Paul Campbell

I've purchased Tegaderm from Wallgrens but found it for 1/5 the cost at

Providence hospital pharmacy. They will sell it by the sheet for about a

buck apiece.



 From: mike.m-@obra.org

Reply-To: mike.m-@obra.org

Date: Tue, 12 Mar 2002 06:41:18 -0800

To: "OBRA Remailer" <ob-@topica.com>

Subject: RE: [OBRA Chat] Fwd: Wound care



==========================================================

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sports, and lifestyle news you can't afford to miss, all

at a price you can afford to pay! Click now!

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==========================================================



Personally I think that the Spenco product is inferior to the other

semipermeables but it is more available since it is marketed to the general

public rather than just to the medical community.



Mike Murray



-----Original Message-----

From: Darell Provencher [mailto:dare-@qwest.net]

Sent: Monday, March 11, 2002 21:12 PM

To: eri-@erikv.com; ob-@topica.com

Subject: Re: [OBRA Chat] Fwd: Wound care





Duct tape wound tightly around the wound works best. Take it off at the end

of the season.



-- Darell ;-)



Actually, try Spenco's 2nd Skin wet bandages (blue box, Beaverton Pharmacy

has the best choices in sizes). Web site is

http://www.spenco.com/advanced.html



Take it from an old trackie, this stuff costs more butt you can move on with

your life.



-- DP



----- Original Message -----

From: "Erik Voldengen" <eri-@erikv.com>

To: <ob-@topica.com>

Sent: Monday, March 11, 2002 5:59 PM

Subject: RE: [OBRA Chat] Fwd: Wound care





Has anyone tried NuSkin spray for abrasions?



Spray it on, run up and down the hall swearing because

it stings so bad for about 5 minutes, then voila! instant

skin. I was picking it off my arm after the wound healed,

so it lasts a long time. It's easier to put on than tegaderm

(although it has a slightly more painfull application). It

also smells pretty bad when you apply it.



-Erik



 -----Original Message-----

From: Candi Murray [mailto:cmur-@obra.org]

Sent: Monday, March 11, 2002 4:56 PM

To: ob-@topica.com

Subject: [OBRA Chat] Fwd: Wound care







 There seemed to be a number of individual who went down this

weekend and I

 thought that I would repost this note about wound care

Candi









 The most important thing about abrasions is to keep them from scabbing.

Scabs made sense from an evolutionary point of view since they

limit protein

 and fluid losses which is important if these things are difficult to come

by. Since modern man can stop at McDonald's and fill all those

needs, scabs

 no longer work so well for us. When a wound heals it is in part

because the

 skin cells slide in to cover the opening. If there is a scab then this is

inhibited and wound healing is delayed. Dressing materials also promote

wound healing by increasing the temperature locally at the wound site,

something that has been experimentally demonstrated to speed

wound healing.

 

I use Tegaderm. There are many other brands of semi-permeable membrane

dressings and they all work more or less as well. The way I use it is to

first make sure that the wound is clean and dry. This means that the

bleeding needs to have stopped. Usually I will clean the

abrasion first with

 saline and a surgical scrub brush and then cover it with

Vaseline gauze and

 an absorbent dressing. This is what the OBRA first aid providers

will do at

 the bike race. At some point several hours to a day later I will wash the

wound again with soap and saline (or just water) and then apply the

semi-permeable dressing. First I paint around the wound with Mastisol or

tincture of benzoine. These are products that make the skin sticky so the

Tegaderm (or whatever brand you use) will stick to the skin

around the wound

 better. Be careful not to get this stuff in the actual abrasion

because it

 will sting like mad. I then take a Q-tip and some greasy stuff, like

Vaseline, and draw a line of grease from the middle of the

abrasion to the

 most dependant part. This line of grease will keep the Tegaderm from

sticking at that point and will allow the fluid that comes out

of the wound

 to drain out. The Tegaderm then goes over the abrasion. If the

abrasion is

 too big to be covered by one piece you can overlap the pieces to get it

covered. It is important that the Tegaderm extends out over

about an inch of

 intact skin. Now cover at least the opening of the drain created by the

grease with an absorbent dressing to catch the goo that will

come out of the

 wound. If you place the dressing this way you can usually leave

the Tegaderm

 on for 4-7 days. Obviously the absorbent dressing should be changed when

soiled but the Tegaderm stays in place and you can exercise and

shower with

 it in place. Remove the Tegaderm if you start to see red spots around the

wound. The red spots are infection focuses at the hair follicles. Usually

this will clear up if the Tegaderm is left off for a day or so.



There are lots of other ways that you can treat abrasions but this is the

least fuss way and it will heal the fastest. Unfortunately the

semi-permeable membrane dressings, like Tegaderm are hard to find because

they are not marketed to the general public. Try pharmacies or medical

supply places. I have been told that Walgreen's pharmacies

carries it. It

 should be available at places that sell catheter or stoma care

products. It

 is likely that any pharmacy or medical supply house could order some for

you, although they may require a minimum purchase. Personally,

I just buy

 the stuff in 100 count boxes. It takes many years to go through

that much

 but it is not like the stuff is going to go bad or I am going to stop

scrapping myself up. It also works well to put on the kid's skinned up

knees and such.



There are some products that combine the semi-permeable membrane with an

absorbent gel. These are actually a bit better than the semi-permeable

membrane products but I think they are not quite so user

friendly and they

 are considerably more expensive. Duoderm is an example of such

a product.

 These work very well for "drier" wounds, like bedsores or chronic leg

ulcers. My experience is that wetter wounds like abrasions will fill the

gel so rapidly that the dressing will need to be changed daily,

negating the

 no fuss aspect of the semi-permeables and upping the cost quite a bit.



Conventional dressings work pretty well too but they require

daily dressing

 changes. Since the can't be worn while bathing often this means more

frequent than daily dressing changes, particularly for the

active athlete.

 They also do not relieve discomfort as well as the

semi-permeables. To use

 conventional dressings appropriately they need to be layered. The first

layer needs to be a fine mesh "non-adherent" type material, like Adaptic,

Vaseline Gauze or Xeroform. "Non-adherent" is actually a

misnomer since the

 goal of this layer is to allow the stuff that comes out of the

wound to go

 through this layer and then be removed with the dressing change. A true

non-adherent dressing, e.g. Telfa or Band-Aid, does not work

well since all

 it does is absorb the liquid from the wound but is still allows scabbed

material to form over the wound. In addition, the plastics in these type

dressings often cause the wound margins to macerate, i.e. get

full of water

 and turn white, which will inhibit wound healing. The cheapest way to do

the non-adherent layer is to take an old bed sheet, cut it in the

appropriate size, smear it with Vaseline and then apply to the

wound. The

 bed sheet material has about the right mesh size. The

non-adherent material

 should be applied only 1 layer thick. Over the top of the non-adherent

layer you put some absorbent gauze pads and then hold the whole thin in

place with some elastic dressing retainer, like the fishnet material that

the OBRA first aid people use, or tape and/or Ace bandages.



On areas that it is difficult to cover with a dressing, like the face, it

works best to just clean the wound frequently, 3-4 times per

day, and then

 keep a good layer of something greasy like Vaseline on the

wound. If you do

 this the wound fluids will not be able to congeal together to form a scab

and the wound will heal quicker.







Mike Murray

To respond to the whole group send to ob-@topica.com.

To respond to the list manager send to ob-@teleport.com

To unsubscribe send to obra-uns-@topica.com



 

To respond to the whole group send to ob-@topica.com.

To respond to the list manager send to ob-@teleport.com

To unsubscribe send to obra-uns-@topica.com



To respond to the whole group send to ob-@topica.com.

To respond to the list manager send to ob-@teleport.com

To unsubscribe send to obra-uns-@topica.com



============================================================

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to Ladies' Home Journal? Only a FREE year's subscription!

Check out this great offer now!

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============================================================



To respond to the whole group send to ob-@topica.com.

To respond to the list manager send to ob-@teleport.com

To unsubscribe send to obra-uns-@topica.com

mike.m-@obra.org

Personally I think that the Spenco product is inferior to the other

semipermeables but it is more available since it is marketed to the general

public rather than just to the medical community.



Mike Murray



-----Original Message-----

From: Darell Provencher [mailto:dare-@qwest.net]

Sent: Monday, March 11, 2002 21:12 PM

To: eri-@erikv.com; ob-@topica.com

Subject: Re: [OBRA Chat] Fwd: Wound care





Duct tape wound tightly around the wound works best. Take it off at the end

of the season.



-- Darell ;-)



Actually, try Spenco's 2nd Skin wet bandages (blue box, Beaverton Pharmacy

has the best choices in sizes). Web site is

http://www.spenco.com/advanced.html



Take it from an old trackie, this stuff costs more butt you can move on with

your life.



-- DP



----- Original Message -----

From: "Erik Voldengen" <eri-@erikv.com>

To: <ob-@topica.com>

Sent: Monday, March 11, 2002 5:59 PM

Subject: RE: [OBRA Chat] Fwd: Wound care





Has anyone tried NuSkin spray for abrasions?



Spray it on, run up and down the hall swearing because

it stings so bad for about 5 minutes, then voila! instant

skin. I was picking it off my arm after the wound healed,

so it lasts a long time. It's easier to put on than tegaderm

(although it has a slightly more painfull application). It

also smells pretty bad when you apply it.



-Erik



 -----Original Message-----

From: Candi Murray [mailto:cmur-@obra.org]

Sent: Monday, March 11, 2002 4:56 PM

To: ob-@topica.com

Subject: [OBRA Chat] Fwd: Wound care







 There seemed to be a number of individual who went down this

weekend and I

 thought that I would repost this note about wound care

Candi









 The most important thing about abrasions is to keep them from scabbing.

Scabs made sense from an evolutionary point of view since they

limit protein

 and fluid losses which is important if these things are difficult to come

by. Since modern man can stop at McDonald's and fill all those

needs, scabs

 no longer work so well for us. When a wound heals it is in part

because the

 skin cells slide in to cover the opening. If there is a scab then this is

inhibited and wound healing is delayed. Dressing materials also promote

wound healing by increasing the temperature locally at the wound site,

something that has been experimentally demonstrated to speed

wound healing.

 

I use Tegaderm. There are many other brands of semi-permeable membrane

dressings and they all work more or less as well. The way I use it is to

first make sure that the wound is clean and dry. This means that the

bleeding needs to have stopped. Usually I will clean the

abrasion first with

 saline and a surgical scrub brush and then cover it with

Vaseline gauze and

 an absorbent dressing. This is what the OBRA first aid providers

will do at

 the bike race. At some point several hours to a day later I will wash the

wound again with soap and saline (or just water) and then apply the

semi-permeable dressing. First I paint around the wound with Mastisol or

tincture of benzoine. These are products that make the skin sticky so the

Tegaderm (or whatever brand you use) will stick to the skin

around the wound

 better. Be careful not to get this stuff in the actual abrasion

because it

 will sting like mad. I then take a Q-tip and some greasy stuff, like

Vaseline, and draw a line of grease from the middle of the

abrasion to the

 most dependant part. This line of grease will keep the Tegaderm from

sticking at that point and will allow the fluid that comes out

of the wound

 to drain out. The Tegaderm then goes over the abrasion. If the

abrasion is

 too big to be covered by one piece you can overlap the pieces to get it

covered. It is important that the Tegaderm extends out over

about an inch of

 intact skin. Now cover at least the opening of the drain created by the

grease with an absorbent dressing to catch the goo that will

come out of the

 wound. If you place the dressing this way you can usually leave

the Tegaderm

 on for 4-7 days. Obviously the absorbent dressing should be changed when

soiled but the Tegaderm stays in place and you can exercise and

shower with

 it in place. Remove the Tegaderm if you start to see red spots around the

wound. The red spots are infection focuses at the hair follicles. Usually

this will clear up if the Tegaderm is left off for a day or so.



There are lots of other ways that you can treat abrasions but this is the

least fuss way and it will heal the fastest. Unfortunately the

semi-permeable membrane dressings, like Tegaderm are hard to find because

they are not marketed to the general public. Try pharmacies or medical

supply places. I have been told that Walgreen's pharmacies

carries it. It

 should be available at places that sell catheter or stoma care

products. It

 is likely that any pharmacy or medical supply house could order some for

you, although they may require a minimum purchase. Personally,

I just buy

 the stuff in 100 count boxes. It takes many years to go through

that much

 but it is not like the stuff is going to go bad or I am going to stop

scrapping myself up. It also works well to put on the kid's skinned up

knees and such.



There are some products that combine the semi-permeable membrane with an

absorbent gel. These are actually a bit better than the semi-permeable

membrane products but I think they are not quite so user

friendly and they

 are considerably more expensive. Duoderm is an example of such

a product.

 These work very well for "drier" wounds, like bedsores or chronic leg

ulcers. My experience is that wetter wounds like abrasions will fill the

gel so rapidly that the dressing will need to be changed daily,

negating the

 no fuss aspect of the semi-permeables and upping the cost quite a bit.



Conventional dressings work pretty well too but they require

daily dressing

 changes. Since the can't be worn while bathing often this means more

frequent than daily dressing changes, particularly for the

active athlete.

 They also do not relieve discomfort as well as the

semi-permeables. To use

 conventional dressings appropriately they need to be layered. The first

layer needs to be a fine mesh "non-adherent" type material, like Adaptic,

Vaseline Gauze or Xeroform. "Non-adherent" is actually a

misnomer since the

 goal of this layer is to allow the stuff that comes out of the

wound to go

 through this layer and then be removed with the dressing change. A true

non-adherent dressing, e.g. Telfa or Band-Aid, does not work

well since all

 it does is absorb the liquid from the wound but is still allows scabbed

material to form over the wound. In addition, the plastics in these type

dressings often cause the wound margins to macerate, i.e. get

full of water

 and turn white, which will inhibit wound healing. The cheapest way to do

the non-adherent layer is to take an old bed sheet, cut it in the

appropriate size, smear it with Vaseline and then apply to the

wound. The

 bed sheet material has about the right mesh size. The

non-adherent material

 should be applied only 1 layer thick. Over the top of the non-adherent

layer you put some absorbent gauze pads and then hold the whole thin in

place with some elastic dressing retainer, like the fishnet material that

the OBRA first aid people use, or tape and/or Ace bandages.



On areas that it is difficult to cover with a dressing, like the face, it

works best to just clean the wound frequently, 3-4 times per

day, and then

 keep a good layer of something greasy like Vaseline on the

wound. If you do

 this the wound fluids will not be able to congeal together to form a scab

and the wound will heal quicker.







Mike Murray

To respond to the whole group send to ob-@topica.com.

To respond to the list manager send to ob-@teleport.com

To unsubscribe send to obra-uns-@topica.com



 

To respond to the whole group send to ob-@topica.com.

To respond to the list manager send to ob-@teleport.com

To unsubscribe send to obra-uns-@topica.com



To respond to the whole group send to ob-@topica.com.

To respond to the list manager send to ob-@teleport.com

To unsubscribe send to obra-uns-@topica.com

Darell Provencher

Duct tape wound tightly around the wound works best. Take it off at the end

of the season.



-- Darell ;-)



Actually, try Spenco's 2nd Skin wet bandages (blue box, Beaverton Pharmacy

has the best choices in sizes). Web site is

http://www.spenco.com/advanced.html



Take it from an old trackie, this stuff costs more butt you can move on with

your life.



-- DP



----- Original Message -----

From: "Erik Voldengen" <eri-@erikv.com>

To: <ob-@topica.com>

Sent: Monday, March 11, 2002 5:59 PM

Subject: RE: [OBRA Chat] Fwd: Wound care





Has anyone tried NuSkin spray for abrasions?



Spray it on, run up and down the hall swearing because

it stings so bad for about 5 minutes, then voila! instant

skin. I was picking it off my arm after the wound healed,

so it lasts a long time. It's easier to put on than tegaderm

(although it has a slightly more painfull application). It

also smells pretty bad when you apply it.



-Erik



 -----Original Message-----

From: Candi Murray [mailto:cmur-@obra.org]

Sent: Monday, March 11, 2002 4:56 PM

To: ob-@topica.com

Subject: [OBRA Chat] Fwd: Wound care







 There seemed to be a number of individual who went down this

weekend and I

 thought that I would repost this note about wound care

Candi









 The most important thing about abrasions is to keep them from scabbing.

Scabs made sense from an evolutionary point of view since they

limit protein

 and fluid losses which is important if these things are difficult to come

by. Since modern man can stop at McDonald's and fill all those

needs, scabs

 no longer work so well for us. When a wound heals it is in part

because the

 skin cells slide in to cover the opening. If there is a scab then this is

inhibited and wound healing is delayed. Dressing materials also promote

wound healing by increasing the temperature locally at the wound site,

something that has been experimentally demonstrated to speed

wound healing.

 

I use Tegaderm. There are many other brands of semi-permeable membrane

dressings and they all work more or less as well. The way I use it is to

first make sure that the wound is clean and dry. This means that the

bleeding needs to have stopped. Usually I will clean the

abrasion first with

 saline and a surgical scrub brush and then cover it with

Vaseline gauze and

 an absorbent dressing. This is what the OBRA first aid providers

will do at

 the bike race. At some point several hours to a day later I will wash the

wound again with soap and saline (or just water) and then apply the

semi-permeable dressing. First I paint around the wound with Mastisol or

tincture of benzoine. These are products that make the skin sticky so the

Tegaderm (or whatever brand you use) will stick to the skin

around the wound

 better. Be careful not to get this stuff in the actual abrasion

because it

 will sting like mad. I then take a Q-tip and some greasy stuff, like

Vaseline, and draw a line of grease from the middle of the

abrasion to the

 most dependant part. This line of grease will keep the Tegaderm from

sticking at that point and will allow the fluid that comes out

of the wound

 to drain out. The Tegaderm then goes over the abrasion. If the

abrasion is

 too big to be covered by one piece you can overlap the pieces to get it

covered. It is important that the Tegaderm extends out over

about an inch of

 intact skin. Now cover at least the opening of the drain created by the

grease with an absorbent dressing to catch the goo that will

come out of the

 wound. If you place the dressing this way you can usually leave

the Tegaderm

 on for 4-7 days. Obviously the absorbent dressing should be changed when

soiled but the Tegaderm stays in place and you can exercise and

shower with

 it in place. Remove the Tegaderm if you start to see red spots around the

wound. The red spots are infection focuses at the hair follicles. Usually

this will clear up if the Tegaderm is left off for a day or so.



There are lots of other ways that you can treat abrasions but this is the

least fuss way and it will heal the fastest. Unfortunately the

semi-permeable membrane dressings, like Tegaderm are hard to find because

they are not marketed to the general public. Try pharmacies or medical

supply places. I have been told that Walgreen's pharmacies

carries it. It

 should be available at places that sell catheter or stoma care

products. It

 is likely that any pharmacy or medical supply house could order some for

you, although they may require a minimum purchase. Personally,

I just buy

 the stuff in 100 count boxes. It takes many years to go through

that much

 but it is not like the stuff is going to go bad or I am going to stop

scrapping myself up. It also works well to put on the kid's skinned up

knees and such.



There are some products that combine the semi-permeable membrane with an

absorbent gel. These are actually a bit better than the semi-permeable

membrane products but I think they are not quite so user

friendly and they

 are considerably more expensive. Duoderm is an example of such

a product.

 These work very well for "drier" wounds, like bedsores or chronic leg

ulcers. My experience is that wetter wounds like abrasions will fill the

gel so rapidly that the dressing will need to be changed daily,

negating the

 no fuss aspect of the semi-permeables and upping the cost quite a bit.



Conventional dressings work pretty well too but they require

daily dressing

 changes. Since the can't be worn while bathing often this means more

frequent than daily dressing changes, particularly for the

active athlete.

 They also do not relieve discomfort as well as the

semi-permeables. To use

 conventional dressings appropriately they need to be layered. The first

layer needs to be a fine mesh "non-adherent" type material, like Adaptic,

Vaseline Gauze or Xeroform. "Non-adherent" is actually a

misnomer since the

 goal of this layer is to allow the stuff that comes out of the

wound to go

 through this layer and then be removed with the dressing change. A true

non-adherent dressing, e.g. Telfa or Band-Aid, does not work

well since all

 it does is absorb the liquid from the wound but is still allows scabbed

material to form over the wound. In addition, the plastics in these type

dressings often cause the wound margins to macerate, i.e. get

full of water

 and turn white, which will inhibit wound healing. The cheapest way to do

the non-adherent layer is to take an old bed sheet, cut it in the

appropriate size, smear it with Vaseline and then apply to the

wound. The

 bed sheet material has about the right mesh size. The

non-adherent material

 should be applied only 1 layer thick. Over the top of the non-adherent

layer you put some absorbent gauze pads and then hold the whole thin in

place with some elastic dressing retainer, like the fishnet material that

the OBRA first aid people use, or tape and/or Ace bandages.



On areas that it is difficult to cover with a dressing, like the face, it

works best to just clean the wound frequently, 3-4 times per

day, and then

 keep a good layer of something greasy like Vaseline on the

wound. If you do

 this the wound fluids will not be able to congeal together to form a scab

and the wound will heal quicker.







Mike Murray

To respond to the whole group send to ob-@topica.com.

To respond to the list manager send to ob-@teleport.com

To unsubscribe send to obra-uns-@topica.com



 

To respond to the whole group send to ob-@topica.com.

To respond to the list manager send to ob-@teleport.com

To unsubscribe send to obra-uns-@topica.com

Erik Voldengen

Has anyone tried NuSkin spray for abrasions?



Spray it on, run up and down the hall swearing because

it stings so bad for about 5 minutes, then voila! instant

skin. I was picking it off my arm after the wound healed,

so it lasts a long time. It's easier to put on than tegaderm

(although it has a slightly more painfull application). It

also smells pretty bad when you apply it.



-Erik



 -----Original Message-----

From: Candi Murray [mailto:cmur-@obra.org]

Sent: Monday, March 11, 2002 4:56 PM

To: ob-@topica.com

Subject: [OBRA Chat] Fwd: Wound care







 There seemed to be a number of individual who went down this

weekend and I

 thought that I would repost this note about wound care

Candi









 The most important thing about abrasions is to keep them from scabbing.

Scabs made sense from an evolutionary point of view since they

limit protein

 and fluid losses which is important if these things are difficult to come

by. Since modern man can stop at McDonald's and fill all those

needs, scabs

 no longer work so well for us. When a wound heals it is in part

because the

 skin cells slide in to cover the opening. If there is a scab then this is

inhibited and wound healing is delayed. Dressing materials also promote

wound healing by increasing the temperature locally at the wound site,

something that has been experimentally demonstrated to speed

wound healing.

 

I use Tegaderm. There are many other brands of semi-permeable membrane

dressings and they all work more or less as well. The way I use it is to

first make sure that the wound is clean and dry. This means that the

bleeding needs to have stopped. Usually I will clean the

abrasion first with

 saline and a surgical scrub brush and then cover it with

Vaseline gauze and

 an absorbent dressing. This is what the OBRA first aid providers

will do at

 the bike race. At some point several hours to a day later I will wash the

wound again with soap and saline (or just water) and then apply the

semi-permeable dressing. First I paint around the wound with Mastisol or

tincture of benzoine. These are products that make the skin sticky so the

Tegaderm (or whatever brand you use) will stick to the skin

around the wound

 better. Be careful not to get this stuff in the actual abrasion

because it

 will sting like mad. I then take a Q-tip and some greasy stuff, like

Vaseline, and draw a line of grease from the middle of the

abrasion to the

 most dependant part. This line of grease will keep the Tegaderm from

sticking at that point and will allow the fluid that comes out

of the wound

 to drain out. The Tegaderm then goes over the abrasion. If the

abrasion is

 too big to be covered by one piece you can overlap the pieces to get it

covered. It is important that the Tegaderm extends out over

about an inch of

 intact skin. Now cover at least the opening of the drain created by the

grease with an absorbent dressing to catch the goo that will

come out of the

 wound. If you place the dressing this way you can usually leave

the Tegaderm

 on for 4-7 days. Obviously the absorbent dressing should be changed when

soiled but the Tegaderm stays in place and you can exercise and

shower with

 it in place. Remove the Tegaderm if you start to see red spots around the

wound. The red spots are infection focuses at the hair follicles. Usually

this will clear up if the Tegaderm is left off for a day or so.



There are lots of other ways that you can treat abrasions but this is the

least fuss way and it will heal the fastest. Unfortunately the

semi-permeable membrane dressings, like Tegaderm are hard to find because

they are not marketed to the general public. Try pharmacies or medical

supply places. I have been told that Walgreen's pharmacies

carries it. It

 should be available at places that sell catheter or stoma care

products. It

 is likely that any pharmacy or medical supply house could order some for

you, although they may require a minimum purchase. Personally,

I just buy

 the stuff in 100 count boxes. It takes many years to go through

that much

 but it is not like the stuff is going to go bad or I am going to stop

scrapping myself up. It also works well to put on the kid's skinned up

knees and such.



There are some products that combine the semi-permeable membrane with an

absorbent gel. These are actually a bit better than the semi-permeable

membrane products but I think they are not quite so user

friendly and they

 are considerably more expensive. Duoderm is an example of such

a product.

 These work very well for "drier" wounds, like bedsores or chronic leg

ulcers. My experience is that wetter wounds like abrasions will fill the

gel so rapidly that the dressing will need to be changed daily,

negating the

 no fuss aspect of the semi-permeables and upping the cost quite a bit.



Conventional dressings work pretty well too but they require

daily dressing

 changes. Since the can't be worn while bathing often this means more

frequent than daily dressing changes, particularly for the

active athlete.

 They also do not relieve discomfort as well as the

semi-permeables. To use

 conventional dressings appropriately they need to be layered. The first

layer needs to be a fine mesh "non-adherent" type material, like Adaptic,

Vaseline Gauze or Xeroform. "Non-adherent" is actually a

misnomer since the

 goal of this layer is to allow the stuff that comes out of the

wound to go

 through this layer and then be removed with the dressing change. A true

non-adherent dressing, e.g. Telfa or Band-Aid, does not work

well since all

 it does is absorb the liquid from the wound but is still allows scabbed

material to form over the wound. In addition, the plastics in these type

dressings often cause the wound margins to macerate, i.e. get

full of water

 and turn white, which will inhibit wound healing. The cheapest way to do

the non-adherent layer is to take an old bed sheet, cut it in the

appropriate size, smear it with Vaseline and then apply to the

wound. The

 bed sheet material has about the right mesh size. The

non-adherent material

 should be applied only 1 layer thick. Over the top of the non-adherent

layer you put some absorbent gauze pads and then hold the whole thin in

place with some elastic dressing retainer, like the fishnet material that

the OBRA first aid people use, or tape and/or Ace bandages.



On areas that it is difficult to cover with a dressing, like the face, it

works best to just clean the wound frequently, 3-4 times per

day, and then

 keep a good layer of something greasy like Vaseline on the

wound. If you do

 this the wound fluids will not be able to congeal together to form a scab

and the wound will heal quicker.







Mike Murray

To respond to the whole group send to ob-@topica.com.

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Candi Murray

 There seemed to be a number of individual who went down this weekend and I

thought that I would repost this note about wound care

Candi









 The most important thing about abrasions is to keep them from scabbing.

Scabs made sense from an evolutionary point of view since they limit protein

and fluid losses which is important if these things are difficult to come

by. Since modern man can stop at McDonald's and fill all those needs, scabs

no longer work so well for us. When a wound heals it is in part because the

skin cells slide in to cover the opening. If there is a scab then this is

inhibited and wound healing is delayed. Dressing materials also promote

wound healing by increasing the temperature locally at the wound site,

something that has been experimentally demonstrated to speed wound healing.



I use Tegaderm. There are many other brands of semi-permeable membrane

dressings and they all work more or less as well. The way I use it is to

first make sure that the wound is clean and dry. This means that the

bleeding needs to have stopped. Usually I will clean the abrasion first with

saline and a surgical scrub brush and then cover it with Vaseline gauze and

an absorbent dressing. This is what the OBRA first aid providers will do at

the bike race. At some point several hours to a day later I will wash the

wound again with soap and saline (or just water) and then apply the

semi-permeable dressing. First I paint around the wound with Mastisol or

tincture of benzoine. These are products that make the skin sticky so the

Tegaderm (or whatever brand you use) will stick to the skin around the wound

better. Be careful not to get this stuff in the actual abrasion because it

will sting like mad. I then take a Q-tip and some greasy stuff, like

Vaseline, and draw a line of grease from the middle of the abrasion to the

most dependant part. This line of grease will keep the Tegaderm from

sticking at that point and will allow the fluid that comes out of the wound

to drain out. The Tegaderm then goes over the abrasion. If the abrasion is

too big to be covered by one piece you can overlap the pieces to get it

covered. It is important that the Tegaderm extends out over about an inch of

intact skin. Now cover at least the opening of the drain created by the

grease with an absorbent dressing to catch the goo that will come out of the

wound. If you place the dressing this way you can usually leave the Tegaderm

on for 4-7 days. Obviously the absorbent dressing should be changed when

soiled but the Tegaderm stays in place and you can exercise and shower with

it in place. Remove the Tegaderm if you start to see red spots around the

wound. The red spots are infection focuses at the hair follicles. Usually

this will clear up if the Tegaderm is left off for a day or so.



There are lots of other ways that you can treat abrasions but this is the

least fuss way and it will heal the fastest. Unfortunately the

semi-permeable membrane dressings, like Tegaderm are hard to find because

they are not marketed to the general public. Try pharmacies or medical

supply places. I have been told that Walgreen's pharmacies carries it. It

should be available at places that sell catheter or stoma care products. It

is likely that any pharmacy or medical supply house could order some for

you, although they may require a minimum purchase. Personally, I just buy

the stuff in 100 count boxes. It takes many years to go through that much

but it is not like the stuff is going to go bad or I am going to stop

scrapping myself up. It also works well to put on the kid's skinned up

knees and such.



There are some products that combine the semi-permeable membrane with an

absorbent gel. These are actually a bit better than the semi-permeable

membrane products but I think they are not quite so user friendly and they

are considerably more expensive. Duoderm is an example of such a product.

These work very well for "drier" wounds, like bedsores or chronic leg

ulcers. My experience is that wetter wounds like abrasions will fill the

gel so rapidly that the dressing will need to be changed daily, negating the

no fuss aspect of the semi-permeables and upping the cost quite a bit.



Conventional dressings work pretty well too but they require daily dressing

changes. Since the can't be worn while bathing often this means more

frequent than daily dressing changes, particularly for the active athlete.

They also do not relieve discomfort as well as the semi-permeables. To use

conventional dressings appropriately they need to be layered. The first

layer needs to be a fine mesh "non-adherent" type material, like Adaptic,

Vaseline Gauze or Xeroform. "Non-adherent" is actually a misnomer since the

goal of this layer is to allow the stuff that comes out of the wound to go

through this layer and then be removed with the dressing change. A true

non-adherent dressing, e.g. Telfa or Band-Aid, does not work well since all

it does is absorb the liquid from the wound but is still allows scabbed

material to form over the wound. In addition, the plastics in these type

dressings often cause the wound margins to macerate, i.e. get full of water

and turn white, which will inhibit wound healing. The cheapest way to do

the non-adherent layer is to take an old bed sheet, cut it in the

appropriate size, smear it with Vaseline and then apply to the wound. The

bed sheet material has about the right mesh size. The non-adherent material

should be applied only 1 layer thick. Over the top of the non-adherent

layer you put some absorbent gauze pads and then hold the whole thin in

place with some elastic dressing retainer, like the fishnet material that

the OBRA first aid people use, or tape and/or Ace bandages.



On areas that it is difficult to cover with a dressing, like the face, it

works best to just clean the wound frequently, 3-4 times per day, and then

keep a good layer of something greasy like Vaseline on the wound. If you do

this the wound fluids will not be able to congeal together to form a scab

and the wound will heal quicker.







Mike Murray