Minor wounds and bleeding do not require the use of powders to compress and stop bleeding

Recently, a Weibo post about a doctor who was "under cross-provincial investigation" caused a stir. The doctor was under cross-provincial investigation by Yunnan police because he talked about "using mercurochrome + Yunnan Baiyao powder after skin abrasion, which caused epidermal necrosis, dermal fibrosis, and basically confirmed disfigurement" on Weibo. What should the scientific truth be? Can mercurochrome and Yunnan Baiyao be used to treat minor wounds? We asked experts to talk about their opinions.

Powder is not as good as pressure to stop bleeding

If someone is injured accidentally and the wound is small and there is not much bleeding, some ordinary people will just grab a handful of incense ash, tobacco, charcoal ash, or even mud and sand and sprinkle it on the wound. In this regard, experts said that if we only consider the effect of stopping bleeding, these substances can indeed be effective, because these granular substances have adsorption function, which can absorb exudate at the bleeding site and stimulate the contraction of local small blood vessels, thereby achieving a temporary hemostatic effect. However, items such as incense ash, tobacco, and charcoal ash may carry a large number of bacteria and even pathogens, which can easily lead to wound contamination and cause wound infection. Moreover, if these items are used to stop bleeding, when the patient comes to the hospital for treatment, the doctor will have to clean the wound and remove foreign matter before stopping bleeding and suturing. These tiny particles increase the difficulty for doctors to remove.

Yunnan Baiyao is an oral medication. It is a foreign body to the wound and must be thoroughly removed before debridement and suturing. For bleeding wounds, the best way to stop the bleeding before reaching the hospital is to apply pressure. The method is to press the relevant blood vessels with your palms, fingers or cloth strips at both ends of the bleeding area, according to the location and size of the bleeding, so as to block the blood flow and achieve the purpose of hemostasis; or directly press the wound with cloth strips. This method is quick and effective and does not carry the risk of wound infection.

Temporary treatment of minor wounds

The expert further explained that for doctors, there are standardized procedures for treating minor wounds. If ordinary people are accidentally injured and bleeding, they can immediately cover the wound with clean gauze, apply appropriate pressure to stop the bleeding, prevent the possibility of worsening infection, and then go to the hospital as soon as possible. If you really can't find clean gauze around you, you can choose a relatively clean towel for pressure.

If it is a relatively shallow skin injury and there is no need to go to the hospital, you can wash it with saline at home first. If there is no saline, you can use boiled warm water or cold water to wash it to wash away dirt such as mud, clothing fibers, etc. If conditions permit, you can choose low-concentration disinfectants such as iodine, iodine tincture, chlorhexidine, etc. After cleaning, if there is no obvious bleeding on the seeping surface, it is recommended to expose the wound so that it is easier to heal. Some people like to cover their wounds with gauze. In fact, if there is exudate in the wound, new tissue will easily grow into the holes of the gauze close to the wound. In this way, when changing the dressing, tearing off the gauze is equivalent to tearing off the new tissue, which is very painful. If you really need to cover the wound, you can choose a spray-type polymer antibacterial film. It sprays out polymers that are invisible to the naked eye and have a diameter similar to that of bacteria. When sprayed on the surface of the skin, it can effectively block bacteria. Now, you can also use medical glue to treat small cracks on the head and face. It does not require sutures and is very convenient to use.

Multiple choice questions on wound disinfectants

If a small abrasion or scratch bleeds, what kind of disinfectant should be used to disinfect the wound?

Red potion:

Mercurochrome is red mercury, which was once a widely used disinfectant, but has now been eliminated by major hospitals. This is because red mercury has weak penetrating power and only a small antibacterial effect. Organic matter and alkaline environment will reduce its effect, and the disinfection effect is not reliable. Moreover, organic compounds containing heavy metal mercury are toxic to the human body. Red mercury should not be used to disinfect large wounds, as it can easily cause mercury poisoning. In addition, people who are allergic to mercury should not use it.

Purple potion:

Gentian violet is a 1%-2% solution made of gentian violet and water. Due to its strong bactericidal ability, good anti-inflammatory effect and astringent effect, it has always been considered a irritating, non-toxic skin and mucous membrane disinfectant. However, in recent years, gentian violet has been found to be a potential carcinogen. Therefore, it has been abandoned by clinicians.

1. KAIHUA OIL:

Wanhua oil contains volatile substances similar to essential oils. After being applied to the skin, the volatilization of the substances can take away a large amount of heat, causing the skin temperature to drop, causing blood vessels to contract, and achieving the purpose of reducing swelling. Therefore, it can be used to treat bruises, sprains, and mild burns from water or fire. However, it should not be used on open wounds.

Alcohol:

Alcohol is cheap and its molecules have good penetrating ability, but it can only kill bacteria and has no killing effect on spores, viruses, etc., so it can only be used for skin surface disinfection, such as acupuncture, sponge bath and other simple disinfection. It has certain limitations in the disinfection of external injuries and is not suitable for disinfection of larger wounds and wounds, disinfection of mucous membranes such as eyes, nose, and mouth, disinfection of chronic inflammation and deep suppurative skin, etc.

Iodine tincture:

Iodine tincture is a mixed solution of iodine and alcohol. It has a better disinfection effect than alcohol, but because it contains alcohol, it also has the contraindications of alcohol, and it needs to be deiodinated with 75% alcohol after application.

Iodine:

Povidone-iodine is a complex of iodine. It has a wider range of disinfection than alcohol, is less irritating to the skin than iodine tincture, and is safer. Therefore, it is more commonly used in clinical practice and home self-medication. However, it should be noted that, like tincture of iodine, it cannot be used together with mercurochrome, because the mercury in mercurochrome can easily react chemically with iodine to form mercuric iodide, which is corrosive and toxic to the skin.

Hydrogen Peroxide:

Hydrogen peroxide is relatively safe, and the residue after sterilization is water, which will not cause secondary pollution. However, its disinfection effect is average. For invasive skin treatment, you can first clean it with hydrogen peroxide, and then use other disinfectants for secondary treatment. It is important to note that the concentration of hydrogen peroxide must be strictly controlled when using it, otherwise it will cause local skin burns.