Ripped hand. How to help a victim with a laceration

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Violation of the integrity of the skin and mucous membranes, which is formed under the action of a rupture, when the ability of the skin to stretch stops - this is called a laceration.

Such a lesion occurs with damage to muscles, blood vessels, nerve fibers and accompanied by . The boundaries of the wound are uneven, sometimes significant skin detachment and scalping are noticeable. In this case, only surgery, but in any situation it is clearly necessary to provide first aid as soon as possible.

What is a laceration

Violation of the integrity of the skin occurs under acute angle, as a result of a blow with a heavy object, areas of exfoliated skin are formed. Such damage is characterized by shallow depth and torn edges. The resulting wound does not gape, however, the exfoliated skin flap often has a large area, its complete separation is possible.

Causes of lacerations:

Blood from such an injury follows to a lesser extent than, for example, with incised wounds, but they are more contaminated, since a fall often occurs on gravel, asphalt.

If the hair as a result of a torn injury gets into moving mechanisms, scalping of the scalp occurs with partial or complete detachment of the skin.

Scalping of hands or feet occurs during an accident if the limb gets under the wheels of vehicles.

Most often, such injuries are received by motorcyclists, cyclists, summer residents, fishermen or hunters.

Symptoms

The degree of damage inflicted directly affects how pronounced the signs are. Very often, the damaged area becomes infected, as dirt, fabric from clothing, glass fragments, small pebbles, and sand get into the wound.

Immediately after receiving a laceration, a person feels sharp pain. In some cases, the scalped piece hangs from the surface, complete or partial detachment of individual foci occurs.

Symptoms of a torn type injury:

The borders of the lesion are of an irregular patchwork shape, crushed;
At the bottom of the wound, a fatty layer is noticeable, a little less often muscle fibers or tendons;
Subcutaneous hematomas are formed;
Sensitivity around the damaged area is disturbed.

AT rare cases these wounds are combined with other types of injuries, such as fractures of the arms, legs, spine, craniocerebral injuries, fractures of the pelvic bones, rupture of internal organs.

First aid for lacerations

To help the victim with lacerations, you need to follow a few basic points, just as with other injuries.

Stop bleeding

The victim needs before arrival medical team Ambulance. To do this, it is necessary to determine the amount of blood loss and the type of bleeding.

If the blood does not flow out of the wound much, it is enough to press the vessel with your fingers.

With massive bleeding and in the case when the exact localization of the laceration cannot be determined, it is necessary to apply a tourniquet or a tight pressure bandage.

If there is no medical tourniquet nearby, stop the nearest car and use car first aid kit. Can also be used for or twist dense fabric, scarf, belt, scarf.

Keep the tourniquet on the damaged area in the summer for no more than 2 hours, winter time no more than 1.5 hours.

Treatment of a laceration

Being at home as part of the treatment of a lacerated wound, it is necessary to exclude further infection - the damaged focus should be treated with any antiseptic. It is best to use 3% hydrogen peroxide for this, it creates a rich foam on the surface, which helps to expel dirty elements.

After treatment with peroxide, the wound must be dried with a sterile gauze swab and the borders of the injury should be treated, capturing healthy areas of the skin.

You can treat the edges of the injury with any alcohol solution: brilliant green, iodine solution, alcohol or vodka.

dressing

The next step is to bandage the damaged area in order to maintain sterility after treatment.

Small lesions are isolated with a sterile napkin and adhesive tape. Extensive injuries should be bandaged with sterile material or a clean cloth.

Treatment of lacerations

An injured person should be quickly taken to the hospital, where he will be provided with qualified assistance.

First aid for laceration in an outpatient setting:

Minor injuries are treated on an outpatient basis;
The surface is abundantly washed with antiseptics, non-viable edges swell, drain or sutured;

With a successful outcome suture material removed on day 10;
If the wound is infected, it is washed, if necessary, opened and expanded, freed from purulent contents, non-viable tissues are removed, drainage is used without suturing.

Victims who have extensive torn surfaces are subject to hospitalization in traumatology. It is likely that these patients have traumatic shock they need urgent anti-shock measures. The earlier the measures are taken, the more favorable the prognosis.

AT intensive care unit the condition of the victim, the nature of the injury, the severity of the injury are taken into account. The patient is being active anesthesia, use all measures to restore blood circulation, cardiac activity, respiration.

Qualified doctors for serious lacerations:

In the phase of healing and epithelialization, patients undergo general strengthening treatment, dressings are carefully made using antibacterial drugs which further enhance tissue regeneration.

If the injured area is very extensive and a large skin defect is observed, free skin grafting or plastic surgery with a displaced flap is performed.

Drugs and antibiotics for lacerations

Eliminate the possibility of the wound moving into purulent stage and warn various complications possible with antibiotics.

In order to prevent complications of injury, specialists may prescribe the following groups of antibiotics for lacerations:

Antibiotics penicillin series- Amoxicillin, Ampicillin, Benzylpenicillin, Ampiox, Oxacillin;
If the pathogen is resistant to penicillin, cephalosporins are prescribed - Cefamisin, Cefalexin, Cefazolin;
Macrolides are used if the pathogen is resistant to both penicillin and cephalosporins. These are drugs such as Erythromycin, Macropen, Spiramycin, Roxithromycin;
In some cases, a tetracycline series of drugs is prescribed - Minocycline, Tetracycline.

Most often in the absence allergic reactions antibiotics from the penicillin series are prescribed, their use causes the least harm to the body.

Consequences of injuries and healing time

Ragged injuries after healing leave large flaws on the skin. To prevent this, immediately after first aid and wound cleansing, skin grafting is done.

Skin plasty methods:

The operation is done on extensive wounds with a clean bottom and starting healing. The graft is taken from the front of the thigh or from the abdomen. The flap is applied to the wound, straightened on the surface, sewn along the border. Then superimposed pressure bandage to press the flap. Healing takes place in 2 weeks;
Displaced way skin flap is used for granulating lacerations after infection is eliminated, the wound bed is cleared of necrosis, microcirculation and blood flow are restored.

The essence of the method of displaced skin flap is that the skin defect is replaced by a piece of skin from neighboring areas.

Before the operation, the surgeon draws up a plan of movement, depending on the shape of the damaged surface. Most often, counter pieces are used in the form of rhombuses or triangles. The graft takes root within 10 days.

muscles human body, in case of violation of integrity, are able to independently recover. If an open wound on the leg is treated in time from dead cells, a new healthy tissue begins to grow in their place, gradually closing the wound opening.

The process of healing an open wound on the leg takes place in three stages:

Independent primary cleansing, in which blood flows abundantly into the wound cavity.
Inflammation that begins after injury provokes tissue swelling. Leukocytes are massively formed, contributing to the cleansing of the wound site from dead cells.
The final stage is characterized by the formation connective tissue, which gradually tightens the edges of the wound, forming a scar.

Injury classification

Wounds on the leg are divided according to the following criteria:

Violations of the tissue surface (penetrating and non-penetrating). The former are characterized by damage to the integrity of the joint membrane, in the latter case, the skin and subcutaneous muscles are susceptible to injury.
The presence of an infection of unclear, purulent, aseptic origin.
The change in the wound cavity depends on the type of object that caused the violation of the integrity of the tissues.

Open wounds are:

Stab - the depth of penetration is greater than the diameter of the superficial wound.
Carved - characterized by an extensive entrance, but shallow depth.
Chopped - they are distinguished by a deep wound, often with bone damage.
Torn - obtained by breaking the skin and muscle layer. Characterized by a wound surface with uneven edges, in some places the epidermis is absent.
Gunshot - degree of damage muscle tissue depends on the type of weapon.

First aid

If a lacerated wound is received on the leg, it is advisable to take the victim to the doctor, after first providing first aid. The speed of healing of an injury depends on the correct pre-medical actions, the prevention of purulent inflammation wound cavity, sometimes even human life.

Instructions on how to treat an open wound at home:

If there is bleeding, then it must be stopped. injured leg should be raised so that the foot is above the level of the head. If the artery is damaged, it is recommended to pinch the vessel with a finger and apply a tourniquet, recording the time of manipulation.
The wound on the leg should be disinfected with antiseptics: 3% hydrogen peroxide, furacilin solution (1 tablet per 100 ml of boiled water), a slightly pink solution of potassium permanganate. You can crush the tablet "Streptocide" into powder and sprinkle the affected area. AT last resort you need to treat the wound with brilliant green or apply a thin layer of anti-inflammatory ointment on it.
Fragments of a foreign object present in the wound cavity must be removed with tweezers treated with alcohol. If the fragment is large and the wound is deep, it is better not to touch anything and provide assistance to a specialist.
Cover the injured surface with a sterile napkin and apply a tight bandage.
If a bone in the leg is broken, or a joint is broken, it is necessary to ensure that the limbs are immobile by applying a splint from improvised material.

How to make a dressing

It is recommended to change the bandage on the leg daily, for this it is necessary:

Take off dressing. If the bandage is stuck to the wound, soak the scab boiled water with the addition of an antiseptic, which is available: furacilin solution, hydrogen peroxide and others.
Wash the edges of the wound on the leg with warm boiled water, disinfect with brilliant green or alcohol solution calendula, chamomile, St. John's wort. If the surface is contaminated with auto-lubricating mixtures, it should be used for hygiene procedure refined gasoline. Processing is carried out with gauze balls. Iodine should not be used due to high danger burn.
Examine the inflamed cavity for the presence of pus, fragments foreign objects. Large deep-seated fragments are not recommended to be removed independently. It is safer to contact medical institution to provide qualified assistance.
If purulent contents have formed on the surface, it is recommended to clean the wound gauze swabs, drenching each only once.
With suppuration inside, cleaning should be entrusted to a surgeon in order to exclude the consequences of inflammation, up to blood poisoning and death. How to properly treat a purulent injury can only be known by a doctor who will make an appointment, combining medicines for external and internal use.
after cleansing wound surface cover with sterile material and fix with a gauze bandage.

When is it necessary to visit a doctor?

The patient should be shown to a specialist if:

the integrity of blood vessels, tendons is broken;
it is necessary to sew up a deep wound;
stab wound, with infection;
the bone is damaged, the joint is broken;
the leg does not perform functional movements;
the person is in shock.

If the wound surface is contaminated with earth, it is necessary to treat the leg with an antiseptic to prevent suppuration. Be sure to get vaccinated against tetanus.

The formation of a purulent wound is accompanied by the following symptoms:

an increase in body temperature;
throbbing pain at the site of inflammation;
the occurrence of a tumor.

Treatment of an open wound on the leg must be carried out under the guidance of a doctor, strictly following all his prescriptions and recommendations. sew up deep incised injury should be no later than six hours after the injury. If there is a suspicion that the wound is infected, then stitching is not recommended. Zones high risk infection - the upper third of the thigh, the sole of the foot.

What to do at home to speed up the healing of an open wound on the leg:

daily dressing, each time treating the injured area with an antiseptic and applying a sterile napkin;
lubricate treated area wound healing ointments after consulting with your doctor.

It should be remembered that medicinal ointments on a fatty basis, applied to the wound surface in a thick layer, can cause inflammation and the formation of pus.

Variety open wounds on the leg are considered trophic ulcers that occur with varicose veins lower extremities. Provoke the formation of weeping injuries endocrine diseases, diabetes. People suffering from these diseases should be especially careful.

Why open wounds take a long time to heal

As a rule, the following reasons prevent rapid healing:

high sugar content in tissues;
subcutaneous layer of fat;
decline vitality with anemia, iron deficiency;
skin diseases.

Folk methods for the treatment and treatment of an open leg injury

It happens that in time to receive a timely medical care fails. In this case, you can start treating an open wound using folk recipes.

When choosing how to treat the wound surface, it is recommended to use medicinal plants with disinfectant action. These include:

Water decoction or alcohol tincture of calendula, birch buds, wormwood.
leaflets indoor plants- Aloe or Kalanchoe. Remove the thin skin and apply the fleshy side to the wound, fixing it with a bandage or plaster.
Bee honey, smeared with it thin layer wound surface, place a sterile napkin on top and make a dressing.
Yarrow greens should be chewed until smooth and applied to a cut or stab shallow wound.
Treat the affected area with celandine juice.

The following folk remedies help speed up the treatment of a wounded limb:

Ointment made according to the recipe of Valentina Seymova. Spread a thin layer of ointment on the injured surface overnight. Do not apply a bandage.
St. John's wort. Fill a dark glass container with dry or fresh flowering St. John's wort by ¾. Fill to the brim with refined sunflower oil, insist in warmth and darkness for three weeks. Smear the resulting composition on the wound 3-4 times a day until healing.
Wormwood, coltsfoot, plantain, calendula. Make lotions on the wound surface from the infusion on the water.
Plantain leaves. Apply to the wound with a smooth side, fixing with a gauze bandage.

How to treat an open wound on the leg, the patient himself chooses, but it is advisable to consult a doctor before that so as not to harm your health. During treatment, it is desirable to supply the diet with vitamins to speed up the healing process. It is recommended to additionally drink multivitamins.

Lacerations are formed under the influence of solid blunt objects acting at an acute angle to the surface of the body. A feature of a lacerated wound is a significant detachment, as well as scalping of the skin over a very large area. Moreover, the exfoliated area of \u200b\u200bthe skin may lose nutrition and become necrotic. In addition, the uneven edges of lacerated wounds slow down the healing process.

A laceration on the leg is a fairly common occurrence. The most susceptible to the formation of such wounds are gardeners and summer residents, with careless handling of garden tools, as well as children, fishing enthusiasts, hunters and many others. No one is immune from this trouble.

What to do if a laceration occurs? It should be remembered that all wounds that are accidentally formed are bacterially contaminated, therefore, in order to prevent additional penetration of bacteria into the wound, when providing first aid, cotton swab moistened with an antiseptic solution (alcohol, iodine), remove contamination from the surrounding wound skin. Then lubricate the edges of the wound 5% alcohol tincture iodine, alcohol or a solution of brilliant green and apply an aseptic dressing. It should not be removed from the wound. foreign bodies and rinse it, when giving first aid. In addition, with extensive injuries of the soft tissues of the lower extremities, as well as with fractures, immobilization is used to prevent even greater damage. In the future, you should go to the hospital to the surgeon, who will determine further tactics laceration treatment.

If the laceration is small in size, then it can heal on its own, without the help of a specialist. But if, after a few days, swelling, redness appear around the wound, body temperature rises, you should consult a doctor immediately. Features of lacerations, in the form of uneven edges and significant exfoliation (scalping) of the skin, require careful treatment by a specialist. Deep wounds need to be operated on. They are sewn up to speed up healing and prevent the formation of rough scars. This must be done on time so that there are no complications. The surgeon performs a wound dissection and revision of the wound channel, then cuts out the edges, walls and bottom of the wound, stops the bleeding and sutures the wound. As a result, the wound turns from torn and infected into incised and aseptic, which contributes to its rapid healing. by primary tension.

Healing of lacerations usually occurs within two weeks. This process depends on many factors. Among them are:

Age of the patient: wounds heal most quickly in children.

Body weight: cachexia and obesity slow down the healing process.

The presence of secondary infection of the wound, which significantly lengthens and worsens the result of healing.

Chronic accompanying illnesses(tumors, cardiac vascular insufficiency, diabetes mellitus), which slow down the repair process.

Radiation therapy and anti-inflammatory drugs for early dates can slow down the healing process.

It should be remembered that a wound, even the smallest one, can lead to the development of sepsis (blood poisoning) and further to lethal outcome. Also, at improper treatment, the development of nonspecific purulent infection, as well as anaerobic infection, tetanus, rabies. Therefore, one should not be surprised why wounds heal poorly. Ultimately, the patient may even lose a leg. Therefore, it would be better to consult a specialist immediately after receiving this injury and not to self-medicate.

A lacerated wound is a traumatic injury soft tissues as a result of the tearing effect of any blunt mechanical damaging factor.

For most people, there is no significant difference between wounds. However, from the point of view of medicine, and traumatology in particular, there is a huge difference between various wounds. This difference primarily depends on how long the wound takes to heal, and what potential complications are expected during the healing period.

Slightly digressing from the topic, I would like to note one very important thing, understanding which it becomes clear why one wound heals quickly, and the other for weeks, or even months.

There are two main types of wound healing: healing by first intention and healing by secondary intention.

Healing by primary intention- this is the most favorable type of wound healing, in which the edges of the wound are even, are close to each other and, when in contact, fit snugly against each other. There are no blood clots, infection or bleeding in the wound. In this case, the edges of the wound seem to stick together themselves. Wound healing by primary intention occurs within 7-10 days from the date of its receipt. After its healing, there is no rough scar and any serious complications. A typical example of such healing is incised wound such as a knife or blade.

Wound healing by secondary intention- this is a type of wound healing, in which the edges of the wound are uneven, far apart from each other. The healing of such wounds usually occurs as if from the inside by gradually filling with young tissue. This tissue is discussed in detail in the article wound granulation. The duration of healing of such wounds is long and varies greatly depending on the size of the wounds. It can reach several weeks and even months and in most cases ends with the formation of a rough keloid scar. A typical example of such healing is any laceration.

What is a lacerated wound, and what are its features of healing?

The wound is called mechanical injury, in which damage occurs either to the skin or mucous membranes. In the vast majority of cases, the wound is characterized precisely by a violation of the integrity of the skin of the human body. A typical example of a torn is a rupture of the skin and deep tissues when they are overstretched, for example, when a limb gets stuck in any mechanisms or a rupture of the perineum during childbirth, and so on.

As a rule, the wound at the same time has uneven edges with many hemorrhages and necrosis of the edges of the skin. Without treatment, such a wound heals by secondary intention, i.e. for a long time, often accompanied by suppuration and in most cases leaves behind a rough scar.

There are two main methods of treating lacerations.

1) conservative method- it consists in performing banal dressings until the wound is completely healed. The wound heals by secondary intention. This type of treatment is acceptable only for small lacerations. In this case, the wound is most often treated with a 3% solution of hydrogen peroxide, its edges are smeared with iodine or alcohol, and a bandage with an antibacterial ointment is applied to the wound itself, for example, Levomekol ointment. This is discussed in more detail in the publication on ointments for rapid wound healing. With extensive lacerations, the duration of treatment is delayed and is fraught with the complications described above. That is why a different type of treatment is used to treat such wounds, such as:

2) Surgical treatment of the wound. The essence of this method of treatment is as follows. depending on the size of the wound or local anesthesia, or under anesthesia, torn and uneven edges of the wound are cut out with a scalpel (or, more correctly, excised) within healthy tissues. In this case, the edges of the wound become smooth and even, when they approach, the edges of the wound fit snugly against each other. Per additional information refer to the PST material of the wound (primary debridement). Most often, after surgical treatment of lacerated wounds, they are sutured with sutures applied to the skin, after which, in the absence of complications, they heal much faster, on average in 7-10 days (wound healing after surgical treatment occurs by primary, not secondary intention).

In conclusion, I would like to note that, regardless of the size of the laceration, with the exception of very small ones, the most favorable method treatment in terms of recovery and prevention of complications - surgical treatment of the wound. Moreover, the likelihood of complications directly depends on the timing of its implementation. To paraphrase the above, we can say the following - the earlier the surgical treatment of the wound is performed, the fewer complications are expected in the future and the Great chance its healing in terms of up to 10 days without the formation of rough scars.

That is why, in the presence of any lacerated wound, it is necessary on the very first day from the moment of its receipt to contact either the trauma center or the duty surgeon or traumatologist, depending on the profile medical institution to which you are applying.

Treatment of open wounds is phased and corresponds to the stages of development wound process- intracellular biochemical change tissues and other structures in the affected area. According to the canons clinical surgery, there are three such stages: primary self-purification, inflammatory reaction and tissue repair by granulation.

In the first stage, immediately after the formation of the wound and the onset of bleeding, blood vessels first reflexively contract (so that the platelets have time to form a clot), and then expand with complete cessation contractions (because neurohumoral regulation of vasoconstrictor and vasodilator nerves is blocked). In addition, the decay products of damaged cells expand the vessels in the wound area. The result is a slowdown in blood flow, increased permeability vascular walls and soft tissue edema. It has been established that all this contributes to their purification, since the expansion large vessels leads to an increase in the capillary bed and a rush of blood to the damaged area.

The second stage of the wound process is characterized by the development inflammatory response. Edema increases, hyperemia appears (due to increased blood flow). The accumulation of acid products of destruction of the intercellular matrix of damaged tissues and red blood cells causes local increase acidity (metabolic acidosis) and increased synthesis of antibodies that help remove dead cells from the body. Moreover, bleeding and inflammation increase the level of white blood cells in the blood. And leukocytes are neutrophils (the main phagocytes are killers pathogenic bacteria), basophils (involved in inflammatory processes) and agranulocytes (help neutrophils in cleansing the body of the remnants of destroyed cells and dead microbes).

During the third stage (which can also begin against the background of inflammation), cells of the new granulation tissue proliferate - in the open wound, as well as epithelial cells - from the edges and over its entire surface. Gradually granulation tissue converted to connective. And ends this stage when a scar appears at the site of the wound.

It is customary to distinguish between wound healing by primary and secondary intention. The first option is realized when the wound is small, its edges are maximally reduced to each other and there is no pronounced inflammation. In all steel cases, including those with purulent wounds, healing occurs by secondary intention.

Since the features of the treatment of open wounds depend on the degree of biochemical disorders in damaged tissues and the intensity of the recovery processes occurring in them, then the task of doctors is to correct and, if necessary, stimulate these processes.

Importance of primary treatment in the treatment of open wounds

First pre-medical actions to stop bleeding and antiseptic treatment wounds. To reduce the level of infection in washing the damaged area, peroxide, potassium permanganate, furatsilin or chlorhexidine (as a solution) are used. And brilliant green and iodine are needed to disinfect the edges of the wound and the skin around it. You also need to apply a sterile bandage.

The whole process depends on how clean the wound is. further treatment. In a medical institution with open stab-cut, chopped, torn, crushed and gunshot wounds their primary surgical treatment is carried out, which experts consider mandatory. Cleaning the wound of dead, damaged, or infected tissue will greatly facilitate and improve the healing process.

The surgeon removes foreign bodies and blood clots, excised crushed tissues and uneven edges, and then sutures - to bring the diverged edges as close as possible. In cases where the gaping of the wound does not allow to reduce the edges, it is left open, and the stitches are applied later. Final stage- overlay aseptic dressing. Serum against tetanus is also mandatory, and in case of animal bites - a rabies vaccine.

These measures allow you to speed up the healing process and minimize complications (suppuration, sepsis, gangrene). And if such treatment is carried out within the first days after receiving the wound, then you can count on the maximum positive result.

Treatment of an open weeping wound

With an excess of secreted serous-fibrinous exudate, an open weeping wound should be treated.

Discharge from the wound increases with an increase in hydrostatic pressure in inflamed tissues and a decrease in the oncotic pressure of blood plasma proteins (due to the loss of serum albumin). For healing, these secretions are necessary, since they contribute to active phagocytosis and cleaning of the open wound cavity. However, a weeping wound needs to reduce the accumulation of exudate - to improve blood circulation in the capillaries.

AT this case dressings should be changed frequently as they become soaked with secretions.

When changing the dressing, the wound is treated with a solution of furacilin (aerosol Furozol), sodium salt sulfacyl, sodium hypochloride, gramicidin, as well as liquid antiseptics such as Miramistin (Miramidez, Dezmistin, Okomistin), Betadine, Oxyquinoline, Octenisept, Iodizol.

To reduce the level of exudate in a weeping wound, an open wound is treated with common salt: a bandage moistened with a 10% aqueous solution of sodium chloride is applied (due to the combined action of chloride and sodium ions, normalization occurs osmotic pressure interstitial fluid). In this case, the bandage should be changed every 4-5 hours.

For application under a bandage or impregnation of tampons, Fudisin gel (with fusidic acid and zinc oxide), streptocid ointment, Nitacid ointment (with nitazole and streptocide) are recommended. Also, sulfonamides include antimicrobial ointments Streptonitol and Mafenide.

And the composition of Levomikol ointment, which, as practice has shown, promotes dehydration of the wound cavity and faster tissue regeneration, includes the antibiotic levomycetin (chloramphenicol) and methyluracil (a substance with anabolic activity). The ointment is recommended either to be applied to sterile wipes (to fill the wound cavity), or to be injected directly into the wound.

To dry weeping wounds, Xeroform powder (bismuth tribromophenolate), which also has bactericidal properties, or Baneocin (with the antibiotic neomycin and zinc bacitracin) are also used.

Treatment of an open purulent wound

An open purulent wound should be treated with regular removal purulent exudate, which during inflammation is formed in its cavity. Accumulations of purulent masses should not be allowed, as they can penetrate into nearby tissues, expanding inflammatory focus. Therefore, drainage systems are installed in festering wounds, including with the introduction of antibacterial drugs in the form of solutions. local action, for example, Dioxidine (Dioxysol). Local anesthetics are used to anesthetize drainage procedures: Dimexide (50% water solution for tamponing), dosed Lidocaine spray, Xylocaine aerosol.

For the purpose of biolysis of necrotic tissues and the destruction of pus, protein-splitting enzymes (proteases) are used in surgery: powdered preparations Trypsin, Himopsin (Chimopsin), Terrilitin, as well as Profezim suspension. A solution with sodium chloride and novocaine is prepared from the powder, sterile napkins are moistened with it and placed in the wound cavity (the napkin is changed every 1-2 days). If purulent wounds are deep, these agents can also be used dry.

In addition, to combat pathogenic microorganisms and the development of secondary infectious inflammation in conditions inpatient treatment antibiotics are used both by mouth (or by injection) and antibacterial ointments for the treatment of open wounds.

Inside the wounds (after cleaning their cavity from pus) is injected combined ointment Levosin, which includes chloramphenicol, sulfadimethoxine, methyluracil and trimecaine. This remedy not only kill germs and reduce the intensity inflammatory process but it also relieves pain. For medicinal and occlusive dressings, Levomikol ointment (with levomycetin) and Synthomycin liniment (racemic form of levocycetin) are used.

Ointments with antibiotics neomycin (Baneocin) are most effective against Staphylococcus aureus, ointments with nitazol (Nitacid) - against anaerobic microbes, 5% Dioxidine ointment - against many pathogenic microorganisms, including Pseudomonas aeruginosa and gangrene pathogens.

With regard to the treatment of open wounds, surgeons have recognized the advantage of ointments not based on petroleum jelly (or lanolin), but based on polyethylene glycols, in particular polyethylene oxide, a water-soluble viscous high-molecular homopolymer. Due to the hydrophilicity of this substance active ingredients ointments penetrate deep into the tissues and do not damage the intercellular membranes. In addition, the absence of fat, which seals the wound cavity and creates conditions for the reproduction of anaerobic infections, contributes to the accelerated removal of microbial toxins.

For this reason, classic vaseline ointments have become less commonly used in the treatment of wounds. Antibacterial liniment or Vishnevsky ointment (xeroform + birch tar on castor oil) dissolves pus and accelerates its excretion, resolves infiltrates and increases blood flow to the area of inflammation. The ointment is applied under the bandage - 1-2 times a day.

Hospitals also provide detoxification and immunotherapy for patients with open wounds. And ultrasound can be used to accelerate wound healing, a liquid nitrogen(cryotherapy) or hyperbaric oxygen therapy.

Treatment of open wounds at home

With minor and shallow injuries, open wounds can be treated at home. What kind pharmaceuticals- in addition to those listed above - are they used most often?

Streptocid (sulfanilamide) is used for superficial damage: grind the tablet to a powder state and sprinkle on the wound. Keep in mind that BF glue can only be used for scratches, small cuts and abrasions.

Balm Rescuer (with milk lipids, sea buckthorn, terpene and lavender oils, oil tea tree, echinacea extract, tocopherol and beeswax) forms a film on the surface of the epidermis. Therefore, the Rescuer ointment should be applied to an open wound after it has been treated with the same peroxide or chlorhexidine and dried.

Solcoseryl (belongs to the group biogenic stimulants): the ointment is recommended to be applied twice a day to dry wounds, jelly - to weeping.

Zinc ointment (usually used for weeping eczema and dermatitis): can dry out abrasions with excessive exudation. Imanin powder (from St. John's wort) will also help dry a weeping wound. And anti-inflammatory cream or spray Panthenol (dexpanthenol) can only be applied from the outside - on an abrasion or burn.

Troxevasin ointment (intended for patients with varicose veins), Heparin ointment (used for thrombophlebitis of superficial veins), Dolobene gel (heparin + dimethyl sulfoxide + dexpanthenol) can help relieve tissue swelling and bruising after bruising. Badyaga is used for the same purpose.

Cream or liniment Eplan (Kvotlan) on glycerin contains a complex of polyethylene glycols that have disinfectant and bactericidal properties; reduces the likelihood of infection in skin lesions.

Homeopathic ointment Traumeel (containing arnica, echinacea, belladonna, witch hazel, comfrey and other herbal ingredients) is used to relieve pain and bruising from bruises, sprains, fractures.

Treatment of open wounds with folk remedies

If a slight level of damage allows the treatment of open wounds folk remedies, then you should use:

St. John's wort, yarrow, heather, elecampane, fireweed, comfrey and calamus root, plantain, eucalyptus and raspberry leaves, as well as chamomile and calendula flowers (in the form of decoctions for compresses);
Fresh Juice aloe, sea buckthorn oil, rosehip oil - to lubricate the surface of shallow dry wounds;
propolis (aqueous solution) - for weeping wounds.

Also, do not forget about the mummy (caprolite or evaporite) - a powerful natural antiseptic and a reparative agent that has long been used in the treatment of any injuries, including open wounds.