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From: Craig Poole (no email)
Date: Sat Mar 02 2002 - 20:21:59 EST
> NOT Pasteurized is exactly the PROBLEM!
> Please everybody stop smearing stuff on your wounds/burns.
> Your skin needs OXYGEN to heal. No kidding. Ask somebody who
> has actually done some study on the issue. Preventing the
> air from reaching a wound PREVENTS healing.
actually the truth is probably in the middle. I've worked with a number of
patients with long term and difficult healing wounds for years now. The
manner of treatment largely depends on the extend of wound and tissue
damage. Just blankly saying get oxygen to the wound will heal it without
others factors is just not true.
Some of the best wound healing I've seen is with the use of a vacumn device
and wound sealants. Essentially - wounds need moisture to heal and yes
oxygen but the oxygen is internal not external - whether it's through a
sealant film or a cream. Also good nutrition.
For healing to occur the lowest damaged tissue bed needs to be kept moist -
if granulation occurs on the surface first then that tissue has to be
removed mechanically. If the wound can be kept moist all the time than the
granulation occurs from the bottom upwards until the skin matrix has time to
form.
The two best methods are use of a barrier film ( we use a hydrocolloid film
called "duoderm") for long term "clean" wound management. It keeps the
wound both clean and help keep moisture on / in the wound. For more
difficult wounds a new procedure uses a sterile sponge material over / in
the wound which is sealed with a sterile film and attached to a mechanical
suction device with approx 50-100 mmhg intermittent or constant suction.
The suction keeps the wound moist by pulling in nutrient and oxygen rich
intracelular fluid towards the wound. By far this has been the most
successful wound healing method I've seen.
At one time hospitals used heat lamps and open air to wounds in the hope of
quick healing but it was eventually found that both procedures did nothing
but dry out the outer layers which caused the need for eventual debridement
of those layers and delayed healing of the interior layers of the wound.
Personally the best solution I have found has been the liberal and constant
use of aloe-vera cream. I've healed a number of wounds quite quickly and
without scarring by applications of natural aloe vera or a processed aloe
vera cream to the wound 4-6 times a day.
Craig Poole, RN, MSN, Nurse Practitioner
s/v Evensong
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