Back wound care measures

Reduce the traction and pressure on the wound site, clean and change dressings regularly, and identify signs of infection as soon as possible. If you do these three things well, more than 90% of ordinary back wounds can heal smoothly, and scarring and inflammation will rarely occur.

Many people think that it doesn’t matter if the wound on the back is invisible, and they should just put a band-aid on it. I can meet three or four such patients a week in the outpatient clinic. The most typical one is a young man in his 20s who fell on his back while riding an electric bicycle and scratched a large superficial wound. To put it bluntly, we don’t take “reducing compression” seriously. The back is no better than the hands and legs. We sleep for at least five or six hours a day. If we happen to put pressure on the wound, not only will the exudate become stuffy in the dressing and breed bacteria, but the new tissue that has just grown will also be easily crushed to death. If you are really used to sleeping on your back, you can buy a U-shaped backrest cushion with a hollow center to free up the wound area. By switching between sleeping on your side and lying on your stomach, you can avoid a lot of suffering. If the wound is just near the shoulder blade, you usually have to be slow to lift your arm to reach things or put on a jumper. I had a patient who was almost recovered. He raised his hand to reach the suitcase on the top of the wardrobe, and directly pulled off the scab and bled half of his back. He was forced to stay for ten days longer.

When it comes to changing dressings, many people still hold the idea of "applying iodine every day to make it clean." In fact, the score: There is a lot of exudation in the first three days after the injury. Use iodine to disinfect the wound from the center to the outside once a day, and then replace it with clean sterile gauze or dressing. If the wound has started to grow pink granulations and the exudate is very small, don't rub it with iodine every day. It will kill the new healthy tissue. It will be no problem to change the dressing every three days. If you can't reach it, ask your family for help. Don't twist your body and smear it in front of the mirror. The pain of rubbing the scab off is really unbearable. If no one can help, just buy a long-handled applicator. Ten yuan is much more cost-effective than scratching the wound. Pay more attention when wearing clothes. Don't wear tight-fitting chemical fiber T-shirts. When you sweat, they will stick to the wound, which will cause tears when you remove it. A loose cotton cardigan is the first choice. You don't need to put it on your head when changing clothes to avoid pulling the wound.

The "dry-wet healing debate" that everyone has been arguing about in the past two years has no absolute right or wrong when it comes to back wounds. The traditional view is that dry scabs heal quickly and are suitable for very shallow abrasions. If you don’t sweat much and can ensure that the wound is not exposed to water, you can leave the scabs to dry and then fall off naturally, and the probability of leaving scars is not high. However, wet healing, which is now more recommended by the international wound ostomy group, does have its advantages: especially for those with deep lacerations or those who have scars, they should be covered with regular hydrocolloid dressings to keep the wound moist. Granulation will grow faster, and the probability of scarring is about 30% lower than dry healing. It is necessary to pay attention to the exudation. If the exudate soaks into the dressing, change it in time, and don't be bored. The same goes for the controversy over whether or not the scab should be removed: If the scab is dry, has no fluctuation when pressed, and is not red or swollen around, just wait for it to fall off on its own; if it is soft and soft when pressed, and there is yellow exudate coming out from the edge, it means that pus has accumulated under the scab, and you need to find a doctor to remove the scab and debridement. Holding it on will only make it worse and worse.

Don’t deal with all situations by yourself at home. If you find that the redness and swelling around the wound are getting bigger and bigger, it feels hot to the touch, the pain is getting worse, or even yellow-green pus leaks out, and you have a fever all over your body, don’t force yourself to go to the hospital. Especially for wounds scraped by rusty iron or unclean wood, get a tetanus shot as soon as possible. Don’t gamble with your body.

In fact, it is not difficult to care for the wound on the back. You just need to be more careful. After all, you can't see it. If something goes wrong, it often takes several days to react. It's always good to be careful.