Best disinfectant for cuts in the out doors?

averageiowaguy said:
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.



I was always taught this. The hyper-osmolar environment is the benefit of honey.
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I remember seeing canisters of Barbasol menthol shaving cream in the nurses station of the nursing homes that he served, which were either there at his request or because it was the kind of shaving cream that they had on hand already. Not sure. I do remember him saying that he thought the sugar was the most important ingredient and that the thick shaving cream, being thick and adherent was more of a vehicle to hold the other ingredients. His dad (my granddad) was a pharmacist and used menthol in some of his concoctions ;so maybe that was the impetus for it's use.
 
taldesta said:
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?
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Jake is a hyperactive dog. He loves to swim, even though he is not a waterdog breed. And with that, he digs into the rock riverbed chasing crawdads, minnows and, well, just digging. So he cuts his pads on the limestone rock shards. If I throw a rock in the water, he will dig for it until he thinks he has it, then dive under to retrieve it and bring it to me. So anyway, rock cuts. I am using udder creame now. A day or two of constantly soaked paws dries out all the oils that keeps them pliable and teh cream has lanolin to help soften and moisturize them. But I am going to try water boots. Maybe they wont impede his swimming since some waterfowl dogs use them. And maybe he won't act like a cat with duct tape on it's paws.
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interesting read fellas. two things....
1) thanks for caring averageiowaguy (and DoctaD)
2) speedy recovery Codger. bummer.
 
Today was day five and the hand feels a lot better. The quarter sized patches are down to dime sized and the dime sized are just q-tip sized scabs with very little tightness and puckering. I am feeling some pain deeper in my hand now so a small fracture is possible. I did get the hand caught between a rock (sharp limestone outcropping) and a hard place (my 1 1/2" aluminum canoe gunnel) with the full force of the river. This too shall pass.
 
I'm a pharmacist and I'm finding this thread interesting. I've got a doctor of pharmacy degree, and work retail pharmacy. I also was a chemist and drug compounder for a pharmaceutical company before I went to pharmacy school. My wife is an Internal medicine physician. So this is like my normal table talk. :)

In retail I am often confronted with all sorts of minor cuts, blisters, and scrapes at the pharmacy counter. So I end up being a triage station. Of course the minor things I just help them out with, anything I feel is infected or too deep I either send to ER or their doctors. The people come to the pharmacy cause my opinion and advice is free, and most people aren't sure what to do. I agree with Doctor Averageiowaguy. I usually give them the same advice. If they have tried triple antibiotic before, then I will usually tell them it's fine for minor cut and abrasions. I've also had doctors send patients to the pharmacy to buy it as well. I also usually tell them to keep it clean and covered if it is in a place that can easily get dirty. If it isn't in an area where it will get rubbed or dirty, and not bleeding, I tell them to just leave it uncovered. Again this is MINOR scrapes and cuts. I also frequently get people with friction and heat blisters in as well. Large scrapes and some burns I've seen doctors send them in for occlusive, or semi occlusive bandages to keep the area moist. But don't quote me on that cause its definitely beyond my area of expertise.

I usually have mercurochrome (monkeys blood) around for the old timers that come in. My grandmother put that stuff on me for just about anything. Bactroban (mupirocin) is pretty awesome because it has good staph and strep coverage, but that's a prescription drug.

The menthol shaving cream in DoctaD's uncles home remedy is not a bad idea. Most shaving cream has plenty of emollients, moisturizers, and cleansers in them. The thickness of the shaving cream would be pretty good to help spread it around. Plus it would smell good. :) I've compounded creams with some of the same ingredients.

I have some shaving cream around here that has aloe in it too. That would be great as long as you weren't allergic to it. As far as what to carry in a PSK, I carry around a small container of Vaseline, various sized bandages, and some alcohol swabs. The Vaseline, bandages, and alcohol swabs have multiple uses. I'm sure you could see fire starting potential with all three.

One thing I would add is to make sure your tetanus vaccine is current. Tetanus vaccine is usually given every 10 years.

Thanks for all the input, this has been pretty informative. Averageiowaguy, I'm going to try to catch your podcast. I would definitely love to get some wilderness first aid CE. I'm going to look into that. Might be a tad bit more interesting that going to drug rep dinners.
 
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DoctaD said:
I remember seeing canisters of Barbasol menthol shaving cream in the nurses station of the nursing homes that he served, which were either there at his request or because it was the kind of shaving cream that they had on hand already. Not sure. I do remember him saying that he thought the sugar was the most important ingredient and that the thick shaving cream, being thick and adherent was more of a vehicle to hold the other ingredients. His dad (my granddad) was a pharmacist and used menthol in some of his concoctions ;so maybe that was the impetus for it's use.
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When I did my clinicals as a CNA in nursing homes (about 3 years ago), the residents got to chose their own shaving cream :)

So maybe it was at his request is just that comes have changed. Idk.
 
Codger_64 said:
Today was day five and the hand feels a lot better. The quarter sized patches are down to dime sized and the dime sized are just q-tip sized scabs with very little tightness and puckering. I am feeling some pain deeper in my hand now so a small fracture is possible. I did get the hand caught between a rock (sharp limestone outcropping) and a hard place (my 1 1/2" aluminum canoe gunnel) with the full force of the river. This too shall pass.
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I'm about 2 months in and my finger is still not healed, thankfully just all skinned over.

Hand wounds are very inconvenient.

Good luck in your speedy healing Codge :)
 
stvpourciau said:
When I did my clinicals as a CNA in nursing homes (about 3 years ago), the residents got to chose their own shaving cream :)

So maybe it was at his request is just that comes have changed. Idk.
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I believe that the nurses had the shaving cream to shave debilitated residents that couldn't shave themselves and were unable to obtain or choose it. Things have definitely CHANGED...it was over 30 yrs ago that I saw him use the concoction.
 
Did anyone see the article on the internet yesterday about guy that cut the end of his finger off? The insurance company wanted to remove the rest of the injured finger. He chose to go with a Doctor experimenting with a new procedure and the result was he grew the finger tip back, including the nail? The process involved using a pig bladder, freshly covering the wound each day with new layers of the bladder. The doctor said it caused the finger to regenerate much the same as using stem cells would.
 
The ability of a healthy human body to heal on it's own is quite amazing to me. At five years old I had the tip of a finger amputated in a farm accident, well below the nail. The bone was left exposed when the flesh was stripped away, so the doctor clipped the bone off flush with the remaining flesh. A bit more than a half century later, I have a fingernail on that finger and flesh that extends well beyond the end of the trimmed bone. And I have full function and sense of touch of even the last joint to the "new" fingertip. Had this happened to me today, the amputated tip could be reattached, including muscle and nerve, useing microsurgery.
 
stvpourciau said:
When I did my clinicals as a CNA in nursing homes (about 3 years ago), the residents got to chose their own shaving cream :)

So maybe it was at his request is just that comes have changed. Idk.
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That's if your patient's aren't on heparin, Coumadin, Lovenox or the like. Then its the Norelco for them.

Menthol is a nice soothing solution. It's one of the active ingredients in IcyHot. I'm a big proponent of the Gate Theory, so if the pain meds I dose my patients with aren't as effective as I want them to be, I use A little IcyHot on their shoulders and back. They love it, takes their mind right off the pain. The docs are fine with it, too. One of the things I've found is that if you have all your info together, a good plan, and know what you're talking about, the docs are usually more then amicable towards your requests. Of course, this is surgical/oncology. Not sure what it's like in the other areas.

When we get surgery patients, its keep the wound clean, covered and dry. We get plenty of post-op open surgeries, but we get more patients coming in for exploratory laparotomies, fibroid lysis and removals, and they leave small holes which may get a few stiches, then covered with a bandaid, with the above protocols, sometimes without them having received any abx, topical or otherwise. When I was with trauma, lacerations and road rash would be treated with one or two applications of triple antibiotic ointment, then covered with tape over gauze, or left open to air. We didn't slather the stuff on, just a thin film. I think too many people put half the tube on a small cut.
 
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averageiowaguy said:
One of these days I need to do a video on wound care in the woods. Once you've broken the skin, there is no such thing as a sterile wound, even in surgery. There are bacteria and other organisms on your skin even after we've "prepped" it with betadine, alcohol scrub, chlorhexidine etc. But even though we never get a completely sterile wound, the wound infection rate for a "clean" wound in surgery is only 1-4%. It can be even less depending on the type of surgery and the body part operated on. I have a zero percent infection rate with surgery on the face after 5 years of doing so.

In the woods, you're dealing with a contaminated wound. The thing to do is stop the bleeding with direct pressure and then wash the wound with water that you would drink. If you can drink the water, you can wash a contaminated wound out with it. Get all of the dirt and other debris out of the wound. If it starts bleeding again, hold pressure. Seek medical attention as soon as possible.

Bandage requirements are much too complex for me to get into in a short post, but suffice it to say that the bandage will vary based on the wound itself and the environment you're in. Using no bandage at all is acceptable depending on the wound itself and the environment you're working in.



If you want to put something on the cut, put vaseline on it, unless you're allergic. Do this ONLY AFTER the wound has been cleaned.
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Wouldn't the high bacterial load and the less than perfect cleaning you would get in the woods using just water - (no mention of soaps)
plus the addition of a Vaseline covering promote anaerobic bacterial infection ?

People like to use CA glue to close up wounds to - bit of a DIY macho thing to do
Wouldn't that have the same problems?
 
averageiowaguy said:
I think if all you have to clean out a heavily contaminated wound is pee, you're in a world of trouble despite having a wound. That said, unless the person doing the peeing has a urinary tract infection, urine coming straight out Anthony Weiner (sorry, I couldn't resist) should be sterile. If you have no other options to clean a wound, in theory this would work. The only problem would be, if you waste all your pee cleaning out a wound, Bear Grylls would have nothing to drink.

Does anyone know anyone first hand who has used pee to clean out a wound? I mean, verifiable, trustworthy, first hand information? As I said above, if you're down to using pee to clean out a wound, likely you've got other major problems. I wonder how many people walking around would survive a situation like that?
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You may find this entertaining

http://www.youtube.com/watch?v=b8zd5mMDuew

This is one in a series of videos documenting "urine therapy" on a patient with gangrenous toe
They mean - topical application as well as drinking it - they call it "water of life"


I can't believe they didn't die from it.
 
Thomas Linton said:
How often would you encounter anaerobic bacterial in the woods? Commonly? Rarely?

Is WPJ air-tight?
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It's on your skin and in your mouth
Wiki quote
" anaerobes are the predominant components of the skin's and mucous membranes normal flora, they are a common cause infections "

Vaseline is a grease / oil that can seal out air
 
This, he knows what he's talking about.

averageiowaguy said:
One of these days I need to do a video on wound care in the woods. Once you've broken the skin, there is no such thing as a sterile wound, even in surgery. There are bacteria and other organisms on your skin even after we've "prepped" it with betadine, alcohol scrub, chlorhexidine etc. But even though we never get a completely sterile wound, the wound infection rate for a "clean" wound in surgery is only 1-4%. It can be even less depending on the type of surgery and the body part operated on. I have a zero percent infection rate with surgery on the face after 5 years of doing so.

In the woods, you're dealing with a contaminated wound. The thing to do is stop the bleeding with direct pressure and then wash the wound with water that you would drink. If you can drink the water, you can wash a contaminated wound out with it. Get all of the dirt and other debris out of the wound. If it starts bleeding again, hold pressure. Seek medical attention as soon as possible.

Bandage requirements are much too complex for me to get into in a short post, but suffice it to say that the bandage will vary based on the wound itself and the environment you're in. Using no bandage at all is acceptable depending on the wound itself and the environment you're working in.

If you want to put something on the cut, put vaseline on it, unless you're allergic. Do this ONLY AFTER the wound has been cleaned.
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averageiowaguy said:
I think if all you have to clean out a heavily contaminated wound is pee, you're in a world of trouble despite having a wound. That said, unless the person doing the peeing has a urinary tract infection, urine coming straight out Anthony Weiner (sorry, I couldn't resist) should be sterile. If you have no other options to clean a wound, in theory this would work. The only problem would be, if you waste all your pee cleaning out a wound, Bear Grylls would have nothing to drink.

Does anyone know anyone first hand who has used pee to clean out a wound? I mean, verifiable, trustworthy, first hand information? As I said above, if you're down to using pee to clean out a wound, likely you've got other major problems. I wonder how many people walking around would survive a situation like that?
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The self same said uncle 50 years ago used it
He was an educated man and was a wealth of knowladge

But I am not going to where I could verify with him..............
 
I was taught in my advanced first aid class years ago to use normal saline solution for wound irrigation, as has been mentioned here in this thread, and from what I understand irrigating a wound with saline solution will not only wash away dirt and debris, it will also disinfect the wound. I'm curious just how good of a disinfectant it is... anyone know? I've never made if myself, but it can be easily improvised in the field with simple table salt and sterile water (about 1tsp salt per litre of water).

I've always had good luck with Bactroban, a prescription is needed so I usually pick up a tube or two when I'm out of the country somewhere where a prescription is not required. I'm curious about how the medical professionals here feel about a glycol based cream (i.e. Bactroban) vs a petrolatum based cream (i.e. Polysporin) and are there any health effects or benefits to either (wondering about the "base" rather than the "active ingredients")?
 
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