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Two Letters Re: Wound Irrigation in Austere Environments

Hello James,
Regarding wound irrigation, wound preps, surgical site prep, etc., folks would do well to purchase a gallon each of Betadine, Povidone, or other generic tamed iodine, in both the scrub and solution formulations. These are not terribly expensive and one likely could talk his/her Veterinarian into getting some for them, as they are not controlled substances. [JWR Adds: They are also available in the vet supply department at some of the larger feed stores, and via mail order and Internet vet supply companies like Jeffers.] These are concentrates and can be diluted, and used on wounds if the patient has no iodine allergies. Sincerely, - Mike M., DVM

Jim,
The key to stopping a wound infection is to change the physical characteristics of the wound to make it hard for the bacteria to live. Most bacteria are very specialized and sometimes something as simple as oxygen will kill them dead. Irrigation is a great help too, it gets rid of a large numbers of bacteria and the pure water causes bacteria to swell up and pop. You can also change the pH of the wound, or the salinity.

Wound care in the Third World is almost always a problem. It seems that you never have all the supplies you need. Antibiotics and even antiseptics are scarce.

One of the key pieces of kit used by some NGOs in Africa is something called "sugardine". It's just plain old table sugar, mixed with a mild solution of iodine. Either one works pretty well, but for a raging infection, plain old table sugar (granulated sugar or sucrose), will cause bacteria to dehydrate. Your body will respond by oozing liquid into the wound, which also helps dislodge bacteria. The normal way of using it in Africa is to unwrap the wound, irrigate it with clean water and then pack it full of sugar and re-wrap it loosely. (Don't worry too much about dry dressings. It's going to ooze quite copiously.) After a couple of hours, you can open it back up and irrigate it again and let it air out with loose, cry bandages until the next sugar treatment.

Repack the wound with sugar twice a day and the results are amazing. - Jon

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