How To Heal Open Wounds Faster

A wound is an injury in which the skin is torn, cut (incisions), rugged (lacerations), grazed (abrasions) or punctured. In order to determine which treatment is recommended for a certain type of open wound it is useful to be able to describe the type of wound.

Wikipedia's open wound type classification by object that caused the wound.

• Incisions or incised wounds: caused by a sharp-edged object such as a knife or a glass splinter
• Lacerations: irregular tear-like wounds caused by blunt trauma. The term laceration is commonly misused in reference to incisions
• Abrasions (grazes): superficial wounds in which the topmost layer of the skin (epidermis) is scraped off. Often caused by a sliding fall onto a rough surface
• Puncture wounds: caused by an object puncturing the skin, such as a nail or needle
• Penetration wounds: caused by an object such as a knife entering the body
• Gunshot wounds: caused by a bullet or similar projectile driving into or through the body.

The first step in treating an open wound is to properly clean it. This is important because if not cleaned well a wound will heal not heal as fast, is prone to get infected and subsequently will have a bigger chance on scar development.

Here are some basic initial wound care steps which will prevent the chance on infection:

• Rinse the wound with salt water, a very mild soap or Saline . You can make the saline yourself. Dissolve one teaspoon of salt in about half a liter of boiled water.
• It's best not to use an antiseptic such as Dettol or Savlon but if you do make sure to dilute it well. Many times antiseptics can harm delicate skin cells thus delaying wound healing.
• It's best to remove loose skin or scabs as these delay the healing process and harbor infection.
• Use dry dressings for cuts lacerations and for covering Steristrips
  
• Use paraffin gauze for open wounds, ulcers and burns.
• Use Povidine-iodine solution to clean scrapes and grazes.

The primary rule here is: don't clean a wound with something you wouldn't put in your eye.

Scientific research has shown that a moist healing environment is beneficial for wound healing. Wounds heal 50% faster if kept moist (Winter, 1962)

Moist wounds enhance the regrowth of new skin (epithelialisation). Other studies have shown that a moist wound prevents tissue dehydration and cell death.

The cells in a to the air exposed wound will dry out and die. This dead tissue, often mixed with gauze pad fibers will lead to more wound pain, chance on infections and as a result scarring.








Why covering wounds?

Necrotic tissue and slough in a wound prevent healing. An epitheliasing wound is a wound that is forming a film of new cells. ( the beginning of a crust) When a wound is left uncovered this new epithelium dries out and forms a scab or a crust. This is not desirable because crusting slows down wound healing and is a major factor in scar creation.

Dr. George D. Winter's wound care study showed that the regrowth of skin over a wound (epithelialization) was twice as fast in those wounds covered with a film dressing. His wound care case study showed that wounds that were kept moist healed in approximately 12 to 15 days while the same wound when exposed to the air healed in about 25 to 30 days.

Read more about Winter's case studies on The care of wounds by Carol Dealey on Google Books.

And also:
"Despite the theoretic risk that a moist environment is associated with a higher risk of wound infection, studies have shown that occlusive dressings do not increase the incidence of infection."
source: Hutchinson J. Prevalence of wound infection under occlusive dressings: a collected survey of reported research. Wounds 1989;1:123-33.

"Moisture prevents the formation of a hard scab, which acts as a barrier to the development of new tissue,"
source: dermatologist Bruce Katz, M.D., associate clinical professor at Columbia University College of Physicians and Surgeons.

How to heal open wounds faster: keep them moist with honey, vaseline, transparent films, hydrogel dressings, or hydrocolloid dressings.

More on these various moist wound healing modalities soon.

"Exposing a wound to the air so it can breathe is a terrible mistake, experts say, because it creates a dry environment that promotes cell death."

"Another common mistake is applying antibiotic ointments, said Dr. Mark D. P. Davis, a professor of dermatology at the Mayo Clinic in Rochester, Minn. These ointments may keep the wound moist, he said, but they can also lead to swelling and an allergic reaction called contact dermatitis."

Read the whole article on the website of the New York Times

"As a plastic surgeon, I put all my patients on post-operative vitamin C because you need vitamin C to heal. I also recommend it to boxers following a fight,"

"In fact, I'd recommend 2,000 milligrams of vitamin C to anyone with an open wound because there is evidence that it helps them heal faster."

says Michael A. Fiorillo, MD, a New York City area plastic surgeon who serves as a spokesman for the AAPRP (American Association of Professional Ringside Physicians ) Source: WebMD

"In ancient history the Egyptians, Assyrians, Chinese, Greeks and Romans all used honey, in combination with herbs and on its own, to treat wounds" (Zumla and Lulat,1989).

Since the dawn of mankind honey has been used effectively in wound care. In the beginning of the 20th century this ancient natural remedy has been replaced by antibiotics. But when a growing amount of bacteria tends develop resistance against antibiotics honey is being rediscovered as a medicine. The promising outcome of scientific research conducted by e.g. the Waikato University New Zealand adds to this development.

Honey provides a protective barrier defending the wound against infections and the tissue growth is not slowed down by drying.* source: Waikato Honey Research Unit

Especially Manuka honey, a honey with unique antibacterial, antimicrobial, antifungal properties and powerful moisturizing aspects, has proven to be a very effective wound care product.

A disadvantage of many dressings that create a moist environment is that the moist conditions stimulate the growth of bacteria. That's why some of these products are not recommended for use on infected wounds. But manuka honey creates a moist environment in which bacterial growth is prevented by the antibacterial activity of the honey.

The antimicrobial properties of honey prevent microbial growth in the moist healing environment created. Unlike other topical antiseptics, honey causes no tissue damage: in animal studies it has been demonstrated that it actually promotes the healing process. It makes direct contact with the wound's surface but the dressing does not stick, so there is no pain or tissue damage when dressings are removed.



Medical grade (sterilized by gamma irradiation) Manuka honey has shown to effectively * treat:

• burns
• (peptic) ulcers
• infected wounds (even with MRSA and VRE)
• Gastroenteritis
• Tineas
• fungal infections such as ringworm

* link to case studies and clinical reports by the Waikato University Honey Research Unit

Clinical trials show infections being cleared rapidly, inflammation, swelling and pain are quickly reduced, sloughing of necrotic tissue is generated, granulation and epithelialisation are hastened, and healing occurs rapidly with minimal scarring.

Honey is more effective than silver sulfadiazine (Thermazene 1% Silver Sulfadiazine Cream ) and a polyurethane film dressing (Opsite®) for the treatment of burns.

This The evidence for honey promoting wound healing article by Dr. Molan addresses this matter more thoroughly.

Manuka honey is proven to be effective where conventional modern therapeutic agents like antibiotics are failing.

Kara Couch, a nurse practitioner at Georgetown University Hospital's Center for Wound Healing in Washington, said manuka honey works well for patients who have "wound pain" or infected wounds.

One patient who had an open wound that didn't heal for a few years "healed 90 percent in three weeks," she said, adding that the usual rate for chronic wounds is barely 10 percent a week. Source: msnbc.com

New Zealand natural health products company Derma Sciences and stakeholder Comvita are owner of the Medihoney trademark. Comvita is the global leader in medical grade wound gels and dressings based on Manuka honey.

The Medihoney brand incorporates a range of medical grade wound treatment honey and honey dressing products that are in some cases proven * to be more effective than conventional medications. (Read about how Medihoney saved a man from leg amputation.)

Medical Manuka honey products manufactured by the company Derma Sciences, are the only FDA-cleared, honey-infused wound dressings on the American market. Medical grade honey is sterilized by gamma irradiation for safe use on open wounds.

Other companies, such as Honeymark, sell Manuka honey-based wound lotions and creams online. These products are less tightly regulated by the FDA.

* Extended information on honey as a wound dressing on the Waikato Honey Research Unit website

Comvita / Medihoney offers several FDA regulated wound care products such as Manuka honey wound ointments / gels, wound dressings.

The Manuka honey wound dressing
"provides a moist environment conducive to wound healing" have recently been approved by the FDA. "The new dressing is indicated for managing moderate to heavily exuding wounds such as diabetic foot ulcers, leg ulcers, pressure ulcers/sores, and first- and second-degree partial thickness burns, in addition to donor sites as well as traumatic and surgical wounds. This is the first honey-based dressing to become available in the United States."

Other factors that function as a wound healing barrier are; excessive pressure and stretching of the wound, high blood sugar, stress and anxiety, existence of necrotic (black dead) tissue, pain and nutritional deficits. So things to keep in mind are to relax and make sure to rest well, eat and live healthy and take care of problematic issues such as black tissue in a wound.

A major downside of using gauzes as a primary dressing is that they physically inhibit wound contraction. That's why, for many wound types, other dressings are recommended.

Cover the wound with a non-adhesive sterile dressing and make sure it is large enough to cover the surrounding area. (dressings that stick to the wound tend to slow the healing process.)

Secondly cover the dressing with a gauze pad. This can be attached by using (silk) tape or with a roll of stretch gauze.

Make sure to keep the outside of the dressing dry and clean. If it gets wet or dirty it is recommended to change it.

There are some dedicated wound care products available that offer something extra for people with delicate skin:

• Adaptic Pads (Johnson & Johnson)
  These pads are non-adherent and petroleum saturated. They will keep draining wounds sterile, prevents the dressing from sticking to the wound and also helps to control bleeding / prevent pooling of wound fluid.



• 3M Micropore Paper Tape
  People with delicate skin prone to develop rash (dermatitis) might benefit from this lightweight paper tape. It is hypoallergenic and leaves little or no residue. Silk tape also seems to be an option although I have used it myself and it did leave some glue residue.



• Medipore Soft Cloth Surgical Tape
  Latex-free tape, offers excellent adhesion with reduced skin irritation.



• 3M Microfoam Tape
  Elastic foam tape products designed to stretch and conform while providing secure adhesion.

According to the American Academy of Dermatology, covered wounds heal better.

Abstract of a report on the Journal of the American Academy of Dermatology:
"Almost all documented clinical experience shows that occlusively dressed wounds heal more quickly and with less pain, tenderness, and swelling than undressed wounds. Clinical experience with occlusive skin dressings on acute and chronic wounds, on diseased skin, and on normal skin is reviewed."

Topical antibiotic ointments like Neosporin (triple-antibiotic),Neomycin and Bacitracin can cause skin reactions and tissue damage with prolonged usage. Many doctors recommend only 3 to 5 days of a topical antibiotic.

So the benefits of honey in wound care are versatile:

• Honey provides a moist healing environment.


• Unlike many other topical antiseptics honey causes no tissue damage.


• Honey makes direct contact with the wound's surface but the dressing does not stick, so there is no pain or tissue damage when dressings are removed.


• Honey prevents wounds from infections and is effective in fighting infections and around 60 species of bacteria.


• Antimicrobial properties prevent new microbial growth.


• Quickly reduces swelling, inflammation and pain


• Clears infections rapidly


• honey is more effective than silver sulfadiazine and a polyurethane film dressing (OpSite®) for the treatment of burns.


• Promotes rapid healing with minimal scarring


• Stimulates tissue healing. The acidity of honey might be the cause of the stimulation of the healing process.

In spite of its high osmolarity and its various anti bacterial factors in addition to hydrogen peroxide honey is not sterile, but may contain bacillus and clostridum spores. Although these amounts are very low, sterilization of honey is necessary in some cases, e.g. when honey is used for the preservation of skin. For other medical purposes sterility is at least highly desirable.

Normal, non sterilized honey can contain bacteria that are possibly harmful. So especially in case of severe wounds, when preservation of skin is important or in case of other delicate situations it is strongly recommended to use pharmaceutical grade honey.

Rapid wound closure is recommended. Research has shown that when wound closure (epithelization) is delayed beyond 10-4 days the chance of developing hypertrophic scars goes up dramatically.

The first step in case of a minor burn is to cool the affected area. This will stop the tissue from heating any further. Its best to use cold running water (not too cold) and not ice because ice will freeze the flesh. Cooling the burn will conduct the heat away from the tissue thus reducing swelling.

Then apply honey on the burn. Use a modest quantity of honey. The burn should be saturated but it should not be overdone.

Then cover the burn and honey with a gauze or patch. Make sure to regularly change the gauze and keep on eye on possible infections. Burns tend to get infected rather quickly but with the use of manuka honey this risk is reduced significantly. For more severe burns medical manuka honey based dressings can be used. They do not stick to the wound thus reducing pain with changing the dressings.

After the wound has closed the next phase of treatment can be started:

Minor burns, cuts and scrapes heal automatically in most healthy people. More severe wounds and wounds like diabetic ulcers are more difficult to heal. Sometimes a wound that won't heal can be life threatening.

Maybe you already know the amazing story of Mr. Tom Lloyd who suffered from a wound that wouldn't heal. Read more about how the medical personnel prevented leg amputation.

1. Never use cotton wound gauze dressings directly on an open wound. This material will not prevent bacterial contamination and will leave cotton fibers in the wound. Walsh and Ford 1989; Jones, 2006).



2. In case a dressing does stick to the wound it can be moistened (soaked) with a little saline or warm water.



3. Change wound dressings at least every 24 hours. But sometimes dressings need to be changed more often, up to three times a day.



4. Avoid too much pressure on the wound. Abrupt or intense movements will delay wound healing.



5. Wounds that tend to reopen and start bleeding again (despite soaking the pad) should better be left uncovered.



6. Wash your hands with water and soap before and after changing the dressing.



7. When washing or bathing do not use hot water. It dries out the skin. Use warm water instead.

Itchiness is actually some sort of pain that is inherent to the healing process. The nerves and biological processes are working to heal the wound. It has something to do with histamine. Check out Wikipedia for more info on histamine.

A wound that is itching is healing. Most important is not to scratch it because this will delay the healing process.

Propolis or bee glue is is a resinous mixture that honey bees collect from tree buds, sap flows, or other botanical sources. (source Wikipedia) It is used by the bees to close small gaps in the hive. It is used as a seal to strengthen the hive structure and at the same time keep hazardous elements such as bacteria and larger organisms out.

Propolis literally means "defender of the city" and originates from the Greek words, "pro," meaning "in defense of" and "polis," meaning city.

Propolis is thought to have several health benefits such as a sore throat remedy, stimulating heart health, and boosting the immune system. It is commonly thought propolis is an effective wound, burn and infections treatment. Although the results of some studies done are promising more, thorough research has to be done. Research does show propolis has antiseptic and antibiotic properties and may also have anti-inflammatory and antiviral effects.

manuka honey is used on dogs and other animals as well. Maybe you have seen the vets on the animal rescue TV programs applying honey on infected wounds.

This section will be updated soon.

what is the best way to heal from a wound?
The best way is by keeping it clean and moist. Don't let it dry because the cells need a moist environment. Wounds that won't heal optimally can be treated with medical grade honey.

How do you know if a wound is infected?
Signs of infection are redness and inflammation around the wound, a bad odor coming from the wound or a red streak traveling from the wound.

how to use honey for faster wound healing

Some studies on the dermal benefits of topical vitamin c.

"Clinical studies provide evidence that wound healing in subjects judged not deficient in vitamin C can be significantly accelerated with supplements of this nutrient above the recommended daily allowance (RDA).

Source: sciencedirect.com

"Conclusion. A significant body of scientific research supports the use of cosmeceuticals containing vitamin C. Cutaneous benefits include promoting collagen synthesis, photoprotection from ultraviolet A and B, lightening hyperpigmentation, and improvement of a variety of inflammatory dermatoses. Because of the diverse biologic effects of this compound, topical vitamin C has become a useful part of the dermatologist's armamentarium. " Source: Wiley Interscience

And here some more info on the benefits of eating vitamin c rich foods, or the intake of supplements, concerning wound healing. The Facts About Vitamin C and Wound Healing

Proper wound care, among many other factors, can minimize scar tissue creation. More information on how to heal scars on ScarTreatmentBlog.com

For extended information on how medical personnel treats wounds visit this website http://health.vic.gov.au (pdf file)

Note: The information provided on this page is for informational purposes only. Nothing on this page is intended to be used for medical care or treatment. It is important that wounds that are not healing are seen by a registered medical practitioner by physicians or trained medical personnel.