Therapy
The correct treatment of a cut depends on the severity and depth of the wound. Small, superficial cuts should first bleed a little (to flush out bacteria and dirt), rinse with clean water and then apply a sterile plaster. The application of disinfectant is also possible.
Deeper, large cuts should be treated immediately, but the presentation to a doctor should be made as soon as possible, so that a possible treatment with a suture or a wound adhesive can be made. It is important to note that although an initial “bleeding” can reduce the entry of germs, in the case of larger cuts and larger bleedings, the loss of blood must of course be taken into account. If there is a very strong bleeding, a compression bandage/compression bandage is indicated for initial treatment, as well as elevating the affected body part until the doctor arrives.
In the case of wounds of any kind, tetanus protection is also of great importance and is usually also asked by the doctor treating the patient: if the vaccination against tetanus was given more than 5 years ago or if there has never been any immunization against tetanus, it must be refreshed or a basic immunization must be carried out. In most cases, it is sufficient to disinfect the cut once at the beginning. For this purpose, suitable antiseptics should be used which contain the active ingredients octenidine, povidone-iodine or polihexanide.
If a wound infection with bacteria already exists, daily wound disinfection until the wound is free of symptoms is recommended. Before disinfectants are applied, the cut should be cleaned with clean water. Then let the wound dry briefly and apply the disinfectant spray or gel and let it take effect.
This may be followed by further treatment by the doctor (suturing or gluing). If smaller, superficial wounds are treated independently, a sterile plaster should be used. Superficial cuts that bleed little and do not have widely diverging, clean and smooth wound edges can usually be treated by the patient himself.
However, if the cut is very large, deep, wide apart and bleeding heavily, it should be treated by a physician. If the incision is very deep, disturbances of sensation or movement may also occur.B. fingers, a doctor should be consulted as soon as possible.
If an incision is initially self-care and in the course of time the signs of inflammation or even pus described here become apparent, this is a possible indication of an infection with bacteria – a doctor should also take a look at the wound. The decision as to when a cut wound needs suturing depends on various considerations: On the one hand, the size, depth and location of a wound play a role. If the wound is too large or too deep (the wound edges gape too far apart) to heal on its own, the smooth, clean wound edges must be brought together with a suture to allow good healing.
Sewing is particularly useful for cuts in areas under great tension (e.g. over joints) or where there is constant movement, in order to keep the wound edges well together for healing. Sewn wounds also usually heal more aesthetically with narrower and straighter scars, which is especially important in areas of the body that play a major role in appearance. Suturing and thus closing incisions also helps to prevent subsequent infections or significantly reduce the risk of infection.
The decision whether a cut can be closed or not also depends largely on the size, depth and location of the cut. Smaller, less deep wounds are more suitable for adhesion. Wound adhesives are often applied as a spray or gel to the skin surface over the wound and thus close it.
Accordingly, it only makes sense if the edges of the wound do not gape far apart. Wound adhesives are also less suitable for use over very hairy areas of skin and over areas of skin that are subject to heavy wear (e.g. joints). In the case of small incisions, adhesives can often achieve the same cosmetic scar result as sutures, but in comparison they are easier to apply and much more comfortable for the patient.
In surgery, there is a so-called 6-hour rule for suturing incisions or wounds in general. The reason why suturing wounds that are older than 6 hours is as follows: Firstly, it is assumed that germs have migrated into the wound within the 6 hours. If this wound were then sutured, the germs would be trapped in the wound area, increasing the risk of wound infection or even subsequent blood poisoning.
On the other hand, after 6 hours the wound edges are “dried up”, so to speak. If these “old” wound edges are brought together by a suture, the risk of these not growing back together well is increased. Disturbed wound healing can be the result.
However, there is also the possibility of refreshing the wound edges – i.e. cutting out the old wound edges under local anesthesia and sewing the fresh wound edges together (secondary wound suture). If a cut is very painful, general painkillers can be used to relieve the pain. The pain is caused both by the severing of the smallest skin nerves and by the release of messenger substances of the body’s own activated immune system, which also activate local pain receptors.
In the course of the procedure, the body area with the incision can be cooled slightly, which can relieve the pain. The use of painkillers from the class of non-steroidal anti-inflammatory drugs (NSAIDs) can also be useful: taking ibuprofen, for example, not only relieves pain but also has an anti-inflammatory effect. However, aspirin (ASS) should not be taken as an analgesic, as this analgesic also causes the blood to be “diluted”, which can lead to increased bleeding from the cut.