Wound and skin care

The parent page is a good materia medica and rule 4 of the iron rules is the frame for all of it: irrigation with clean water and soap is 90 per cent of wound care, and herbs are the supporting act. This page is about the sequence rather than the ingredients.

The right remedy is usually nothing

A long list of remedies creates pressure to apply one. That pressure is the risk this page exists to relieve, because for most minor wounds the correct treatment is cleaning, covering and leaving alone.

Do not put anything on a wound you are about to ask somebody else to treat. A cut smeared with salve is harder to assess and harder to clean, and it delays the person who can actually help.

Leave blisters alone. The roof of a blister is a sterile dressing your own body made, and it is better than anything in the cupboard. Pad around it with a ring of felt or a doughnut of tape. If it bursts on its own, clean it and cover it, and do not remove the loose skin.

What irrigation actually requires

The parent page says irrigate hard with clean water, which is right, and the two words carrying the work are volume and pressure.

• Volume beats everything. More water, for longer, does more than any additive. A litre for a small wound is not excessive.
• Pressure matters because it dislodges what settling water leaves behind. A syringe without a needle, or a drinks bottle with a pinhole in the cap, gives enough. Squeeze hard.
• Drinkable water is fine. For cleaning a simple wound it performs as well as sterile saline, and the water you would drink is the water to use.
• Soap around the wound, not scrubbed into it. Clean the skin surrounding it, irrigate the wound itself.
• Get everything out. Grit, glass, thread, gravel. A wound that will not come clean is a wound for someone else, because anything left behind is where the infection starts.
• Then dry the surrounding skin and cover it, so tape sticks and the dressing stays on.

Change the dressing daily, or sooner if it is wet or dirty, and look at the wound each time. A dressing left on for four days is how a household discovers an infection late.

Burns get water, and nothing else, for twenty minutes

This is the most important correction on the page, because the parent page lists aloe vera as the burn standard and honey for burns, and both are wrong as a first action.

Honey, honestly

Honey deserves its place on the parent page. It is one of the few entries in this whole module with genuine evidence behind it, and the mechanism is real: it draws water out of bacteria, produces hydrogen peroxide slowly, and is too acidic for most organisms to tolerate.

Two caveats the parent page does not give.

Medical-grade honey is irradiated. Yours is not. Hospital products are gamma-irradiated specifically to kill bacterial spores, which raw honey contains. For a small clean wound on a healthy adult that difference is minor. For a deep or dirty wound it is another reason that wound needs real care rather than the cupboard.

Never on an infant under one year, for wounds or for eating. The parent page flags this and it is worth repeating here, because infant botulism comes from exactly those spores.

Used sensibly it is excellent: a thin layer on a cleaned superficial wound or a cooled minor burn, covered, changed daily. It keeps the dressing from sticking, which alone makes the next change less painful.

Keeping the salve from turning

The parent page's basic salve is a good recipe and shelf life is where home preparations fail.

• Dry ingredients only. Any water in the oil is where mould starts. Herbs must be properly dried, not wilted.
• Warm gently and never fry. Overheated oil goes rancid quickly and smells of it.
• Strain properly, through cloth, so no plant material is left suspended in the tin.
• Clean, dry tins, sterilised and fully cooled before filling.
• Never dip fingers in. A clean spoon or spatula each time. Contamination is almost always introduced by hand, and a tin that everybody dips into is a shared culture.
• Label with the date and what is in it. A year later nobody remembers, and an unlabelled tin gets thrown away.
• Smell it before use. Rancid oil smells like old crayons or wax, and a salve that smells wrong is a salve to bin.

Small tins, made more often, beat one large tin made once. Less to spoil, less to contaminate, and the practice stays current.

And keep a proper first aid kit as well. Sterile dressings, tape, steri-strips and gloves cost very little, last for years, and are better than anything you can make. The homemade layer is a supplement to that, exactly as rule 4 says, not a replacement for it.