The role of wound care ointment

The core functions of wound care ointment are three: to create a moist closed environment suitable for wound repair, to isolate pollutants such as external dust and bacteria, and to assist in relieving wound pain. The overall healing speed is 30% to 50% faster than traditional dry scabs, and it can also reduce the probability of scar hyperplasia.

To be honest, most daily wound care ointments do not have a strong disinfecting effect. If you have just cut your hand and your first reaction is to apply care ointment, it is useless. You should use iodophor. Last week, I met an elder sister who made a two-centimeter gash while cutting ribs. She rinsed the wound and applied a thick layer of erythromycin ointment. The next day, the wound turned white and oozed, and she was in so much pain that she couldn't hold the kitchen knife. When she came to have the dressing changed, she felt extremely aggrieved. She said that others had said that this ointment was omnipotent, but it didn't work for her. In fact, she confused the positioning of disinfection products and nursing cream. Nursing cream is a "protective film + nutrient solution" after disinfection and is never used to replace the disinfection step.

In fact, in the early years, the medical community had been arguing for almost 20 years about whether to use nursing cream for wet healing. Most of the doctors of the old school believe that the wound should be left to dry and scabs will heal, but it will rot easily if it is stuffed in the paste. Scholars of the other school of experiments have tested pig skin countless times. If you are interested in Dr. Winter’s classic experiment in 1962, you can search for it. It confirmed that epithelial cells crawl twice as fast in a humid environment and will not tear the newly grown flesh due to the pulling of the hard scab. Nowadays, wound departments in large hospitals have basically adopted the idea of ​​wet healing, but many older generations have not yet changed their ideas. Last time, a junior high school student dropped his knee, which was bruised and bruised. His grandmother refused to let her apply nursing cream, saying she would let it dry to form a crust. Later, we showed her two similar cases. One was able to walk normally after applying the cream for 3 days, and the other developed a scab and cracked her leg as soon as she bent it. The pain lasted for almost two weeks before she relented and agreed to apply the cream.

Of course, not all care creams are the same, and the effects of different ingredients vary widely. For example, those with silver ions are particularly useful for mildly infected wounds that are already a little red, swollen, and have light yellow exudation. It can basically dry up after two days of application. However, there are different opinions on this topic: some doctors think that silver ions can be used for up to 3 days. If used for a long time, there may be a risk of silver deposition. , the other group thinks that there will be no problem if the care ointment with low concentration of silver ions is used for a week. In our clinic, we usually stop using the ointment until there is no exudation on the wound and new pink granulations begin to grow. Just replace it with ordinary Vaseline ointment. If you don’t blindly use it more, the line will not get stuck for 3 days.

There are also growth factor-containing care creams that have become very popular in recent years. Many people buy them after moles are removed or double eyelids are done. It is indeed useful for lightening scars, but you must pay attention to the prerequisite - it must be a clean wound without infection. Otherwise, it will be equivalent to sending nutrients to the bacteria on the wound, which will only make it worse as it grows. In the past two months, a young man had three moles. He applied growth factors thickly at home every day. As a result, the wound of one mole was infected, swollen, and pus leaked. He came to us to clean the scab twice, and it took almost half a month to heal. I just didn't understand the premise of this application.

Finally, I have to remind everyone that nursing cream is not a panacea and can be applied to all wounds. For example, if you get a deep and narrow wound like a nail or a dirty toothpick, you will need to get tetanus immediately. If you smear it with nursing cream at home and keep it in check, it will easily create a breeding environment for anaerobic bacteria, which will cause big problems; even if you are bitten by a cat or a dog, you should first rinse with soapy water for 15 minutes and get a rabies vaccine. Nursing creams are only supplements that are used during the subsequent recovery, and they will not solve the problem.

When I usually prescribe nursing ointment to patients, I always end up with a long-winded sentence: When applying it, it should be thin enough to see through the wound surface below. If it is thick, it will soften the surrounding good skin and slow down the healing speed. If the wound is so deep that fat can be seen and the bleeding cannot be stopped, don't think about what cream to apply at home, go to the hospital for stitches as it will be more effective than half a tube of expensive imported nursing cream you apply.