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Know When a Bandage Will Suffice

Bandages are a matter-of-fact part of everyday life, an easy treatment for minor wounds.

The first pre-packaged bandage was available in the 1920s from Johnson and Johnson. According to the company, a cotton buyer in the purchasing department of the New Brunswick, N.J., company was frustrated when his wife repeatedly sliced her fingertips while working in the kitchen.

He placed a bit of cotton on the sticky side of a thin strip of adhesive tape and covered the whole length with something he could pull off when he took it home. Thus were born Band-Aids, the brand name the company used for the find and the name that has become synonymous with bandage.

Today, we can choose pre-packaged bandages in a staggering assortment of sizes and colors, including transparent versions or those to fit your skin tone. Shapes include those formed like small dogs to fit over fingertips and knuckles without creating pleats that catch on clothing or work surfaces.

There are extra-wide adhesive strips with gauze pads large enough to cover the back of your hand or your kneecap.

How to handle a cut

Are all these pre-packaged wound coverings the best thing for treatment of cuts and everyday injuries? Can we safely smear a scrape with first-aid ointment and expect it to heal, untended, in a few days?

The American Academy of Family Physicians (AAFP) and other experts say yes to the bandages, no to the ointment, and no to loving neglect of any wound.

All breaks in the skin should be covered to protect against infection, the AAFP says.

The first and best thing to do with a wound is wash it with soap and cool water. If it's bleeding, apply pressure to it with a clean piece of cloth or gauze, and elevate it above the heart.

The next step is to look at the wound. If bright red blood is spurting out at intervals linked to your heartbeat, you are bleeding from an artery. This is serious and needs immediate medical attention to stop the bleeding.

Exposure to fresh air is the quickest way to allow minor wounds to heal, and thus it is generally best not to apply creams or ointments, because they keep the wound moist, the AAFP says.  Never apply a cream or ointment to a burn without checking with your health care provider first.

To stop heavy bleeding, don't use a tourniquet. Instead, use a dry sterile bandage, apply pressure and elevate the wound area. Pressure and elevation will stop the blood flow. A tourniquet, however, will stop all circulation and will cause more trauma.

All dressings should be changed twice a day. At bedtime, the bandage should be replaced with a looser dressing so air can circulate around the wound. Upon waking, a slightly tighter bandage should be applied, but not so tight that it cuts off circulation.

Bandages should be changed even if it means pulling off a part of a scab that's forming. Try to keep the wounded area dry, the AAFP says.

Any wound that is on the face, jagged, very dirty, becomes tender or red, develops pus, or is accompanied by a fever or the appearance of red lines emanating from the injured area is infected and must be treated by a doctor. Any human or animal bite should be seen by a doctor.

To stitch or not to stitch

The need for stitches depends on the depth and location of a wound, the AAFP says. Cuts on the face frequently are closed with stitches instead of gluing or taping. Cuts on non-fleshy areas, like fingertips and parts of the face, often are not suitable for stitches, but can be kept closed with light adhesive strips. These also should be replaced twice daily.

Gaping cuts require stitches. If you're uncertain whether a wound should be stitched, go to a doctor. If stitches are required, the job must be done within six hours.

If a wound is very dirty, or if you fall on gravel or wood splinters, you should go to a doctor to have it cleaned. The alternative may be long-term infection and serious complications if even a sliver of a foreign object remains in the body. Make sure your tetanus vaccination is up to date.

Also, puncture wounds can push particles of dirt deep into the body. If you haven't had a tetanus shot in five years, get one if you have suffered a puncture wound or a scrape or cut from any item that is dirty.