Water for Wounds

[erugs]

Consumer Reports has just published a study showing that hydrogen peroxide is not a good treatment for cuts, that flushing with water is preferable. I've used the pressure from my water bladder tube to clean wounds, but only if I'm using pure water that has not been flavored with more than a little lemon juice.

I've also learned that slathering something like Neosporin on a cut holds germs into the wound, so isn't a good idea either.

Maybe it helps that I'm on long-term antibiotics for Lyme. Anyway, I thought this would be of interest to those of us who are more likely than others to get scrapes in our pursuit of happiness.

Link: http://www.consumerreports.org/cro/...health/water-best-for-cuts/overview/index.htm

 

[JacobH]

Good article. Do you know if this is backed by any medical journals or research. Consumer reports is great, but where did the research come from and is it peer-verified?

I found this article which also agrees with you, from a medical journal, alludes to Hydrogen Peroxide causing scarring (or preventing non-scarring body function):

http://onlinelibrary.wiley.com/doi/10.1111/j.1067-1927.2005.00072.x/abstract

Another article from an MD:

http://familydoctormag.com/first-ai...oxide-for-wounds-is-it-better-than-water.html

Also this site which does not seem to cite references but seems to be valid, doesn't mention cuts but all the other "uses" of H2O2:

http://www.truthorfiction.com/rumors/h/hydrogen-peroxide.htm

What about licking the wound (or having a dog do it)? For example, if fresh water was unavailable on a trail. I kind of think this is an "Old Wives Tale" with a bit of truth behind it. From an evolutionary standpoint there would seem to be some benefit from it. Why else would the instinct be so strong in animals?

 

[Little Rickie]

I've also learned that slathering something like Neosporin on a cut holds germs into the wound, so isn't a good idea either.
]

I would think only if you didn't clean the cut 1st. Even if there are germs in the cut I would expect it to inhibit them?

 

[griffin]

What about licking the wound (or having a dog do it)? For example, if fresh water was unavailable on a trail. I kind of think this is an "Old Wives Tale" with a bit of truth behind it. From an evolutionary standpoint there would seem to be some benefit from it. Why else would the instinct be so strong in animals?

I imagine licking your own wounds is better than nothing, but letting a dog do the work would really be a last resort. They may have immunity/resistance to the bacteria in their own systems, but I don't think we do.

 

[Kevin Rooney]

Am not sure pointing out that hydrogen peroxide and other compounds can produce scarring is anything we didn't know before. Some compounds, like alcohol, always produce obvious scar tissue if I use them on my open wounds, but H2O2 rarely does. About the only use I have for alcohol is disinfecting the thermometer.

As far as I'm concerned, at $1.00/pint for hydrogen peroxide (often less) it will remain a staple in my house. While there's no substitute for proper wound care immediately after an injury, my active lifestyle means that H2O2 and triple-A ointment are often on the grocery list.

 

[TCD]

My routine is soap and water, let it dry, triple A and cover. Seems to work, but I'm not a good test, becasue even if I leave a cut dirty I don't seem to get infected; must have a good immune system...

 

[Seeker]

Did an article on this recently. The sources said that HP and alcohol can be irritating and possibly cause minor damage that can interfere with healing. Antibiotic ointment can help prevent infection on larger wounds, but isn't necessary on small cuts. Sources are at the end. Article here.

 

[Brambor]

altitude

I wonder how do we apply this new info to treating cuts at higher altitudes where bleeding is harder to stop.

 

[daxs]

I believe hydrogen peroxide also prevents new tissue/skin from forming so it takes longer for the wound to heal. I usually tell my oppatients not to use peroxide on cuts.

However, after my wrist surgery, the surgeon told me to use peroxide on the stitches to prevent new skin from growing over them and making them more difficult to remove.

 

[Stash]

Reading the article I see nothing drastic. I'm by no means a medical expert but what I read is to flush it out well with water if you have it and that things like peroxide and alcohol might cause minor irritation and/or slow healing. I don't read that peroxide is bad. Just not a full-on replacement for good old fashioned cleaning. If you don't have access to plenty of water you use what ya brung.

 

[DougPaul]

Seems to me that I heard the same advice in a outdoors medicine course (taught by MDs) 35 years ago... Just use soap and water for cleaning wounds.

"Medicine for Mountaineering" advises the use of sterile water to flush the wound. They suggest a 20-50 ml syringe with a large-bore needle to create a jet of water to flush out dirt and debris. They also suggest that a plastic bag with a pinhole can also be used as a field substitute.


FWIW, if I wanted to apply an antiseptic, I'd probably use 10:1 or 20:1 diluted providone-iodine (Betadine). (Also recommended in MoM.)

Doug

 

[MadRiver]

Both the WFA and WFR courses teach that soap and water is best to clean wounds. I always carry a small vile of soap that I will mix with my fresh water to clean wounds. I have also just recently added a plastic syringe to my first-aid kit.

 

[SAR-EMT40]

Seems to me that I heard the same advice in a outdoors medicine course (taught by MDs) 35 years ago... Just use soap and water for cleaning wounds.

"Medicine for Mountaineering" advises the use of sterile water to flush the wound. They suggest a 20-50 ml syringe with a large-bore needle to create a jet of water to flush out dirt and debris. They also suggest that a plastic bag with a pinhole can also be used as a field substitute.


FWIW, if I wanted to apply an antiseptic, I'd probably use 10:1 or 20:1 diluted providone-iodine (Betadine). (Also recommended in MoM.)

Doug

This is best. H2O2 is damaging and it has been known for years. Clean water to irrigate. If you can drink it, it is clean enough to use for irrigation. Doesn't need to be sterile. Povidone-iodine (PVP-I) can also be used to clean and irrigate. The puncture in a zip lock will work good but you may also carry an irrigation syringe if you wish, the needle isn't really needed and without the needle you probably won't need to answer any question what you are doing with the just the syringe if they find it during a traffic stop. Needles can make them ask lots more questions, like "where is your prescription"? It will produce enough strength in the stream to dislodge things that shouldn't be in the wound. Soap and water is just as effective but can be a lot less pleasant to debride a really badly cluttered wound that way. I hate it when people are screaming in my ear.

While we are at it Mercurochrome is another antiseptic that has fallen into disfavor, not the least of reasons is because it contains mercury. Fortunately, Merthiolate was banned for over the counter sale in the 90's.

Keith

 

[SAR-EMT40]

However, after my wrist surgery, the surgeon told me to use peroxide on the stitches to prevent new skin from growing over them and making them more difficult to remove.

Exactly, it inhibits the growth of new skin. Something most people want to have happen when they have an injury.

Keith

 

[nietzschescat]

h2o2

I've been a nurse for over 20 years and it's been awhile since we used peroxide on wounds and when we did we used saline afterwards to rinse. It's apparently now thought to be more damaging to tissue.

I'd just use water if I was hiking, let it bleed a bit, rinse it, wrap it up and deal with it when I got home. I carry a few steri strips/antibiotic ointment/gauze and an ace wrap in case a wound needs some pressure to stop bleeding.

Spider webs are supposed to make your blood clot, but I've never tried it.

 

[sierra]

here we go again

Maybe someone should do a study on studies. Next there will be a study saying the wheel would work better if it were square. Ive used peroxide, followed by neosporine and a bandage (bandage for minimal time) and my cuts even severe, heal in days with no scarring left behind. Water does not kill germs period, if you have a open wound you need to KILL the bacteria, you want to use just water be my guest. Im not buying into these new "studies" Ill stick to what works.

 

[DougPaul]

The puncture in a zip lock will work good but you may also carry an irrigation syringe if you wish, the needle isn't really needed and without the needle you probably won't need to answer any question what you are doing with the just the syringe if they find it during a traffic stop. Needles can make them ask lots more questions, like "where is your prescription"? It will produce enough strength in the stream to dislodge things that shouldn't be in the wound.

There are also irrigation syringes. They have a built-in plastic nozzle for just such use and are useless for injections. The description using a large-bore needle was from MoM--I agree a plastic irrigation syringe is a better choice for the average hiker.

While we are at it Mercurochrome is another antiseptic that has fallen into disfavor, not the least of reasons is because it contains mercury.

According to http://en.wikipedia.org/wiki/Merbromin it is still a viable topical antiseptic (still used in poorer countries) but has been generally superseded by other agents in the US. It is available in aqueous or tincture--tincture contains alcohol which stings as well as damages tissue.

Tincture of iodine, another topical antiseptic, also contains alcohol. (A tincture is a substance dissolved in a solution of 40+% alcohol. http://en.wikipedia.org/wiki/Tincture) FWIW, the alcohol is what makes a tincture sting on broken skin.

Doug

 

[psmart]

Water does not kill germs period, if you have a open wound you need to KILL the bacteria, you want to use just water be my guest.

The SOLO instructor we used to train trail crews recommended SOAP and water. Irrigate with water, and SCRUB the wound to remove what shouldn't be there, even if it hurts! He advised against other treatments for the reasons already discussed in this thread.

Edit: Soap kills many germs, but more importantly, it's slippery, so the contaminants rinse off more easily.

 

[Kevin Rooney]

Maybe someone should do a study on studies. Next there will be a study saying the wheel would work better if it were square. Ive used peroxide, followed by neosporine and a bandage (bandage for minimal time) and my cuts even severe, heal in days with no scarring left behind. Water does not kill germs period, if you have a open wound you need to KILL the bacteria, you want to use just water be my guest. Im not buying into these new "studies" Ill stick to what works.

Yup, my sentiments exactly.

These threads rarely change anyone's mind. People continue to do what has worked for them in the past.

 

[Craig]

When I was a kid my father repeatedly told my bother and me to pee on a wound if we were unable to get treatment quickly. I think it was in the US Army Field Manual from his WWII days.

Never did try that one tho.

The last backcountry injury I had was last spring. I damn near degloved the pinky finger on my brake hand while glissading down the chute on Whitney. It wouldn't stop bleeding, at altitude, so I applied direct pressure with a ball of snow until the bleeding stopped and the dried blood sealed the wound. I hiked down to the TH and cleaned it out at the last stream crossing. Got back to the car and put some peroxide and antibacterial on it. In a couple of weeks it was good to go. Scarring was a little excessive tho.