Back wound care measures

First avoid external squeezing and tearing to prevent secondary damage, then choose an appropriate healing and matching plan according to the type of wound, and finally do tension reduction care to reduce the probability of scarring. Do not violate these three principles in any additional operations, as it may be a hindrance.

It seems simple to say, but I have encountered too many patients in the outpatient clinic who have suffered a lot. The most typical one is a young man in his 20s who had a sebaceous cyst on his back. He wrapped it in two layers of sterile gauze every day for fear of dust stains. Don't think he is an exception. The first thing most people neglect when caring for back wounds is "prevention of pressure" - after all, unlike the wounds on the hands and face that can be seen by looking up, back injuries often only react to pressure when they hurt. Especially for wounds in the middle part of the back and lumbosacral region, most of the weight of the upper body is pressed against this area when sitting. It is best to prepare a U-shaped cushion to just leave the wound open. If there is no condition, lean slightly to the side when sitting, and do not let the wound directly touch the hard backrest. When sleeping, try to sleep on your side or on your stomach. If you find it hard to breathe when lying on your chest, some patients directly cut a small hole in the latex mattress corresponding to the wound. It sounds like a waste of mattress, but it is better than the newly grown scab being rubbed to tear and bleed.

When it comes to suitable wound healing solutions, there are currently two mainstream views in the industry. There is no absolute right or wrong. It all depends on your own situation. One is the traditional dry care that everyone is familiar with: keep the wound dry and breathable, disinfect it with iodophor 1-2 times a day, and just cover it with a thin gauze cloth to keep out the ash. It is suitable for very shallow scratches, little exudation, and low daily activity. It is easy to operate and saves money. The other is the wet healing concept that has been promoted internationally in recent years: wet dressings such as hydrocolloids and foam dressings seal the wound and keep the moist environment without scabbing. The new epidermis can crawl directly in the moist environment. The recovery speed can be about 30% faster and the probability of scarring is lower. It is more suitable for people who have sutured wounds after surgery, have a lot of exudation, and have to go to work normally and cannot keep the wound dry all the time. I once met an aunt who believed that "wounds should be allowed to dry to heal quickly." She didn't dare to take a shower or put a dressing on her waist for half a month after the operation. As a result, there was a circle of prickly heat around the wound, which made the wound red, swollen and pus-producing. In the end, it took almost a month for the wound to heal. In fact, in her case, she just put on a wet dressing and had no problem taking a normal shower.

Oh yes, I have to say here that many people are deceived by the old idea that "wounds should not touch water". In fact, as long as the wound is well closed after suturing, it can be touched by flowing water after 24-48 hours. Just don't take a bath, don't soak in a hot spring, and don't go to the swimming pool. After rinsing, take a clean cotton towel and gently press it dry without rubbing it back and forth. Instead, it can wash away the sweat and dust around the wound, reducing the risk of infection.

Don’t change the dressing too frequently. Many people always think that it’s better to disinfect and change the dressing several times a day. In fact, if the wound has no exudate and no contamination, it’s okay to change it once every three days. If you find that the gauze is stuck to the wound when changing the dressing, don't tear it off forcefully. Wet it with saline or povidone iodine and then peel it off slowly. Otherwise, the pain will make you gasp, and it will easily tear the newly grown granulation tissue and bleed. Don't blindly pile medicine on the wound, such as erythromycin ointment, Yunnan Baiyao, even folk toothpaste, and plant ash. Unless the doctor specifically tells you to use it, otherwise, messy things piled on the wound will easily block the exudate outlet and induce infection.

Finally, let’s talk about the scar issue that everyone is most concerned about. Don’t rush to apply scar removal cream on the wound just after the stitches are done. Wait until the scab is completely gone and the wound is free of any exudate before applying it. The skin tension on the back is inherently high. If the wound exceeds 2 cm, it is best to apply additional or less adhesive tape. Otherwise, when you lift your hands to pick up things or twist your waist to pick things up, the wound will be stretched repeatedly and it will easily become wider or even produce hyperplasia scars. Oh, by the way, there is also the issue of "hair loss" that has been controversial for many years. Western medicine basically doesn't pay attention to this. As long as you are not allergic to shrimp, beef, or mutton, eat what you should. Sufficient protein can help the wound grow faster. What you really need to eat less is high-sugar milk tea and cakes. High sugar will aggravate the inflammatory reaction and easily make scars red and hard. But if you believe in the dietary taboos of traditional Chinese medicine and you really feel uncomfortable with the wound after eating the so-called hair products, then it’s totally fine not to eat them. There is no need to argue about this kind of thing. Your own comfort is the most important thing.

In fact, wounds on the back are more difficult to care for than wounds on other parts of the body. Whether it is good care or not, the difficulty is that they cannot be seen and are easily pressed. The good thing is that they are rarely touched by hands. As long as you don't mess around, you can basically recover well. If you really find that the area around the wound is red, feels hot to the touch, or even has yellow pus, or you still have a fever, don’t just try to deal with it at home. Go to the hospital and see a doctor for treatment. It will be more effective than searching for ten folk remedies.