Best disinfectant for cuts in the out doors?

My wounds throbbed last night but hurt less elevated. This morning I could hardly bend my hand. They were too dry with skin puckered toward them. I applied a tiny bit of generic triple antibiotic ointment and they moistureized and loosened up quickly. I went to work without bandages this time but was careful to keep the hand clean. Afterward, the pain was no worse, but it did begin to seep more clear fluid from all the flexing. By the way, this was day four. And I am on a light dose of Keflex for another ailment. But no signs of infection. And no astringent applied. And no urine. My initial rinse was with bottled spring water and I have kept it dry since.
 
averageiowaguy said:
Now for some minutia. Feel free to stop reading. I think I remember reading in a journal that someone did a study where they took urine specimens during surgery and did cultures on it to see if it was indeed sterile. The urine cultures grew nothing. But then they took the urine and did DNA tests on it to see if there was bacterial DNA present. I think they did find some DNA in some patients but I could be wrong about that. So what does it mean, in the real world, if there is bacterial DNA present but you can't get it to grow any actual bacteria in a culture? Who knows. Maybe some bacteria traveled up the urethra and made it into the bladder and were destroyed by the immune system. I can't say for sure but that would be my initial thought. In my mind, bacterial DNA present in urine, but no bacteria growing once it hits a culture means that the bacteria were dead, or there was some error in the study somewhere. It happens. One little teeny tiny error in handling a specimen during DNA studies can be compounded massively. Unfortunately I have first hand experience with how difficult those studies can be to execute. Either way, if the urine from the bladder won't grow bacteria in a culture, I can't see how it would cause a wound infection. Science is a tricky thing. Maybe someone will actually research that. Or maybe they have and I just haven't seen the paper because I'm too busy with other things. Another quick point - if I take a beaker and make a slurry of poop and water and put it in an autoclave, it will be sterile when the autoclave is done. There will be bacterial DNA and other DNA present in the beaker, but nothing is going to grow in culture because there are no living organisms. Does this make sense?

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I am actually glad this came up. I was using old advice - that I had researched enough to know that urine was sterile. However - I frankly never thought about why this was the case.

This clarifies a lot for me.

I also agree that if you are in THESE kind of dire straights - you are likely up shit creek. The least amount of your worries is if your cut even has TIME to get infected.


Wait - did you say you toured with Eric Clapton. ;)

TF
 
As a physician I concur with Averageiowaguy's recommendations. I was taught to be gentle with wound tissues, whether surgical or not, to avoid further tissue damage. Most antiseptic products are cytotoxic and probably do more harm than good when used in the wound. They are helpful, theoretically at least, to "disinfect" around the wound so as to avoid introducing bacteria into the wound during surgery or dressing. I usually use mild soap & water or very dilute Hibiclens to clean dirty wounds, and copious moderate pressure irrigation with normal saline (not available in the wilderness....wait, maybe there is something to the pee thing after all :-) ) and manual debridement of foreign material (eg: dirt, gravel, bark, etc), I find substances such as alcohol useless unless trying to remove greasy substances, and even then not much good. It burns like crazy and makes the patient, especially kids, resent and resist my efforts. If I injured myself in the outdoors, I wound do my best to just copiously irrigate it with water and dress with a clean, protective dressing. I might use something like Bactroban or Polysporin ointment. As well, I don't prescribe the use of Neosporin because of the risk of "sentitization" to Neomycin which kinda like having poison ivy around the wound (adding "insult to injury"). Most wounds take 2-3 days to manifiest infection, which allows most hunters/campers/outdoorsmen time to reach medical attention. In a true, long term survival situation you may be, well, screwed. Infections in a survival situation can be deadly, either directly or indirectly by affecting your ability to deal with your other survival requirements.
 
I think, though, that our medical advise has gone well off the question of the OP.

Copious amounts of water, a fresh bandage, rest and relaxation are not exactly in high supply in the bush in the case he was laying out.

If he was to carry one thing (he asked about a small bottle of alcohol) what would it be? I suggested Iodine (as well as - if you are in a tough spot - urine) and many others have had suggestions. I think that is the question of the thread - not necessarily "How should one treat a wound".

So - to the local doc's on this board - if you could carry one thing, a small thing, in a PSK for a wound and preventing infection - what would it be?

TF
 
Talfuchre said:
I think, though, that our medical advise has gone well off the question of the OP.

Copious amounts of water, a fresh bandage, rest and relaxation are not exactly in high supply in the bush in the case he was laying out.

If he was to carry one thing (he asked about a small bottle of alcohol) what would it be? I suggested Iodine (as well as - if you are in a tough spot - urine) and many others have had suggestions. I think that is the question of the thread - not necessarily "How should one treat a wound".

So - to the local doc's on this board - if you could carry one thing, a small thing, in a PSK for a wound and preventing infection - what would it be?

TF
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The question is based on a false premise but I'll play. If I could only carry 1 thing to prevent infection in a wound it would be a way to make water potable. If I was allowed a luxury item on top of that it would be a tube of vaseline.
 
No disrespect intended here, butI have read this thread with some amusement and some amazement. The OP asked what to carry to treat wounds. Two physicians have now said, in effect, that covering a dirty wound with any ointment will not help. They have given good reasons why alcohol and iodine should not be used. They have advised to wash the wound with potable water and apply compression to stop the bleeding. This is great advice from people who know what they are talking about, yet we still are getting responses to the contrary. If you are trying to share your own personal "folk remedy" that's OK, but maybe that should be its own thread. For me, I'll just carry my water filter, some gauze and a tube of Vaseline.
 
It is because of this thread that I've decided to have my real name in the signature of every post on every place I post on the internet. I've been leaning that way for a while, but this thread convinced me. I was worried about weird internet stalkers etc, but it isn't hard to figure out who someone is anyway if you're motivated. This way, the name is right there, you know who you're talking to. I'm doing a podcast episode about this thread in the next few days.
 
"I'm doing a podcast episode about this thread in the next few days." Thank you for taking the time to do that, Kyle. I will be watching for it.

Bill
 
Talfuchre said:
I think, though, that our medical advise has gone well off the question of the OP.

Copious amounts of water, a fresh bandage, rest and relaxation are not exactly in high supply in the bush in the case he was laying out.

If he was to carry one thing (he asked about a small bottle of alcohol) what would it be? I suggested Iodine (as well as - if you are in a tough spot - urine) and many others have had suggestions. I think that is the question of the thread - not necessarily "How should one treat a wound".

So - to the local doc's on this board - if you could carry one thing, a small thing, in a PSK for a wound and preventing infection - what would it be?

TF
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If water is in such short supply that you can't use some to clean a wound then wound infection is the least of your problems. Water is essential. So Water is my first item.
Next, Vaseline has multiple uses in an outdoor situation, from firestarting to treating chaffing / lip balm...as well as wound care., So vaseline . Perhaps vaseline cotton balls could be used, though I would not like the dacron or cotton fibers contaminating the wound. There is a vaseline impregnated dressing (eg: Adaptic) which could serve a dual purpose, I suppose.
Finally, a dressing such as a sterile 4x4 gauze pad, or Telfa dressing., I carry a bit of Cover-Roll Stretch adhesive dressing which is good for dressing areas of the body which bend and move (eg: Hands, knees, elbows)It stays attached even when wet, good to temporarily support of gaping wounds.
 
Damn it, my Feces Urine Belly Button Lint remedy has caused me serious infection in my left eye. I'll heat up my Swiss Army knife to cut it out while simultaneously cauterizing the wound, maybe pour some gun powder on it, then light it on fire. I learn through experience, it's the best way.
 
NeedItCheaper said:
Damn it, my Feces Urine Belly Button Lint remedy has caused me serious infection in my left eye. I'll heat up my Swiss Army knife to cut it out while simultaneously cauterizing the wound, maybe pour some gun powder on it, then light it on fire. I learn through experience, it's the best way.
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A voice from beyond the grave. :eek:
 
Hey, whats the deal with Medi-Honey? How does that work for wound care? The skin/ostomy nurses keep coming by and writing orders for it, but none have ever been able to give me a solid answer on the mechanics and theory behind it. You'd think a sugary, moist environment would promote bacterial growth instead of the opposite.
 
Street Samurai1978 said:
Hey, whats the deal with Medi-Honey? How does that work for wound care? The skin/ostomy nurses keep coming by and writing orders for it, but none have ever been able to give me a solid answer on the mechanics and theory behind it. You'd think a sugary, moist environment would promote bacterial growth instead of the opposite.
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Part of the bees immune system is passed on through the honey they feed their babies.

It has antibacterial properties.
 
Street Samurai1978 said:
Hey, whats the deal with Medi-Honey? How does that work for wound care? The skin/ostomy nurses keep coming by and writing orders for it, but none have ever been able to give me a solid answer on the mechanics and theory behind it. You'd think a sugary, moist environment would promote bacterial growth instead of the opposite.
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Interesting question. My uncle, a GP in the hills of Arkansas, use to use a mixture of Sugar, Betadine and Menthol Shaving cream to treat decubitus ulcers (Bed Sores) with very positive effects. Often, the large necrotic & fetid wounds that would not respond to conventional wound care would respond to this mixture very favorablly. There apparently are different mechanisms involved, and I am not authority on them, but apparently the major effect is being hyper-osmolar, reduces the free water for microbes to thrive in, as well as adversly affects the microbes necessary enzymatic activities, affects the molecular structure of the Microbes DNA and perhaps increases production of bacterial and yeast production of Ethanol and Lactic Acid. There are some studies to indicate that honey is superior to table sugar. I don't have any reliable source for the reason, perhaps Averageiowaguy, a real wound care authority, can explain.
Again, my first aid treatment for acute wounds is to gently clean and dress, and avoid products that may injury tissues (eg: hyperosmolar products).
 
Codger_64 said:
And I didn't let Jake lick it either, though he wanted to. He did carefully lick all of his bleeding paws though. None of his cuts are infected today but he sure is tenderfooted. He is just sitting on the porch instead of romping in the yard chasing bees and butterflies. I gotta buy him some waterboots.
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Whoa ... perhaps I missed something ... but how did Jake cut his paws? Sorry if it is already explained ... I am doing more than reading these summer/autumn days ... already had first frost here. How did Jake cut his paws?
 
DoctaD said:
Interesting question. My uncle, a GP in the hills of Arkansas, use to use a mixture of Sugar, Betadine and Menthol Shaving cream to treat decubitus ulcers (Bed Sores) with very positive effects. Often, the large necrotic & fetid wounds that would not respond to conventional wound care would respond to this mixture very favorablly.
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That is an interesting concept. I treat a whole lot of those. I debride, relieve pressure and choose an appropriate wet to dry or other dressing. Dakin's solution in 1/8th strength (randomized controlled trial supported) is one of the main things I use. He used the menthol shaving cream for smell I reckon.

There apparently are different mechanisms involved, and I am not authority on them, but apparently the major effect is being hyper-osmolar, reduces the free water for microbes to thrive in, as well as adversly affects the microbes necessary enzymatic activities, affects the molecular structure of the Microbes DNA and perhaps increases production of bacterial and yeast production of Ethanol and Lactic Acid.
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I was always taught this. The hyper-osmolar environment is the benefit of honey.
 
averageiowaguy said:
At this point my real name is out there for everyone to hear on the podcast. I guess I don't have any fear of weird stalker types any more like I used to.
I'm going to give it here so that people can verify that I am in fact an expert in trauma/wounds. Look up Kyle Ver Steeg II, M.D. My dad has the same name missing the II part. It should be easy enough to verify that I graduated from Northwestern Medical School, did a general surgery residency at The University of Kansas in Kansas City and a plastic surgery residency at Louisville, with part of my training being at Kleinert and Kutz for hand surgery (hence my interest in ergonomic handles.). You can also verify that I'm board certified in both General Surgery and Plastic Surgery. Also you will find that I am a Fellow of the American College of Surgeons and a full member of the American Society of Plastic Surgeons. I do not give medical advice to patients over the Internet, but I try to make sure that I at least give evidence based answers when it comes to wilderness medical scenarios.
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Thanks for bringing all that to light, doctor. I've been subscribed to your YouTube vids for a while and appreciate you sharing information. I was always curious as to what your education and/or employment was; now, we all know.

Stay sharp,
desmobob
 
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