PUNCTURE WOUNDS

These wounds are made by penetrating objects, such as nails, needles, splinters, and knives. These wounds may be deceptive, because bleeding is usually minimal and the opening at the point of entry is relatively small. But foreign objects, such as splinters, thorns, and needle points, may be broken off and concealed deep in subcutaneous tissue. Such wounds become infected quite easily. Puncture injuries over the joints are especially hazardous, since severely disabling joint infections can result if the joint space is entered.

Treatment for PUNCTURE WOUNDS

Minor injuries, such as small punctures from briars, require no more care than removal of the object and cleansing. Thorough cleansing and the removal of foreign matter is again, of paramount importance. But deep, penetrating wounds which contain dead tissue and debris are ideal for the development of secondary infec­tion and tetanus. If there is any doubt about the handling of these and any other wounds, medical attention should be sought.

FRICTION BLISTERS Treatment

Repeated or prolonged traction over the skin, perhaps from ill-­fitting shoes, wrinkled socks, or unaccustomed raking or shoveling, soon separates the superficial from the deeper levels of the skin. When the space thus created fills with fluid a blister has formed. Friction between the skin and adhesive tape is a prime cause of blisters in athletes. Depending on their location, even small blisters can disrupt the performance of an athlete.

Treatment for FRICTION BLISTERS

Blisters caused by friction from shoes or other equipment should be left intact and protected meticulously. The site can be protected with tape and cushioned with foam rubber or moleskin, as needed, while the roof of the blister keeps the deeper layers of skin from further friction and secondary infection. Medical ad­hesive tape or Zonas tape can be used. If necessary the blister can be punctured and drained, by cleansing the skin around the blister, and then puncturing the blister at its edge with a needle that has been sterilized with alcohol. The fluid can then be pressed out of the blister; if the blister is broken, any ragged edges should be trimmed away since they may irritate the raw wound.

Blisters that occur in areas less troublesome than the feet can be treated in similar fashion.

FRICTION BLISTERS Prevention Tips

Friction blisters are best avoided by wearing carefully fitted shoes and wrinkle-free socks. One must be especially careful when wearing new shoes or orthotics; long runs or hikes should not be attempted in shoes that are not well broken-in. Some runners feel they do better without socks, but most prefer one or sometimes two pairs. Thick ointments, such as petroleum jelly, can be applied liberally to sites of friction on the feet or elsewhere before long hikes or runs. If taping is necessary, it should be done carefully and re-done if it begins to irritate the skin; applying wax or oint­ment to the tape may decrease friction. The ointment should be applied liberally to the sock over the site as well.

Hot spots are red, warm, tender areas that indicate incipient blister formation. The application of an ice cube will minimize the likelihood of blistering; hot spots should then be protected with a layer of very thin, smooth tape or by soft padding to eliminate further friction.