Wound Healing

Your community pharmacy can provide more than just dressings when it comes to wound healing

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What’s the first thing you do when you or someone you know has sustained an injury? Surely, the pharmacy wouldn’t pop up in mind until much later during the wound healing period.

We speak to Mirage Ooi from Centro Maxx (Jalan Radin Bagus branch) on wound care and the role of pharmacists in wound healing.

1Twenty80: What is the number one thing to do when someone is wounded?

Mirage Ooi: Firstly, do not panic. Stay calm and assess the wound. Minor wounds can be treated at home. Rinse and disinfect the wound to eradicate all dirt and debris. Superficial abrasions and lacerations can be cleaned with clean water and a saline solution to get rid of any debris or bacteria.

Often, bleeding can be controlled with direct pressure to the wound, and if possible, elevate the bleeding site above the level of the heart. After cleaning the wound, apply a thin layer of antibiotic ointment to prevent infection, then cover with a bandage.

1Twenty80: Can pharmacies provide wound care?

Mirage Ooi: Pharmacists can treat wounds resulting from minor cuts and grazes to minor burns. Certain wounds run deeper and require medical attention to prevent infection and loss of function, due to damage to bone, muscle, tendon, arteries and nerves. It is advisable to seek medical advice if it involves an open wound which is deeper than half an inch and bleeding that last more than 20 minutes with the application of direct pressure.

Extra attention needs to be given to individuals with diabetes or with compromised immune systems who are at greater risk of infection, therefore requires greater care. On the other hand, animal bites should always be seen by a medical professional due to high chance of infection, and a tetanus shot is required.

1Twenty80: For wounds that have been seen by a doctor, how should a patient take care of it at home?

Mirage Ooi: The Centers for Disease Control and Prevention (CDC) urges routine change of dressing to be done daily whereby, wounds are disinfected with either saline water, hydrogen peroxide or topical antiseptic followed by an antibiotic cream such as fucidic acid, mupirocin or neomycin cream can be applied prior to bandage or dressing.

Physiologic dressings such as transparent film dressings, are sterile, breathable, transparent and waterproof, and it serves as a barrier to external impurities while a hydrogel dressing keeps the wound site hydrated. This makes common healing phases such as granulation, epidermis restoration and the elimination of excess dead tissue, more streamlined. In addition to that, the gel provides cooling sensation which enables relief from pain for up to six hours.

Quote: Pharmacists can treat wounds resulting from minor cuts and grazes to minor burns. 

1Twenty80: What supplies for wound care can be found at a pharmacy and should patients check with the pharmacist what kind of supplies they need?

Mirage Ooi: To clean and disinfect, options ranges from saline water, hydrogen peroxide, povidone iodine, acriflavine and the good old chloroxylenol antiseptic. Next, an over the counter antiseptic cream such as arnica or antiseptic cream can be used to treat minor abrasions while antibiotic cream or ointments namely fucidic acid or mupirocin can be used to combat infection and inflammation. Natural products to consider include cream which possesses the health benefits and healing effect of Channa striatus (haruan) extract can also be used to expedite wound healing via its beta actin, calponin 2, galectin-8 and myoglobin components.

Depending on the nature of the wound, a wide range of bandages offers a vast variety of choices from waterproof clear dressing, soft cloth dressing as well as medicated paraffin ones. Some even has prints of the latest cartoon characters for kids and patients allergic to adhesive can opt for the sensitive range bandages. On the other hand, analgesics such as paracetamol (acetaminophen) and mefenamic acid has anti-inflammatory properties to assist with pain management for more severe cases.

Once the wound has healed, consumers can also consider scar reduction products to smoothen, soften and moisturise skin to lighten the appearance of scars. Besides that, vitamin E oil as well as grape seed oil are popular choices as well.

Quote: In wound management, lifestyle aspects such as age, nutrition, hygiene, medical history, and obesity play a great part in the healing process.

1Twenty80: Other than physical wound care like cleaning and dressing, what other steps should a person take to make sure their wounds heal properly?

Mirage Ooi: Wound healing depends on the category of wound, the underlying injury, and the patient’s health. The ideal objective for all injuries is to nurse and restore the injured fragment back to normal function.

Intake of a balanced diet is imperative to hinder any vitamin and mineral deficiencies as these are necessary to reinforce, develop and retain new tissues. Patients are urged to consume foods high in iron, protein and carbohydrate to accelerate wound healing.

In wound management, lifestyle aspects such as age, nutrition, hygiene, medical history, and obesity play a great part in the healing process. On top of that, one’s lifestyle plays a chief role in healing. In addition, stressed persons are more likely to have unhealthy lifestyles, with poor sleep patterns, lack of exercise, and a greater predisposition for abuse of alcohol and cigarettes. All of these issues may negatively impact the healing process.

1Twenty80: What are signs of infection and what is the next step?

Mirage Ooi: The five typical signs are pain, redness, swelling, heat, and loss of function. Take note of foul-smelling exudates as well. By this stage, a trip to the doctor is a must.

Wounds that do not show indication of healing after 48 hours might signal a progressive infection that may require antibiotics. Advanced infection can become systemic, preceding to symptoms such as fever, lethargy, and chills. In some cases, there might be a need for minor surgery where doctors will debride wounds to eliminate the food source for bacteria and sets the platform for infection management. In severe cases, necrotizing fasciitis (flesh eating bacteria), cellulitis and sepsis can occur. Lockjaw or tetanus is a rare but often deadly illness that distresses the central nervous system by triggering painful muscular contractions. It arises when tetanus bacteria enters the body exposed to contaminated soil. Thankfully, tetanus is preventable through vaccination.

It is crucial to denote that, practicing proper sanitation and wound care procedures can help lessen the hazard of infection and heal faster.

1Twenty80: What is your advice to people about wound care and how a pharmacy can help?

Mirage Ooi: Accidents do occur and most people will sustain an injury thus, it’s important to use appropriate protective gears to prevent an injury. Several factors can slow down wound healing such as infection, age, stress, diabetes, obesity, medications, alcohol, smoking, and poor nutrition.

There are many evidence based products available in the pharmacy that can provide targeted wound care. And most importantly, do not be shy to ask your friendly pharmacists!

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