory tract burns caused by contact with hot gases. In case of burns to the genital area in particular – where the risk of shock and infection is significant, and pain severe – no self-treatment should be attempted. The patient should be brought to a hospital as swiftly as possible. Most commonly, however, we encounter minor, i.e. first-degree burns, with slight skin redness and single small serum-filled blisters. In case of thermal burns, cooling skin down with lukewarm water for approximately fifteen minutes should suffice. In case of chemical (lye or acid) burns, rinse skin with water for a prolonged period and consult a physician. Importantly, the patient should be prevented from rinsing wounds with very cold water, as this increases the risk of skin tissue ischemia and may result in necrosis and exacerbate the risk of bacterial infection or shock. It is recommended to apply gel to relieve pain and fight bacteria. All balms and gels used by patients should contain zinc hyaluronate, an agent conducive to proper healing and scarring reduction. Severe pain may persist for the first 2 days, which is why oral analgesics should be recommended. The patient should further be advised that in case of fever, painful redness expansion or purulent secretion from the burn area, he/she should definitely consult a physician.

Chronic and surgical wounds

Surgical wounds and chronic wounds in patients with serious illness – such as diabetic foot or stasis ulcers of the lower extremities in lower limb varices – are always a special case, as they take a long time to heal and require special treatment. In case of chronic wounds, patients should be advised as to proper hygiene and disinfection. Many diabetics are convinced that standard drugs are sufficient in managing the diabetic foot; such beliefs result in negligence of hygiene and skin care. As diabetic skin is enormously vulnerable, deprived of its natural protective filter (due to of chronic ischemia) and sensitive to infection, it requires adequate care. Silver- or zinc hyaluronate-containing preparations are frequently applied in the treatment of advanced diabetic foot cases. Such agents prevent ambient microorganisms from accessing damaged skin surface, limit the effect of harmful factors, and relieve pain and skin inflammation. Yet it should be borne in mind that the use of any gels or balms on the diabetic foot has to be consulted with a physician and requires medical supervision.