When Mikael Blomkvist is hit by a bullet in The Girl with the Dragon Tattoo, Lisbeth Salander springs to the rescue with a needle and dental floss to sew up his wound. But not before she attempts to sterilise both needle and wound by sloshing them with Swedish vodka. Ouch!
Author
- Dan Baumgardt
Senior Lecturer, School of Physiology, Pharmacology and Neuroscience, University of Bristol
But as an anatomist, dental floss and vodka aren't the most outlandish wound care solutions I've encountered.
Understanding wound care is an important lesson for anyone who sustains an injury: in other words, all of us. And while you don't need to rush to A&E or see a doctor for every nick or scrape, paying attention to the type of wound and how it was sustained can go a long way toward proper healing.
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As soon as the skin breaks, a series of biological processes kick in to stop the bleeding and begin the healing process . Platelets in the bloodstream form a clot to plug any damaged blood vessels. At the same time, white blood cells and other healing agents rush to the site to begin tissue repair.
Healing happens best under certain conditions. First, it's far more efficient when the cut skin edges are brought together, hence the use of stitches, staples, or adhesive strips for larger or wider wounds. In some cases, specially formulated skin glue may be used too.
The absence of infection is also crucial. When bacteria colonise a wound, they can hinder healing, and may even breach the skin barrier to spread elsewhere.
That's why it's vital to watch for any signs of infection , which may require antibiotics. These are redness, swelling, heat and pain - the classic hallmarks of inflammation. You may also notice yellow or green discharge, a sign of pus formation. In some cases, this can progress into a serious systemic infection known as sepsis . Always take these signs seriously, and seek medical advice if they appear.
Keeping a new minor wound covered is important. Applying a clean plaster or dressing helps prevent bacteria or foreign objects from entering. Dressings should be changed as needed, and antiseptic cream can be useful. Once a firm scab has formed - usually after a few days - it's fine to remove the dressing and let the wound dry in the open air. The optimal descriptors for well healing wounds are "clean" and "dry".
The wrong sort of wounds - and fixes
Of course, some wounds need more attention than just a plaster and a dab of Savlon. These include wounds that are deep, wide, won't close, are contaminated, or are bleeding heavily. In these cases, first aid and a visit to A&E are warranted.
In hospital, beyond closing the wound with stitches or adhesive strips, other interventions may be necessary. Contaminated wounds may require treatment to prevent tetanus , a potentially serious condition. Wounds from broken glass or significant trauma may also need an X-ray to check for foreign bodies or fractures.
Bite wounds pose particular risks too. Dogs, cats, foxes, squirrels - and other denizens of Farthing Wood - harbour numerous oral bacteria in their mouths, which necessitate antibiotics. Human bites also carrying the risk of causing an infection, as well as potential transmission of viruses, like hepatitis or HIV.
Top five improvised wound treatments
Here's countdown of the most bizarre - and dangerous - do-it-yourself wound closure attempts that I've seen in practice.
1. Gaffer tape. Imagine trying to peel that off later … Gaffer tape is a heavy cotton cloth tape with strong adhesive qualities that's often used in DIY. For wounds, though, gaffer tape's highly durable adhesive can cause skin irritation and it's not designed to be breathable, which could trap moisture in the wound and promote infection.
Clinical micropore tape can help secure a dressing, but it shouldn't be applied directly to the wound - removal of the tape could reopen the injury and disrupt healing.
2. Honey. Used less to glue the skin together, more as a makeshift poultice . There is some evidence of honey's antimicrobial properties. Varieties like Acacia and Manuka honey have shown some promise, so perhaps not as outlandish as it sounds. Ideally, though, only medical-grade honey, which is sterilised and less likely to cause immune system reactions, should be used on open wounds, so don't try this at home.
3. Super glue. The ultimate DIY fix, but having met someone who superglued a split lip - and an entire tooth - back into place, it's really not advisable. Regular super glue can have side-effects, including irritation of the eyes, nose, throat and lungs and it can also damage the tissue surrounding a cut. Only a medical-grade glue meant specifically for minor cuts and scrapes should be used - and by a medical professional too.
4. Fishing tackle. Line, hooks, the lot. Don't ask.
5. Grout. A favourite among builders. Got a cut or crack? Slapping grout or Polyfilla on a wound to seal it might seem tempting - but please, I beg you, don't. Grout is a cement-based material used for filling gaps in tiles and other surfaces and is certainly not designed for medical purposes. Grout is highly alkaline and can cause severe chemical burns on skin. It's also not a sterile material so it could introduce bacteria into the wound, leading to infection.
So, as you can see, the range of wounds and their relative treatments vary quite spectacularly. The rule of thumb is always to seek medical advice if you are uncertain about the size, scale and nature of a wound. And don't be tempted to resort to a quick fix. It might be to the wound's - and your own - detriment.
Dan Baumgardt does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
