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“НАШЕ ЖИТТЯ”, ЛИСТОПАД 2015 WWW.UNWLA.ORG 33 A REFRESHER ON MANAGEMENT OF SKIN INJURIES by Ihor Magun, MD, FACP Cuts happen when you least expect them. Most cuts, referred to as lacerations in the medical field, are minimal and need no profes- sional intervention. However, there are times when cuts absolutely require medical attention. How can you tell when your cut necessitates a trip to the doctor or the emergency room? Wound assessment is the first step in the process. Where is the location of the injury? What is its depth and what is the cut’s type—jagged, straight, abraded, or torn? Was the injury with a household item like a knife or with an unknown object? This information may determine whether a professional consultation may be needed. All wounds should be washed with water. Tap water is perfectly fine. If your assessment shows only a minor injury, the affected area should be covered with a bandage, preferably with moist occlusion, which permits better healing and includes any over-the-counter antibiotic oint- ments. However, petroleum jelly has also been used and has been deemed just as effective. If you do feel the need for professional med- ical attention, it is always advisable not to wait with injuries: the sooner the injury is addressed, the quicker it will probably heal. If stitches are necessary, the guidelines are as follows: if the wound is clean, it is reasonable to suture within six to twelve hours. Injuries to the head or face can be sutured up to twenty-four hours later. The longer time frame for lacerations to that body part is due to the extensive blood supply to the head and face, which benefits healing. But just as with other wounds, never put off having this laceration addressed. Remember, the clock starts when the cut occurs and there may be unforeseen delays before the injury is treated. It is best to give your- self plenty of time to reach the location for medi- cal attention and allow for any waiting time until you are seen. Not all lacerations require sutures or are amenable to be sutured. There are cases when staples work just as well, and the use of medical glue is effective when lacerations are linear and can be easily aligned. Most bite wounds are not sutured, but all of them require medical attention and almost always oral antibiotics. What about tetanus? Tetanus vaccine is a deactivated toxin that is administered to prevent tetanus, also referred to as lockjaw. This disease is potentially deadly, but because the vaccination is routinely administered in the United States, this complication is rare. Deep puncture wounds are most susceptible to a tetanus infection. The tetanus series is administered in infancy and is given together with diphtheria and pertus- sis. After completing what is referred to as the primary series, booster shots in adults are admin- istered every ten years, usually in the form of only tetanus and diphtheria (Td). Because of issues of lower immunity with pertussis with the aging population, it is recommended to substitute Td with one dose of Tdap—tetanus, diphtheria, and pertussis. Tdap is administered only once after age nineteen. If a tetanus shot is needed during pregnan- cy, Td should be administered. If there was a completed primary vaccination series and there is a low risk of a tetanus infection, Td should be de- layed until the postpartum period. If you do not recall your last tetanus injec- tion and you have a deep cut or puncture wound, it is best to receive the booster dose. Be certain to keep a record of this booster and the actual type. Remember, Tdap can only be administered once after age nineteen as a booster dose. Hopefully, no one will have any lacerations or injuries, but armed with the above information, you would know exactly what to do if one were to occur. Remember, never ignore any wound that you feel just does not “look right,” and though the time frame for suture placement is several hours, never wait too long. The best healing occurs when wound injuries are addressed in a timely fashion. ATTENTION AUTHORS Please send in your submissions, questions, and suggestions in Ukrainian or in English to the email address printed on the front inside cover of Our Life : unwlaourlife@gmail.com
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