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August 7, 2006

BehindTheMedspeak: Don't leave your cut open to the air — it slows healing


Who knew?

Not me, certainly, after all those long years of medical training and practice.

I've been telling people to wash their cuts and scrapes with plenty of running water, then leave them open without doing anything else, since, why, since last century.

What a doofus: no wonder I went into anesthesiology instead of derm or family practice.

But I digress.

Anahad O'Connor, in his "Really?" feature in the August 1 New York Times Science section, debunked all the beliefs about cuts that I'd held dearly as true.

Short story shorter: Do keep your cuts moist and covered — not dry and open; Don't apply antibiotic ointments or creams; and by far best of all: Do pick your scabs, as leaving the original one on until it falls off will increase the amount of scarring.

Who knew that that weird girl at summer camp, the one who would daily sit and meticulously pick at her scabs such that her legs were always covered with dripping blood, was in fact preparing for a career in plastic surgery?

Here's the column.

    The Claim: Wounds Heal Better When Exposed to Air

    The Facts: Most parents and school nurses have a time-honored approach to treating a small wound: clean it up, stop the bleeding and then let it get some air.

    The point of this approach, as described in medical texts, is to lower the odds of infection and to speed the healing process. But over the years, researchers have found that what many people know about treating small cuts and scrapes is wrong.

    Exposing a wound to the air so it can breathe is a terrible mistake, experts say, because it creates a dry environment that promotes cell death.

    A handful of studies have found that when wounds are kept moist and covered, blood vessels regenerate faster and the number of cells that cause inflammation drop more rapidly than they do in wounds allowed to air out. It is best to keep a wound moist and covered for at least five days.

    Another common mistake is applying antibiotic ointments, said Dr. Mark D. P. Davis, a professor of dermatology at the Mayo Clinic in Rochester, Minn. These ointments may keep the wound moist, he said, but they can also lead to swelling and an allergic reaction called contact dermatitis. Plain and simple Vaseline, applied twice a day, works fine.

    And as awful as removing scabs may sound, it may actually be a good idea, Dr. Davis said. A small initial scab will help stop the bleeding, but if left for too long it will do more harm than good.

    “You don’t want it to mature too much because it increases scarring,” he said. “That’s the general thinking.”

    The Bottom Line: Exposing a cut so it can breathe slows healing.



What next?


Next thing you know they'll be telling us pink makes you weak.

August 7, 2006 at 04:01 PM | Permalink


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Used to be able to get colloid gel plasters in Tescos over here in Blighty. They were great - just a translucent plasticky film you stuck straight onto the wound. For burns they were incomparable, they kept them moist but excluded the dirt, protected them but allowed some surveillance because they were clearish. Expensive but great when you needed them.

Can't get them now - or rather you can get something similar but with an absorbant pad in the middle which rather defeats the point.

Posted by: Skipweasel | Aug 9, 2006 6:21:44 PM

I didn't think we reached any new low? Haven't gotten off the old low as of yet. And can I ask what are us "girls" doing by the way?? That we need to stop?

Yep it's Joe's fault...=))
He's even willing to accept responsibility of this one.

Too funny. I just didn't like the fact that I wanted to puke when flutist wants to eat her scabs....still a little icky feeling over that one. But yet I can laugh at it. Because it's a joke. Well I do hope it's a joke...? hehehe

Posted by: Rhonda | Aug 8, 2006 12:48:47 PM

Flutist shows how wise she really is by blaming me.

As any fool knows, when something — anything — goes wrong in the O.R. the first thing the surgeon says is, "It's anesthesia's fault."

Love it.

Posted by: Joe aka bookofjoe | Aug 8, 2006 11:53:31 AM

Hey, Joe started it.

Posted by: Flutist | Aug 8, 2006 11:43:29 AM

Ok, the comments section on this particular post has reached a new low. Girls, Stop it already!!!!!

Posted by: me | Aug 8, 2006 11:19:46 AM

ohhhhhhhh yuck....thanks flutist! =) For making me gag on my coffee this morning. I dont' know if I want to puke or laugh my head off hysterically.

Ok I have to differ on this one. I knew one lady that picked her scabs and she actually made marks on herself. They never healed and they looked hideous. Guess she didn't mind not being asked to dinner or whatever. Actually she was way past the asking to dinner stage of life. I cannot even begin to think like this. Why are we having this discussion today? Joe, the first cut is the deepest, yes it is. It will never heal hun. So quit picking at it and just make do. Cover it up. When out in public. In private, just let it hang out. Air it out. Remember to keep your fingertips out of it though. And always remember the reason you have it. Try not to make that mistake again. But undoubtedly you will. As I have. Because being human we do silly things that make us hurt.

Posted by: Rhonda | Aug 8, 2006 9:09:34 AM

Well, raise my rent! Finally, I can pick my scabs with impunity, not to mention great industry and zeal. I was just having a discussion with a friend after reading this. Back in the day when kids (at least in my neighborhood) covered the waterfront, playing in construction sites and exploring all kinds of heavily wooded areas and forbidden territory like the uncontrollable heathens we were, especially in that golden hour or two after school when we were thrilled to pieces to be latch-key kids because we could eat peanut butter with ice cream and scream and play our records really loud and dance out where the neighbors could see us, back then, we were all of us covered with scabs, all the time. "Don't pick at that!" our elders would shout. "You're gonna make a huge scar and then you'll be an outcast and you'll never get a date or a job or go to Yale! So we picked in private. And now I'm finding out that picking is good. Pick away! "Junior, I haven't seen you picking at that scab all week. I want three picking sessions a day, you hear?"

The big question now is, is it okay to eat them?

Posted by: Flutist | Aug 7, 2006 8:19:06 PM

Who knew. Will revise my doc-mom directors for the last child, 13 year-old dude.

Pink and BOJ green makes Lily Pulitzer richer.

Posted by: Mb | Aug 7, 2006 5:03:17 PM

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