Skin problems - First Aid

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First aid

First aid

Skin problems

Superficial wounds and grazes Burns Sunburn
  • Superficial wounds and grazes
    • The dangers of an injury: bleeding
    • What to do
    • What not to do
  • Burns
  • Sunburn

Superficial wounds and grazes

Wounds are lesions of the tissues that cover our body and which, depending on their depth, can be superficial or deep and are then further divided according to the characteristics of the agent that caused them: tip wounds (for example a nail, but also a dagger), for cutting (if caused by a knife or in any case by a blade that "crawls" on the skin), lacerated (when the object causing the injury does not determine a hole or a clean cut but acts with forces that simultaneously crush and tear the skin: think of the wound caused on the forehead by the violent impact against a smooth and hard surface like that of a wall).

Particular types of superficial wound are abrasions, in which the damage affects only the most superficial layers of the skin, and excoriations, in which the damages are always limited to the outermost layers of the skin, but with a greater extension in depth; skin and immediately underlying tissue, called subcutaneous tissue, can be damaged.

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The dangers of an injury: bleeding

The damage caused by a superficial injury is limited and generally excludes life-threatening conditions; however some considerations are useful to understand the appropriate treatments and to avoid trivial but annoying complications. As a first element to consider there are the dangers related to hemorrhage, that is, the leakage of blood due to lesion of the vessels located in the wound site.

As is known, the blood vessels are divided into arterial (bring oxygenated blood from the heart to the peripheral tissues) and venous (responsible for the return to the heart of the blood that has transferred oxygen to the peripheral tissues). The lesion of an arterial vessel is recognized because it causes the escape of bright red blood, pulsating and with a certain force, proportional to the caliber of the vessel; the lesion of a vein instead leads to the loss of blood of a darker color and with a lower flow of energy. Venous bleeding from a small diameter blood vessel usually subsides in a few minutes, both due to the modest flow rate and the immediate activation by the body of the coagulation processes which form a sort of physiological buffer . A bleeding from an arterial vessel, on the other hand, has a longer duration due to the more lively flow, which slows down or hinders the normal tamponade implemented by the body at the site of the bleeding (formation of a thrombus).

In more superficial wounds, bleeding is usually modest, although sometimes areas of the skin that are very rich in blood vessels may be affected: we have all had the opportunity, for example, to find that even a small wound on the head or a lip usually bleeds in copious and prolonged.

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What to do

  • The first measure to be implemented is to have a clean swab (gauze or cotton), but also a handkerchief or similar objects, and to implement firm and prolonged compression on the wound. In a few minutes the arrest or in any case a clear limitation of the bleeding is obtained, useful to calmly search for the most suitable material for the wound dressing.
  • If the wound was caused by an obviously dirty object or if the injury occurred in an external environment (therefore potentially polluted), the best thing to do, even before dabbing, is to wash the wound abundantly with running water.
  • Once the tampon is applied (and the compression is maintained on the wound), there is no need to hurry to remove it nor to continuously check if the bleeding is still in progress, because keeping the injured part well compressed determines a mechanical closure of the injured vessels and allows more quickly clot formation.
  • After bleeding is stopped, the next step is to disinfect the wound. This is done with what is available: any disinfectant can be used for the skin surrounding the wound, while avoiding to directly wet the injured area with denatured alcohol or with iodine tincture, substances that can damage the tissues placed under the skin, slowing down the healing process. The most effective are iodiopovidone-based disinfectants (Betadine┬« and the like). If intact skin can be cleaned by rubbing even vigorously, to disinfect a wound it is necessary to dab without rubbing, so as not to remove the formed clot and resume bleeding.
  • Subsequently, the wound is covered, possibly with sterile material, fixing it with a plaster or bandages. The application, always above the dressing, of an ice pack (natural or synthetic) promotes the arrest of small bleeds and in any case reduces both the possibility that the affected part (in the case of a lacerated bruised wound) swells, and the pain triggered by the injury. In the event that the wound continues to bleed, compression on the wound should be maintained by applying a swab over the dressing until the bleeding stops, pending medical or nursing staff to take care of the situation, deciding, for example, whether particular interventions should be carried out, or in-depth tests to determine the extent of the lesions (checking for the possible involvement of tendons, muscles, nerve branches, important blood vessels).
  • Although trivial, superficial wounds must be treated by avoiding their exposure to the external environment until the skin closes (scarring), to avoid infections that would cause delay in healing. An infection, which is recognized by the redness of the edges of the wound, local swelling, sometimes throbbing pain that is generated locally, must be checked by the doctor since it must be treated with the intake of antibiotics or, in some cases (for example when collecting pus) with surgical maneuvers.

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What not to do

  • Don't be frightened, even if the visibly superficial wound bleeds profusely.
  • Avoid compressions upstream of the wound with the application of the tourniquet, because they are not effective and may indeed increase bleeding.
  • When fixing the dressing, carefully avoid applying tight patches around a limb.
  • Do not leave the wound uncovered before the skin has closed, thinking that the saying that "air heals faster" is valid.
  • In case of abrasions and grazes a little deeper and extended, avoid the formation of crusts.

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