Treatment Cuts, Grazes, Burns and Scalds and/or Blisters

 

• Please check one is not allergic or sensitive to any of the ingredients.

Aim:

• To stop the cut or graze and/or burn from getting worst and causing an infection and/or  skin scarring as well as allowing the body to have the right conditions  for the healing process to occur.

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Cuts and grazes/Blood blisters

• If a deep cut it will heal longer.
• Numbness indicates a nerve injury and one should seek medical attention
• Blood spurting out indicates a deep wound and one seek medical attention.

 

Treatment

• Wash and dry your hands thoroughly – wear disposable gloves if possible.
• Clean the wound under drinking-quality running tap water and/or use saline water (salt water) for five to ten minutes and/or use non-alcohol free wipe and gently dab or wipe the skin with it
• Do not apply antiseptic creams, alcohol, iodine and/or hydrogen peroxide yet as it can irritate and damage the area and delay skin healing.
• Pat the area dry with a clean towel or apply a pressure to the cut with a clean (ideally sterile dressing) non -fluffy pad.
• When the wound has stopped bleeding, clean it and cover it with a dressing to help stop it becoming infected.
• Apply a sterile adhesive dressing (shiny side), such as a plaster and wrap a dressing round it and make sure its secure.
• If blood soaks through the dressing, add another and apply pressure, if still bleeding heavily, phone for an ambulance.
• One can now apply alcohol , iodine and/or antiseptic creams to prevent a skin infection.
• Hydrogen peroxide is not recommended in cuts and grazes or if being used as a mouthwash (mouth ulcers) as it delays the healing process.
• Keep the dressing clean by changing it as often as necessary. .
• One can remove the dressing after a few days, once the wound has closed itself.
• Use waterproof dressings to keep the wound dry while bathing and showering
• If on arm and leg- raise this body part above the heart level.
• Keep the wound clean with saline solutions and/or antiseptic creams and change the dressing regularly.
• How to Treat Cuts and Grazes

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Minor Burns and scalds

• Stop the burning process as soon as possible.
• This may mean removing the person from the area, dousing flames with water, or smothering flames with a blanket.
• Do not put yourself at risk of getting burnt as well.
• Remove any clothing or jewellery near the burnt area of skin, including babies’ nappies.
• Do not try to remove anything that’s stuck to the burnt skin, as this could cause more damage.
• Cool the burn with cool or lukewarm running water for 20 minutes as soon as possible after the injury.
• Never use ice, iced water (it can cause frost bite and slow the healing process), or any creams yet or greasy substances like toothpaste, oils, butter and eggs.
• Never apply cotton balls to a burn because the small fibres can stick to the injury and increase the risk of infection.
• Compress the area with a non –fluffy pad and or cool cloth (not fluffy) and/or cold compress not from freezer (do not use freeze spray) , make sure it’s not too cold as it can irritate the skin, one can apply the compress from 5-15 minutes intervals, if the burn is small and in a local area.
• Keep yourself or the person warm.
• Use a blanket or layers of clothing, but avoid putting them on the injured area.
• Keeping warm will prevent hypothermia, where a person’s body temperature drops below 35°C (95°F). This is a risk if you’re cooling a large burnt area, particularly in young children and elderly people.
• Cover the burn with cling film. Put the cling film in a layer over the burn, rather than wrapping it around a limb. A clean clear plastic bag can be used for burns on your hand or consider to use a burn plaster.
• Sit upright as much as possible if the face or eyes are burnt. Avoid lying down for as long as possible, as this will help reduce swelling

 

Shaving burns

• Do not use rubbing alcohol/surgical spirit as it can cause chemical burns.

 

Electrical burns

• Electrical burns should be managed only after the patient is separated from the source of electricity. If possible, isolate the source of electricity (e.g. turn off the mains power).
• Attempt a rescue if the source of electricity is of low domestic voltage (e.g. 110–240 volts), using a non-conductible object (e.g. a wooden stick or wooden chair) to separate them from the current.
• Do not attempt to rescue someone who is connected to 1,000 volts or more (e.g. electrical train lines) because the risk of conduction is very high.
• Electrical burns are usually deep and an ambulance should be called immediately.

Chemical Burns

• Cool the burn with cool or lukewarm running water for an hour as soon as possible after the injury.
• Never use ice, iced water (it can cause frost bite and slow the healing process), or any creams yet or greasy substances like toothpaste, oils, butter and eggs.
• Identify the chemical that has caused the burn; different types of chemical will produce different burns.
• Chemical burns are usually deep and an ambulance should be called immediately.

National Institute for Health and Care Excellence. Clinical Knowledge Summaries: Burns and scalds. May 2013. 

The Pharmaceutical Journal, PJ, 9/16 May 2015, Vol 294, No 7861/2;294(7861/2):DOI:10.1211/PJ.2015.20068363

 

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There are a wide range of treatments available.

Antiseptic cream (cuts and/or burns)

• Once the wound is dry (stopped bleeding) – one can apply these products to prevent a skin infection.
• Please follow the manufacturer’s instruction
• If one has to apply a solution then use a clean sterile pad to apply on the skin.

Saline solution (cuts and/or burns)

• This  contains salt and sterile water in an appropriate concentration and has antiseptic properties to treat and prevent further skin infection and aid healing.

Witch hazel (cuts and/or burns)

• Please follow the manufacturer’s instruction

It contains tannins which has:

• Antioxidant properties
• Anti-inflammatory activity
• non anti-inflammatory activity fight against bacteria.
• Can act as an astringent by drying out the skin
• Always use a high quality forms (many cosmetics contain perfumed products and other additives which may not agree with your skin)- preferably non alcohol and/or contain aloe vera (has antiseptic properties and good for sunburns as well as moisturising properties) and/or hyaluronic acid (act as a good moisturizer)
• It does not help to get rid of itchiness
• Witch hazel may not be advisable for certain skin conditions, such as rosacea or extreme dryness.  It can be very drying, which could cause your skin to overproduce oil and worsen blemishes.
• If you have any open skin areas, the rubbing alcohol could also burn when applied
• One may also want to use with caution if you have sensitive skin.
• If one finds condition is getting worse after using witch hazel then stop using it.

To use witch hazel for skin burns :

• Soak either a soft cloth or a sturdy paper towel with the solution. Then gently press onto the burn.
• Don’t rub it in, as this can cause further irritation

Scalp burns/chemical burns/sunburn:

• Witch hazel may be applied directly to your scalp in the shower, or you can mix a small amount with your regular shampoo.
• Do not apply under the skin directly to help bags under the eye (mix with other creams)
• If you’re trying out witch hazel for the first time, it’s a good idea to test it out in a small area of skin away from your face, such as the inside of your arm. If you don’t see any redness, rash, or dryness after a couple of days, then you can try it out on your face.

Aloe Vera gel (burns)

• These products help to soothe the skin and have antiseptic and moisturising properties.

 Lidocaine gel (Burns)

• Please follow the manufacturer’s instructions , these products help to soothe and numb the skin if one has painful skin and/or minor burn  (which is not open).
• Talk to a health care professional/specialist in condition’s such as methemoglobinemia – (red blood cell disorder condition where one skin can turn blue, confusion, drowsiness, headaches, jerky movements nausea and vomiting , rapid breathing and increased heart rate) – (medication list for methemoglobinemia)

Rubbing alcohol/Surgical spirit (caution in burns)

• Once the wound is dry (stopped bleeding) – one can apply these products to prevent a skin infection.
• It kills bacteria but doesn’t necessarily prevent their growth (rubbing alcohol concentration of no less than a 50 percent solution)
• Please follow the manufacturer’s instruction
  • Never drink rubbing alcohol. Doing so can be deadly.
  • One should only use it on your skin and never let children use it without supervision.
  • Never use rubbing alcohol topically to reduce fever and in hot baths — it’s ineffective as well as alcohol can absorb in the skin and become toxic
  • Rubbing alcohol is also highly flammable, so never use it near an open flame or high heat.
  • Can act as an astringent by drying out the skin – it can be very drying to skin so don’t use on any dry areas i.e. acne and dry skin eczema rubbing alcohol can be very drying, which could cause your skin to overproduce oil and worsen blemishes.
  • If you have any open skin areas conditions (not cuts and grazes), the rubbing alcohol could also burn when applied.
  • Applying it after shaving or to open acne areas can cause a burning sensation, best to avoid as it can cause a chemical burn.

Iodine (cuts and/or burns)

• Once the wound is dry (stopped bleeding) – one can apply these products to prevent a skin infection.
• Please follow the manufacturer’s instruction
• Use in caution in those who patients who have a poor thyroid function and/or overactive thyroid function.

Honey (cuts and/or burns)

• Once the wound is dry (stopped bleeding) – one can apply these products to prevent a skin infection.
• Please follow the manufacturer’s instruction
• Use in caution in babies and children under one years old (botulism)

Plasters (cuts and/or burns)

• If have cuts and/or grazes and/or burns and/or blister.

Dressing (cuts)

(If skin infection present– one must talk to a medical healthcare professional to assess if one needs antibiotics).

Types of dressings:

Types of dressing	Minor cuts and grazes
Traditional adhesive plasters	cuts and grazes
Spray plasters	Minor cuts and grazers where plasters don’t stick on easily.
Gauze dressings and adhesive tape	Covers cuts and grazes,

 

Types of dressing	Deep cuts
Anti-scarring plasters	Promote moisture to aid wound healing and prevent scars in deep cuts and grazes.
Low-adherent pads and adhesive tape	Highly absorbent, cushioning and protective, no pain on removal (less sticky) for deep cuts.
Cushioned and foam dressings	Deep cuts where wound opens easily in exposed places (e.g. fingers).

Dressing (Burns, large open wounds and sores)

Superficial dermal burn wounds <3% should be treated as follows:-

(If skin infection present– one must talk to a medical healthcare professional to assess if one needs antibiotics).

1. Deroof blisters and debride loose skin
2. Cleanse with warmed normal saline or tap water
3. Obtain wound swabs
4. Apply a non-adherent dressing (types of dressing- see below) . Use an anti-microbial dressing if required
5. Apply a secondary dressing of gauze/burns swabs and crepe
bandage if required
6. Reassess wounds after 24-48 hours and redress as above.
7. Further dressing changes (types of dressing- see below) should be carried out as dressing application guidelines dictate or if exudate strikes through or
infection is present  (if skin infection present- one must talk to a medical healthcare professional to assess if one needs antibiotics) as well as  wounds should be redressed until area healing and has heeled. Consider dressing that prevent infection.
8. Apply moisturiser and massage healed skin 3-4 times daily.

https://www.cobis.scot.nhs.uk/wp-content/uploads/2016/04/Paed-Guideline-Burn-Dressing-Guidelines-2016.pdf

Types of dressing	Weeping wounds
Hydrocolloid plasters	Weeping open wounds- blisters, pressure sores, minor burns and leg ulcers
Alginate dressings	Light weeping or bleeding wounds, stop wound from drying out.

 

Types of dressing	Prevent infection
Vapour Permeable film dressings	Keep water out, serious cuts, scalds burns, blisters and grazes and protect against infection by checking on it without removing the plaster.   Not good for weeping wounds.
Silver impregnated plasters Iodine impregnated plasters Honey impregnated plasters	Prevent infection in cuts and grazes.   No need for antiseptic creams.

 

Stitches (which ARE NOT self dissolvable-Cuts only)

• Please keep stitches clean and dry and always watch out for a skin infection.
• One should see their Medical doctor and/or after stitches has been applied , do not remove them oneself.
  • Head stitches  should be kept on at least 3 –5 days – contact the health professional if longer
  • Over joints (elbows and/or knees) should be kept on at least 10- 14 days – contact the health professional if longer
  • All other parts should be kept on at least  7- 10 days – contact the health professional if longer

• Some stitches dissolve by themselves; ask your nurse or medical doctor on how long that will take.
• Talk to your Medical doctor and/or nurse on when one can get them wet (i.e. to have a shower) – (most cases they need to be kept dry for a minimum of 48 hours) and/or how long it should be kept dry.
• If stitches need to be kept dry, apply a waterproof dressing over the stitches and do not soak the dressing i.e. having a bath, a light shower is best. If stitches do get wet, pat dry the area thoroughly with a clean tile or sterile dressing and make sure all moisture is soaked up.

 

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Painkillers (if in pain with burn)

Paracetamol

• Paracetamol has no anti-inflammatory action.
• It does help to reduce temperature and pain by blocking signals to the brain and is gentle on the stomach.
• Paracetamol must be taken to the manufacturer’s direction. Do not exceed dose as it can be dangerous.
• Please be aware Paracetamol can be found in many cold and flu products so don’t take them together or talk to your pharmacist if one is not sure.
• Do not store in the fridge.
• This could be used in the first 48 hours of injury if suitable.

Aspirin, Ibuprofen, diclofenac

• These are known as NSAID – Non-Steroid Anti-Inflammatory Drugs.
• They have painkilling, anti-inflammatory and lowering fever properties by helping to blocking prostaglandins.
• They can cause stomach upset (extra caution must be taken with those who have a stomach ulcer) so it is important to have it with or after food.
• It can also raise one’s blood pressure (extra caution on those with heart problems).
• They must be taken according to manufacturer’s directions as exceeding the does can be dangerous.
• Please be aware that cold and flu products have NSAIDS. Do not take at same time or talk to your pharmacist if one is not sure.
• This should be used 48 hour later after injury as it affects the healing process in the first 48 hours of injury and be aware of a skin infection.

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Scarring Products

• Vitamin A and/or Vitamin E and/or Silicone creams /gels/ointments products and/or containing good quality aloe vera creams should be used on a regular basis according to the manufacturer’s instructions.

Vitamins

• Selenium
• Vitamin A
• Vitamin C
• Vitamin D
• Vitamin E
• Zinc

Herbal

• Aloe (cream/gel form)
• Apple cider vinegar
• Calendula
• Cat's claw
• Comfrey
• Danshen
• Echinacea
• Elderberry
• Eucalyptus
• German Chamomile
• Roman chamomile
• Juniper
• Lavender
• MSM
• Propolis
• Red Clover
• Rosemary
• Shark Cartilage
• St John’s wart
• Tea tree oil
• Yucca