Re: [Paddlewise] Puncture wounds, was Re: broken paddles

Boojum writes...<recommended care for puncture wounds is sterile
water, preferably with some level of pressure >

What's used medically is sterile saline solution. Water is hypo-osmolar, and
therefore is pretty hard on tissues, especially damaged ones. Large volumes
of sterile saline - several liters - are used to irrigate wounds, with some
moderate pressure. Most commercially made irrigation systems include a
pulsatile component, which helps to flush out debris.

Sterile water irrigant might be better than no irrigation at all, especially
if the original wound was "dirty" in some way and formal medical help is
more than a couple of hours away.

In a field situation, sterile "saline" can be made by adding a couple of
teaspoons of ordinary table salt to a liter (or a quart) of sterile water
and then boiling for at least 5 minutes. Let it cool in the container in
which it was boiled and then slosh it into the wound. Deep irrigation and
pressure irrigation wouldn't be possible in this situation, but some
cleansing would occur, which will probably be helpful.

I agree with those who have written that irrigation with antiseptic is not
good, since antiseptics will damage tissues. I have a similar aversion to
the ubiquitous "antibiotic creams". What a victory of marketing over science
those are! The antibiotics in them only reach the surface of the "cream", so
they can't penetrate into the damaged tissues. Worse yet, most of these
"creams" are actually petrolatum-based ointments, not creams at all. That
is, they're grease, and they seal a wound, which is just what you don't
want. Still, I realize that people are going to use them, just because
they're marketed so heavily. Even doctors who should know better use them.
Most of the time they (the antibiotic creams) don't do actual harm.

Bill Hansen
Ithaca NY

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