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Deep
Cuts, Lacerations, and Slivers (Oh My!) |
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Cuts & Lacerations |
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Two
Minor Surgical Procedures You Can Probably Do At Home Ever since I got a letter
from a woman who wanted instructions for doing her own thoracic surgery by
correspondence, I
have more truly realized the need for absolute clarity in writing a section
like this one. So here it is: I am not utterly opposed to using the valid skills
of well-trained medical professionals. Get a physician’s opinion
first. There are limits to what you can do. (By the way, I told the
woman to see a surgeon. I considered suggesting that she also see a
psychiatrist.) Yet there are many things we can do for ourselves, as well and
arguably better, than a harried, hurried, hired practitioner. I offer for your
consideration (as Rod Serling would say) one or two
of my more delightful childhood medical dramas, or should I say,
traumas: As kids, we were always
building something in the woods behind my parents’ house. After we
built our tree fort (as differentiated from a mere tree house, mind you), we
practically lived there as well. So, disdaining work gloves, we were
prime candidates for picking up frequent slivers of wood under our skin,
especially in our hands. My first line of
treatment was my father. He was, after all, the one who always patched up our
old tomcat (“Tony,” named after a famous but more peace-loving
tiger). Tony’s nocturnal avocations resulted in his coming home with
substantial portions of his fur, skin and ears missing. We went through many
a bottle of A&P hydrogen peroxide on that cat, since vets were for rich
kids’ pets. For wood splinters in our
skin, Pa used the tried and true Army approach: sterilize a sewing needle
(the bigger the better, it would seem) and unceremoniously dig the splinter
out. This form of frontal attack worked, and of course it hurt. Once
I had a sliver way up under a fingernail. Even Dad backed away from
that one. I was delighted when my folks sent me to our family
doctor. There, I was certain, I would receive
the adept and painless ministrations of a sympathetic healer. Wrong. The doctor sat me on his
all-purpose examination table, and painted my finger orange with lots of
mercurochrome (23% mercury in a colorful solution). Then, he turned to his
little white cabinet of goodies, and calmly produced a large pair of
black-handled office scissors. These are formidable-looking blades to
see coming at your little fore-fingertip.
Without a word, and
without any anesthetic, the doctor began cutting away my fingernail. I
was so surprised I could barely yell… for a moment, anyway. In a
few agonizing minutes, he had removed over half the fingernail, and the
splinter along with it. I decided that the mercurochrome’s real
role was to hide the color of the blood, which it very nearly did. But
the pain of a forcibly removed fingernail is more suited to prisoner-of-war
torture stories than to a doctor’s office. It was almost immediately
afterwards that I decided that not only could my father have done as well, I
could have done as well myself. After all, we had a pair of ten-inch
paper shears at home that were almost as big as the ones the doctor used. The next time I had an
under-the-finger sliver, I had the inspired idea to perhaps avoid the needle,
or the scissors, or the battle ax, or whatever they might throw at me.
I had some experience with “black drawing salve” (ammonium bituminosulfonate; I think the brand of the day was Ichthammol).
Black drawing salve is so-called because it is black (duh) and because it
helps “draw” pus out of a wound or boil. I wondered if it would
physically draw out a sliver of wood. So I applied a small glob
of it, covered it with gauze, and did nothing. The next morning, enough
of the splinter was protruding from under my fingernail for me to simply grab
it with tweezers and pull it out. No pain. No blood. No
skill needed. Equipment list: black
drawing salve (available at any discount drug store), your mother’s
eyebrow tweezers, and one band-aid. Let's now up the ante
somewhat and consider deep cuts and lacerations. How can we close them
without stitches? With butterfly bandages, available at any pharmacy or
discount store. Butterfly bandages look
like doll-sized white paper bow ties. They are narrow in the middle,
hence the name, and have a strong adhesive on the back. To use them
properly, you first must staunch the flow of blood so you can see what you
are doing, and ensure that they will stick. Pressure on or above the wound
will usually to this. With a clean cloth or gauze, blot and dry the area
as best you can. Do not use “Kleenex” or toilet paper, as
these paper products will disintegrate when dampened and make a mess. Paper
towels are OK. Remove the plastic adhesive-protecting strip from one side
only of the bandage. This is easiest if you have an assistant help
you. Then apply the bandage, like a bridge over troubled tissue, to hold
the cut together. THE TRICK IS TO PUT A STRETCH INTO IT. To do so, you
have to place the first side of the butterfly bandage further away from the
cut than you’d think. When you pull it over, it will close the
wound. Hold it, remove the adhesive-cover on the remaining side, and press it
down to complete the maneuver. You can pre-remove the adhesive-covers
from both sides in advance if it works better for you, but this is the way I
do it. Expect to make a schlock
job of it the first time. Have at least half a dozen butterfly bandages
on hand and do not worry if you have to scrap a few and try again. Keep the
wound area as dry as possible, though, and you are likely to get it right on
the first few tries. Even if the first closure
works well, I usually use apply a second butterfly bandage. I do this even if
the wound is a small one. I put the second one on at a slight angle to
the first, to contact different skin and increase the likelihood of success. This results in an “X” shaped appearance that
impresses children a great deal. Then, I cover the “X” with
a fairly large, one inch wide band-aid. This helps lock the butterflies
in place and to a moderate extent keeps them from getting wet. Children, and
adults, invariably manage to get a wound wet no matter how careful you want
them to be to avoid doing so. Wet bandages lose their stick and come off
sooner. Better the outer ones than the butterflies, though, for it is
easy to slap on a plain band-aid or two any time, any place. Ideally, you do
not want to remove the butterfly closures for several days to a week,
depending on the severity of the cut. This gives the skin a chance to
knit together deep down as well as on the surface, and makes it unlikely that
the wound will reopen. On a long laceration, you
can repeat the “bridging” process with a series of butterfly bandage
crosses. There is a limit to how far you can go with this, so use
uncommon sense and get medical assistance whenever you need it. Here’s a hint: As
the skin heals, it will tend to dry and “pull” and itch. Dropping
some natural vitamin E, simply squeezed from a capsule onto the wound, will
help. Do not do this too early, for 1) vitamin E is oily and will
completely ruin and bandage adhesive and 2) applied too soon, vitamin E’s
modest anti-coagulant properties will delay surface clotting. Wait a few
days to a week until you can see that the wound is solidly closed and you are
ready to let the bandages come off anyway. As a side note, I might
mention that if you want to spare your kids the pain of removing a bandage
(slow or fast, it sure does hurt if there is hair under there), try this
vitamin E technique. You will never hear an “ouch” again,
for the bandages will gradually come off on their own. In addition, healing is
likely to be uncomplicated (no infection, scarring or keloid
formation) if you keep putting a tiny but of vitamin E on the wound twice a
day. Again, be sure the wound area is dry. Vitamin E oil and water don’t
mix. You can apply vitamin E to a conventional line of sutures, too. Bleeding is nature’s
way of cleaning a wound, so antiseptics and antibiotics are needed only
rarely. If the wound is less than perfectly clean, I apply some iodine
tincture to it, BUT NOT RIGHT AWAY, because it hurts! Wait until you
see slight redness, giving it a couple of days, before using an
antiseptic. Iodine tincture is less disruptive of bandage adhesive than
vitamin E oil, and may be applied sooner, but sparingly. (You will need
to carefully remove the outer covering bandages to do this, of course, but
you will want to see how the wound is coming anyway.) No need to remove
the butterflies; just touch the iodine applicator to the exposed edge of the
wound and it will be drawn in by itself. One or two applications is usually enough if you then follow up with the vitamin E
treatment as mentioned above. In summary: I may know how to do all
this, but I confess that I still hate buying band-aids. This is because
as a parent, I know all too well for whom I am buying them. I
especially grimace when buying butterfly bandages. The only good thing
about them is that they work as well or better than the alternative:
stitches. I have only rarely had to use butterfly bandages on each of my
children. Once my daughter fell in primary school and cut her
chin. She had a band-aid on when she got off the bus. When we
removed it, we saw that the cut was deep enough to expose yellow-orange
fat. That is a deep cut. I very carefully applied a pair of
butterfly bandages which held the skin tightly together. After four or
five days we started applying vitamin E to the site. Healing was so
successful that you cannot find what otherwise surely would have been a scar
should she have had the several stitches that the school nurse
recommended. When I had a chin laceration of my own some years before, I
had stitches. Aside from the interminable waiting room session, I have a
scar to this day (which I hide nicely under my beard). I have personally
observed children getting stitched up in an emergency room. It is a
scene to be avoided. In my daughter's case, it was. A laceration
was effectively closed without needles, without the pain they necessarily
cause, and without the stress of going to and waiting for assistance. I
don't relish the task, but I'd prefer to be the one delivering care to my own
kids. I think they greatly prefer it as well. If it is a question of
competence, then we must become competent, for even emergency room personnel
might not be. "Many Look, if you really need
an ambulance, call one! Major traumatic injuries and some other
situations absolutely demand medical technology. Even if the medical
residents are not experienced, chances are the nurses and paramedics
are. I submit, however, that we can increase our self-help territory,
reclaiming a significantly larger part of healthier than most doctors would
allow, and by simpler steps than most doctors would admit. I actually
learned how to use the butterfly bandage from a friend over the phone, and by
reading the directions on the package. It was time well spent to save
my little girl from added pain and a facial scar. For further
reading: Richardson, J. G. et al
(1904) Medicology.
The pharmacological
information in this huge (1,400 page) volume is way out of date. On the other
hand, the instructions for how to set a fracture (p 674-679), and how to
employ water therapy, herbs, massage and homeopathy seem as if they were
written this morning. Werner, David (1977) Where
There Is No Doctor. Hesperian Foundation, This book is a favorite
of mine. How to make your own butterfly bandages is on page 98. How to suture
a wound is on page 99. Setting fractures is illustrated in pages
111-114. Incidentally, how to deliver a baby: pages 300-315. I do not
recommend self-deliveries. Copyright C 2007 and
prior years Andrew W. Saul. Andrew Saul is the author of the books FIRE
YOUR DOCTOR! How to be Independently Healthy (reader
reviews at http://www.doctoryourself.com/review.html
) and DOCTOR YOURSELF: Natural Healing that Works. (reviewed at http://www.doctoryourself.com/saulbooks.html
) For ordering information, Click here . |
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AN IMPORTANT NOTE: This page is not in any way offered as prescription, diagnosis nor treatment for any disease, illness, infirmity or physical condition. Any form of self-treatment or alternative health program necessarily must involve an individual's acceptance of some risk, and no one should assume otherwise. Persons needing medical care should obtain it from a physician. Consult your doctor before making any health decision. Neither the author nor the webmaster has authorized the use of their names or the use of any material contained within in connection with the sale, promotion or advertising of any product or apparatus. Single-copy reproduction for individual, non-commercial use is permitted providing no alterations of content are made, and credit is given. |
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