Wound treatment is a fantastic place to start if you want to learn more about survival medicine but don’t know where to begin. Whether it’s in the course of a catastrophe or just in your day-to-day life, you’ll eventually suffer from some sort of wound.

Gashes, bites, burns, and other injuries are all addressed. I’ve also discovered an excellent review regarding certain aspects of wound care: the Wilderness Medical Society Practice Guidelines for Basic Wound Management in the Austere Environment was released last summer.

Researchers examined relevant research for evidence of what works and what doesn’t to produce the conclusions in this document. In this post, I’ll address some of their ideas about wound treatment. Some of the discoveries may come as a surprise to you.

Plain Water Is Usually Best

In my books and articles on wounds, I advocate that drinkable water is one of the finest wound-cleaning choices. The article states that it is the preferred fluid (saline is just as good but no better).

You’ve probably used hydrogen peroxide or povidone-iodine (Betadine) to clean scrapes. Even so, disinfectants such as these might harm tissue to some extent. The researchers of this study, on the other hand, found that the risk is high enough for them to actually advise against using disinfectants or adding them to drinkable water. They also suggest avoiding soap for the same reason.

Damaging the tissue gives the germs a significant edge. You’ll never be able to fully cleanse a wound of germs. All you can do is attempt to flush out most of the germs in order to provide your immune system a fighting chance against those that remain. If the tissue is harmed, it might decrease the body’s resistance to disease, allowing remaining bacteria to survive—and quickly turn into an epidemic if left unchecked.

In austere circumstances, I think we must make the best of what we have. When compared to other treatments that might harm tissues, getting an open wound clean is more beneficial in terms of tissue damage. If water is limited, the potential tissue damage from utilizing other chemicals is offset by cleaning the wound. However, if it’s at all possible, avoid any damage to the tissues whenever feasible; especially when antibiotics and such are in short supply. The less concentrated you can make the solution, therefore, the better.

Exception: According to the study, irrigating with a povidone-iodine solution after being bitten by an animal that could have rabies has been found to lower your risk of contracting the horrible disease. And it’s worth the risk of tissue damage for that. Chlorinated water is next, with soap if available. Of course, you’ll want expert care and possible vaccinations within 24–48 hours if at all possible. For more on how to prevent rabies, go here.

Pressure Helps, to a Point

After you’ve stopped the bleeding and removed obvious debris, pressure irrigation (pressure washing) is the way to go if you want to clean most wounds. I’ve suggested using a bulb syringe (like the one used for cleaning ears or a baby’s nose) or even filling a plastic container with water in the absence of running tap water. However, it appears that this merely delivers a “low pressure” of less than 6 pounds per square inch.

According to the study, a “high pressure” of 6–15 psi, supplied by pushing water through a syringe connected to a needle or IV catheter, cleans the wound and is crucial for cleaning an open fracture wound (a broken bone). A 35 ml syringe and 19-gauge needle, for example, can generate approximately 8 psi. (To give you an idea of the size: A health care provider typically uses a needle that’s somewhat smaller than this when giving you a shot.)

Don’t be too enthusiastic. Although pressures of 15 or more are thought to promote bacterial migration rather than flushing them out, you can still wind up pushing bacteria and debris deeper into the tissue if you go too far. Fortunately, unless you use a water flosser or pulsating showerhead massager, you’re not likely to reach that pressure.

More is Better

Depending on how deep and dirty the injury is, as well as how much solution you have accessible, the review recommends using anywhere from a little over a liter (quart) all the way up to ten liters of water. Unless it’s an open fracture, I would recommend following the amount depending on how far down and filthy the wound is, as well as how much solution you have available. You irrigate to the very top with that.

Warm Is Better

Take my word for it. Any treatments applied to a wound will sting. Most people believe that heating the solution slightly takes away some of the pain.

Do you have any more cleaning tips? Do you agree or disagree with anything I’ve said?

Photo by Brian Patrick Tagalog/Unsplash

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