Cleaning cuts and Flesh-Eating Disease

[Another_David]

I was reading this article and the part I've bolded led me to ask, what does one do to clean a serious wound when the ER is not available???

Georgia Student Fighting Flesh-Eating Disease After Zip Line Injury

...Where the infection came from is unclear, but Schaffner said the most likely culprit is Copeland's own throat.

"It could have come from an outside source; some other person who was perhaps helping clean and dress the wound," he said, adding that the bacteria is transmitted through respiratory droplets. "But more often than not, sadly, it turns out to be the patient's own bacteria."

Frequent hand washing, and avoiding people with sore throats can help reduce the risk of flesh-eating disease, according to the National Necrotizing Fasciitis Foundation. And all cuts, no matter how small, and should be cleaned and covered with sterile bandages.

full article

http://abcnews.go.com/Health/Wellne...ting-infection/story?id=16311568#.T6qxOOhI_vU

So I did some searching and found this wound care manual, which I thought was very practical.

WARNING: there are very graphic photos of wounds in this document

http://practicalplasticsurgery.org/docs/help_basicwoundcare.pdf

 

[dnepro-mike]

I use alcohol for general cuts, not beer kind. That 80% stuff that they sell at the pharmacy.

 

[Another_David]

I use alcohol for general cuts, not beer kind. That 80% stuff that they sell at the pharmacy.

strong solutions of alcohol, hydrogen peroxide, and iodine are NOT good for healing cuts

 

[dnepro-mike]

I understand that it's not for healing, it's for disinfecting. serious cuts are approached on case-to-case basis.
but when we are talking ER not available I assume we are not talking about weekend trip to the woods. eventually you WILL get to ER if wound is serious enough, before that i will be only concerned about controlling the bleeding, not even so much about disinfection. And for SHTF type of situation that you were not specifically preparing for, it's unlikely you would have wound-kit on hand to treat serious wounds.

i'd try to get to nearest medic, preferably before i bleed out or succumb to infection.

 

[Nicole]

I grew up using hydrogen peroxide and the live-in medic has the same proclivity. Used to use iodine on the farm animals. No cuts have spawned flesh-eating bacteria.

Anecdotes not equal to data...blah blah.

 

[dnepro-mike]

I grew up using hydrogen peroxide and the live-in medic has the same proclivity. Used to use iodine on the farm animals. No cuts have spawned flesh-eating bacteria.

Anecdotes not equal to data...blah blah.

i used iodine on myself for 20years and i even wasn't living on the farm
and they still use it in the hospitals for minor wound cleaning and pre-sergury prep under betadine brand

 

[SkuaSeptember]

Gotta love the hydrogen peroxide foaming action!

 

[el duderino]

Wash it out and keep an eye on it, occasional bandaid if its not done bleeding.

 

[RichM]

Maggots and leeches for the win!

 

[Another_David]

Anecdotes not equal to data...blah blah

I agree completely, which is why I have to go with the well researched document I posted that backs up the techniques with lots of photographed "data" and not just one person's anecdotes from their experience on a farm. Unless you lived on some farm that was akin to the movie hostel or the texas chainsaw massacre

You should read a book called The Unthinkable, which talks about, amongst other things, how people fall prey to their personal experiences like those that choose not to evacuate around New Orleans during Katrina because in all their experience a hurricane had never caused them much concern.

And before anyone gets the wrong idea, this thread isn't about preventing flesh eating disease, or how to prep skin or instruments for surgery (which alcohol and iodine is great for btw). It's about how to treat wounds with basic items you find in your house. It's how people were treated in WWI and WWII when supplies were limited and hospitals would boil the bandages (e.g. rags) in water and reuse them again and again. If you had some salt and a little bleach to help you were living like a king!

 

[economist]

Step one would be to avoid the hospital if at all possible. That's where most of this shit lives.

 

[BOBKATT]

I was reading this article and the part I've bolded led me to ask, what does one do to clean a serious wound when the ER is not available???]

Would any field wound care prevented this flesh eating disease?

 

[OB1Kenobi]

Quick clot for everything! .

 

[Boghog1]

soap and water, irrigation and if needed a scrub brush.

 

[Finalygotabeltfed]

Clean hands, preferrably gloved before working on the wound first of all, from there, soap and warm water will work for most wounds. Antibacterial ointment where applicable and a light, clean dry dressing. Telfa pad type dressing for road rash/burn type wounds so it doesn't stick.

 

[Another_David]

Would any field wound care prevented this flesh eating disease?

from the link in the link to the article, which the article since changed to say the bacteria most likely came from the water in the river as oppose to a person with strep. but the sooner you get some anti-bacterial ointment on and cover the wound the better

Preventive Measures

First, let it be said that there is no sure prevention. Necrotizing fasciitis has been known to be spontaneous. A bruise or abrasion are all the "opening" in the skin necessary for bacteria to enter. However, there are some things you can do decrease risk.

The single biggest preventative measure is keeping the skin intact!

Next is cleanliness. Always wash even the smallest opening in the skin and apply an antibiotic ointment. Buy tubes of antibiotic ointment and keep one in your car, your desk, your exercise bag, and at home.

Take care with your children, impressing upon them the importance of cleanliness.

Be respectful to protect others from infection if you suspect that you may have a Strep infection, such as Strep throat, or have been exposed to someone with a known Strep infection. Symptoms do not have to be present for a person to be carrying the bacteria and infect others. One case of infection that comes to mind is a health care worker with two children at home with Strep throat. She had no symptoms, but innocently infected three people, one of whom died.

 

[redtail]

Carbolic soap, if you can find some, is a pretty fair bacteria-killer. Our grandparents grew up with the stuff in nearly every bathroom in the country back then.

Chlorine bleach, don't forget about that. 10:1 water/bleach ratio will kill everything pretty quick, this ratio has been used to sterilize and disinfect field hospital ORs for over a century.

 

[Rider]

My bride recently had a minor outpatient procedure performed, and they instructed her to shower using Hibiclens the night before the procedure, the morning of the procedure, and then in the evening after the procedure. I don't know if you've ever used that stuff, but it's pretty strong. They are either being very overly cautious, or they have some very nasty stuff living in the hospitals.

 

[bullseye]

MRSA , bad stuff, its all over the place and if you get it without antibiotic help, your dead. Vancomyacin, clindomyacin or levaquin may help, but usually its a cocktail of a combination. If you hit high fever, your septic and dead, soon.

 

[ARV]

MRSA , bad stuff, its all over the place and if you get it without antibiotic help, your dead. Vancomyacin, clindomyacin or levaquin may help, but usually its a cocktail of a combination. If you hit high fever, your septic and dead, soon.

I know a guy that got shot in the leg, and developed a MRSA infection. He was on vancomyacin with a pump that kept a slow but steady supply going into him for months before it cleared up.

 

[bullseye]

I know a guy that got shot in the leg, and developed a MRSA infection. He was on vancomyacin with a pump that kept a slow but steady supply going into him for months before it cleared up.

My wife is Director of Microbiology in a Western Mass hospital, she was the one that enlightened me to this stuff and I dug a bit deeper and low and behold, my older boy scraped his arm bike riding, he plays hockey also, so he was skating and after a week or so I noticed some nasty pimples around the wound. I popped one and it oozed white crap for days. I put a hot compress on it to continue draining and brought him straight to the ER, I was sure he had a MRSA infection. Culture came back positive for MRSA, they treated him with Clindomyacin and also Mupirocin for his nose, it's an antibiotic to kill any colonized MRSA in the nasal passages. It took a few weeks to clear up, but we now have to watch him so any cuts, scrapes he gets he doesn't get a recurrence. Also, if he goes into the hospital, we have to inform the Drs. that he has a MRSA history.
My wife has told me of some really nasty crap floating around that is pretty much antibiotic resistant, the only way to treat it is with a cocktail of antibiotics, but if you are immunocompromised from some other illness, your pretty much toast, burnt toast.

 

[vellnueve]

If you get a MRSA infection in a SHTF scenario with no access to professional medical care, you're not going to be in great shape.

 

[hankster]

Don't forget C- Diff , it's horrendous . Had it in 2007 , lost approx. 50 pounds in about 50 days . Thought I was going to die . It's also community based like MRSA . Gotta watch out for this stuff as best you can , WASH your hands .

http://www.webmd.com/digestive-disorders/news/20100322/c-diff-infection-rate-may-overtake-mrsa

 

[vellnueve]

C. Dificile isn't fun but overgrowth can be treated quite effectively with metronidazole. MRSA is a far worse animal.

 

[MetalgodZ]

If you get a MRSA infection in a SHTF scenario with no access to professional medical care, you're not going to be in great shape.

I've been trying to find info on how long it will take for various bugs to lose their antibiotic resistances after a SHTF or other event that causes a drop in antibiotic availability/use. Any info I find is either very basic (i.e.: "Bugs can lose their resistance." [link]) or not really what I'm looking for (but still cool).

 

[ShadeWPI]

Metal,

Antibiotic resistance is a genetic mutation, not an aquired tolerance. It is unlikely that antibiotic resistance will be lost entirely.

It is the definition of darwinism. When you apply an enviornmental factor that kills off all those existing members of a species that lack the genetic mutation to resist the effects of an antibiotic, the remaining percentage, regardless of how small, are all that multiply, passing that genetic mutation down to the next generation. With less non-resistant bacteria to compete against for resources, they grow more rapidly and eventually the only bacteria that exist are those which are resistant to the antibiotics. To lose this resistance, you'd need enough generations that mutations not-resistant to the antibiotic and overwhelm those which are, or for an alternate mutation, not resisant to antibiotics to develop which has a greater likelihood of reproduction than its resistant cousin.

It has taken use near 100 years to kill off enough non-resistant bacteria that we've started seeing wide spread applications of purely resistant strains, and enviornmental factors that kill off non-mutant strains work much more rapidly than free form evolution, so anti-biotic resistant bacteria strains will likely be around well beyond anyone currently alives life-span.

 

[vellnueve]

I've been trying to find info on how long it will take for various bugs to lose their antibiotic resistances after a SHTF or other event that causes a drop in antibiotic availability/use. Any info I find is either very basic (i.e.: "Bugs can lose their resistance." [link]) or not really what I'm looking for (but still cool).

That really would be the least of my concerns

 

[GunGrey]

id be dead already

 

[Grimlock]

I was reading this article and the part I've bolded led me to ask, what does one do to clean a serious wound when the ER is not available???



full article

http://abcnews.go.com/Health/Wellne...ting-infection/story?id=16311568#.T6qxOOhI_vU

So I did some searching and found this wound care manual, which I thought was very practical.

WARNING: there are very graphic photos of wounds in this document

http://practicalplasticsurgery.org/docs/help_basicwoundcare.pdf

Loved the link thank you. I am not into macabre stuff but as an EMT I love seeing wounds and thinking about the best way to treat them. Altho, anyone can fix a wound it's the medical stuff that get's me really thinking. MRSA is nasty stuff I ALWAYS use Body Substance Isolation (gloves, etc), and even more so with a MRSA patient. Worse is when I have made contact, am placing the PT on the stretcher and there was nothing in past medical for MRSA, then the nurse walks up and says, " Oh yeah he has MRSA".....

 

[emkay]

Alcohol is an effective antiseptic but should only be used on intact skin. The same goes for chlorhexidine (Hibiclens). Peroxide kills skin cells slows healing and should be avoided on open skin. And for the love of God, please don't ever put bleach on yourself.
Recent studies suggest that high pressure irrigation is the most important factor in prevent wound contamination initially, regardless of what is used. Good, clean water is just as effective as sterile normal saline (shot placement vs. caliber).