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Hola! Bienvenido a Medical Monday!
Todayâ€™s Topic: INFECTIONS!
So I saw this guy who almost lost his leg because he didnâ€™t clean his leg after he got a scratch. Legit scary. So I would like to impart upon you the merits of cleaning wounds.
First off, you need to maintain hygiene during the apocalypse. Iâ€™m talking, if you canâ€™t bathe, then get some water and a washcloth and clean your dirty body. I mean look at Daryl from The Walking Dead. Love than man, but he always seems to need a goddamn bath! If you are dirty and you get a scrape, you are at higher risk of infection.
In addition to healthy hygiene, you need to assess yourself periodically for any scrapes that may have gone unnoticed. I would suggest every night before you go to bed. This would be a good time for your washcloth bath and now you can check your body for cuts, ticks, whatever.
Cuts should be washed out. If it is an abrasion that took the top layer of skin off (think a skinned knee), then you should wash it with water and lightly scrub it with that washcloth that you use to bathe yourself. (Are you getting the hint that a washcloth should be in your BOB?) Any gravel or dirt needs to come out. And Bleeding is goodâ€¦itâ€™s your bodyâ€™s way of cleaning the wound.
Large lacerations, like those that may need stitches, need a more thorough cleaning. HIGH PRESSURE water should be used. I keep a water bottle with a squirt top in my BOB. Yes, less useful than a Nalgene, but with a squirt top, I can force water under much higher pressure than I could if I was just pouring water over it. You need about one liter of fluid, or more if you think it is super dirty, to effectively clean out a wound. The laceration should be free of any dirt or gravel before you stitch it up or put the butterfly bandages on it. Then cover it with gauze and a few band-aids to prevent any more dirt from getting in it. During your nightly washcloth bath, you should examine the wound for the following: redness, pain (obviously there will be some pain, Iâ€™m talking about excruciating pain), drainage, and warmth. If any of those are present, you may need an antibiotic.
You should NOT need antibiotics if you washed the cut out well and made sure it stayed clean. If it gets infected, you failed. So now you need to raid a pharmacy for antibiotics. I would choose clindamycin 300mg 3 times a day for 7 days. Or Bactrim (Trimethoprim-sulfamethoxazole) one extra-strength tablet every 12 hours for 7 days.
Moral of the Story: Stay Clean, Stay Healthy