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Purell instead of Triple Antibiotic Ointment?
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Andrew Shapira
(northwesterner) - MLife

Locale: Pacific Northwest
Re: re: gauze on 10/04/2009 23:17:13 MDT Print View

If you're carrying gauze, maybe you could ditch the mole skin, and make something from gauze as needed, attaching it with duct tape.

Thomas Burns
(nerdboy52) - MLife

Locale: "Alas, poor Yogi.I knew him well."
Re: gauze on 10/05/2009 04:39:59 MDT Print View

>If you're carrying gauze, maybe you could ditch the mole skin, and make something from gauze as needed, attaching it with duct tape.

Gotta agree with this post. I kept cutting the moleskin in half and in half again until there was nothing left. Eventually, I left the gauze behind, as well. I figured a bandaid works just as well for small wounds, and you can always use duct tape and an antibiotic "wipe" for larger wounds.

However, some posts on this thread are making me reconsider reintroducing gauze. especially on longer walks.

BTW, some banaids are treated with antibiotic. Can't hurt to have a few of those along instead of the untreated variety.

Stargazer

Edited by nerdboy52 on 10/05/2009 04:40:36 MDT.

Lori Pontious
(lori999) - M

Locale: Central Valley
re: gauze, duct tape, leukotape on 10/05/2009 08:44:15 MDT Print View

NO duct tape on my skin. Especially on the foot - all that friction rubs it right off. I've never successfully used duct tape in a medical application, it's either been sweated off, rubbed off or rolled off, and not on purpose. Leukotape stays on the skin for a week and protects the hot spot much better. If there is a blister instead of a hot spot, moleskin takes a beating, unlike gauze, and once taped in place it protects better. Cut a hole in moleskin, put over the blister, slap in some antibiotic, add a small piece of nonstick gauze, run a strip of leukotape over the hole, done. If I'm going to take just one type of tape instead of the sports tape, etc. it would be leukotape. I've repaired hydration bladders with the stuff - duct tape just slides right off a Camelbak.

Gauze is too flimsy for use in a boot but it's great for spots that aren't going to see abrasion and need to breathe. Roll gauze wraps on awkward spots like fingers or elbows, keeps things clean and hopefully dry, and an ace bandage provides a good level of protection - I was very grateful to have one because once wrapped around my hand I could continue using the hand in a limited fashion without worrying about re-injuring the palm.

And what's most likely to get injured, due to the endless things you do with it? the hand. What do you rely on the most other than your feet - the hand. Being able to get a cut or scrape clean, and hopefully mostly healed in a couple days, is important. Having stuff that works with a wound when it's wet, and some more stuff that protects it in later stages of healing, leads to a nice dry scab that doesn't need much attention and protects it from infection. It's 48 hours later and my palm has a two inch scab - already the edges are healing inward. Skin is fantastic stuff. No bandages today.

Edited by lori999 on 10/05/2009 09:07:33 MDT.

Lori Pontious
(lori999) - M

Locale: Central Valley
re: antibiotic? on 10/05/2009 08:46:07 MDT Print View

"figured a bandaid works just as well for small wounds, and you can always use duct tape and an antibiotic "wipe" for larger wounds."

If your antibiotic wipe is an alcohol swab, this would damage your wound. Leave it out to dry for a while and you might reduce the risk.

John S.
(jshann) - F
Re: Re: re: gauze on 10/05/2009 08:52:43 MDT Print View

If the duct tape moves with gauze next to a blister, it could act like sandpaper since it will stick to the bleeding blister base? ..ouch

Andrew Shapira
(northwesterner) - MLife

Locale: Pacific Northwest
Re: re: gauze, duct tape, leukotape on 10/05/2009 12:17:28 MDT Print View

Here is what I do when I see that a blister is forming. First, I take one of those pre-made thin blister pads and put it on the wound. Next, I take mole foam, fold it in half, cut out a triangular or semicircular shape, unfold the moal foam, leaving a diamond or circular hole in the mole foam, and put the mole foam over the blister pad. Then I duct tape the whole thing.

The purpose of the mole foam in this arrangement is to make some space between the wound and the boot, so that the boot is not directly touching the wound. I have had much better success with mole foam than with mole skin. I carry only mole foam now - no mole skin.

I find that without the duct tape, the mole foam comes off. With the duct tape, the setup stays in place long enough to last the day.

98% of my hiking is in day hikes, so my needs are not as demanding as those for people going on multiday hikes. Duct works ok for me. Maybe people going out for longer periods would want to use use some other tape for this setup, e.g., leukotape.

I'm thinking that gauze with a hole cut into it in the same way as above with the mole foam, and maybe folded over a few times, would do exactly what the mole foam does - provide a space between the wound and the boot. If so, then I could carry only the gauze, and ditch the mole foam. Mole foam is extremely light, and carrying it around is not bad at all, but it'd still be nice to be able to get rid of it in order to reduce the number of items in the pack. Simplicity is good.

Hart -
(backpackerchick) - MLife

Locale: Planet Earth
Bactroban on 10/05/2009 12:42:17 MDT Print View

Mupuricon (trade name Bactroban) is probably a better choice than "triple ointment". Broader coverage and more potent. Neomycin hypersensitivity rxns are a problem as people are increasingly exposed to neomycin. Usually mild -- cut will itch. In the US, you will need a script for mupuricon ointment. Of course, there exists a great controversy as to whether we should be using any of this stuff without evidence of infection! Soap and water is the most important thing.

Edited by backpackerchick on 10/05/2009 12:50:10 MDT.

Hart -
(backpackerchick) - MLife

Locale: Planet Earth
Neomycin rxns on 10/05/2009 12:45:04 MDT Print View

Have come across estimates that hypersensitivity reaction to this drug may be as high as 15-20%. Of course, this would depend on prior exposure to the drug.

Lori Pontious
(lori999) - M

Locale: Central Valley
re: controversy on 10/05/2009 12:48:22 MDT Print View

"there exists a great controversy as to whether we should be using any of this stuff without evidence of infection!"

No controversy in my mind a'tall. If I want to continue hiking without threat of infection, the cut gets the antibiotic immediately. The last time I didn't give a minor scrape an antibiotic I had a lot of medical bills. I don't have the resources right now to take risks, thanks.

Tohru Ohnuki
(erdferkel) - F

Locale: S. California
Re: re: controversy on 10/05/2009 13:17:27 MDT Print View

I'm not a medical doctor, and at the risk of wading into this issue, my experience has been that it's entirely appropriate to treat a cut or scrape with small amounts of topical antibiotic ointment to prevent infection. Prevention in this case is worth a pound of cure; if a cut on your foot gets infected to the point where you can't walk on it and you're 15 miles out, that can get very bad very quickly.

I think the controversy is over other, less appropriate uses such as the ubiquitous, every day use of antibacterial soap (my understanding is that this soap doesn't improve cleanliness and may foster the growth of resistant strains on your hands, not such a good situation when you DO get a cut or scrape!)

Or the request some people make of their doctors for broad spectrum antibiotics for a cold. Colds are viral, not bacterial and usually run their course anyway, the only thing an antibiotic would do is kill all the healthy bacteria in your gut giving you digestive problems and again, fostering the growth of resistant bugs.

Thomas Burns
(nerdboy52) - MLife

Locale: "Alas, poor Yogi.I knew him well."
Re: antibiotic? on 10/05/2009 13:50:03 MDT Print View

>If your antibiotic wipe is an alcohol swab, this would damage your wound. Leave it out to dry for a while and you might reduce the risk.

Note: Please see previous posts on this thread. An alcohol swab is, as I understand it, antiseptic, not antibiotic. The pads/ wipes soaked in antibiotics work pretty well as the "gauze" part of a bandage. As for the sticky part, take your pick.

To each his/ her own on this point, but IMO alcohol and other antiseptics are of very limited use here because their bacteria-killing powers disappear as soon as the alcohol evaporates. Antibiotics stay on the wound and prevent long-term infection. Given how far you are from a hospital on most-long term hikes, I'd treat every cut and scrape as a potential opening for an infection.

Stargazer

Lori Pontious
(lori999) - M

Locale: Central Valley
re: alcohol on 10/05/2009 13:54:39 MDT Print View

"Note: Please see previous posts on this thread. An alcohol swab is, as I understand it, antiseptic, not antibiotic. The pads/ wipes soaked in antibiotics work pretty well as the "gauze" part of a bandage. As for the sticky part, take your pick."

So you would slap an alcohol wipe on an open wound and tape it down because it's an antiseptic? Despite the warnings upthread that prolonged exposure to alcohol can cause damage? I'm not disagreeing with the use of alcohol - I use it then apply the antibiotic with some sterile gauze for wrapping. But as you say, alcohol evaporates quick. Unless you use it for dressing, which prolongs the exposure to alcohol, which can cause further damage.

Hart -
(backpackerchick) - MLife

Locale: Planet Earth
Re: re: controversy on 10/05/2009 14:06:34 MDT Print View

I'm with Lori on this. Every little thing gets a smear of Bactroban (much better than triple ointment in terms of microbial coverage, does require a script) and I'm sensitive to neomycin. Similar rationale! I swear things seem to heal faster! But there is very little evidence that such an approach is useful. Soap and water should be enough when it comes to managing minor wounds. Though I DO use antibiotic ointment in the absence of infxn, I doubt that this practice is very useful!

josh wagner
(StainlessSteel) - F
alcohol on 10/05/2009 15:34:59 MDT Print View

this could actually slow down the healing process, as it kills cells regardless of whether they're nice or bad :D


i carry triple antibiotic for cuts and use the purell for washing my hands

Lori Pontious
(lori999) - M

Locale: Central Valley
re: alcohol on 10/05/2009 15:46:30 MDT Print View

Not to mention alcohol on an open wound hurts like a MOFO.

I do use alcohol to sterilize the abrasion and the surrounding area - and let it dry before applying actual medication. Fortunately it takes no time at all to evaporate.

Gordon Smith
(swearingen) - MLife

Locale: Portland, Oregon
Irrigate with water on 10/05/2009 16:01:39 MDT Print View

My understanding is that the current preferred method of cleansing a wound is with clean water or saline solution, NOT alcohol or other antiseptic products. Antiseptics can kill living tissue and haven't proven to be more effective than irrigation. Water irrigation requires pressure to be effective, so I carry a small syringe in my first aid kit. It's been suggested in the past that a water-filled ziplock bag with a clipped corner can be used for irrigation in a pinch but there's debate on whether that provides enough water pressure. Here's a good synopsis of first aid treatment for wounds, including info on irrigation.

G

Edited by swearingen on 10/05/2009 16:16:16 MDT.

Hart -
(backpackerchick) - MLife

Locale: Planet Earth
Re: Irrigate with water on 10/05/2009 16:22:11 MDT Print View

Gordon, I'm afraid you are CORRECT. Despite the evidence to the contrary, there are those of us (me included) who think we need a little smear of antibiotic ointment -- this probably isn't going to hurt us. Placebo effect can be powerful. But let's not be fooled -- such ointment is NOT an effective substitute for thorough cleaning (with water and perhaps a drop of dr. bronner's) and drying of the wound. Of course sterile saline is ideal but who wants to carry it. The syringe is a great thing to have in the case of gashes and punctures. Would not care to muck up a wound with Purell and all it's perfume and other additives. As always, current tetanus immunization. Recommendations I believe are every 10 years after initial series. Can probably go some years longer.

Lori Pontious
(lori999) - M

Locale: Central Valley
re: water irrigation on 10/05/2009 16:25:47 MDT Print View

If you are recently fallen on a granite slab and in a world of hurt not to mention panic, afraid that you have cracked your tailbone, broken your wrist and thumb, and imagining that the rocks you see surrounded by blood in your fleshy palm are really ends of bones, a little water dribbled from your bite valve really sets your mind at ease quite well. With no third hand, I used what I could as best I could, and pressurized water jets were out of the question. Stopping the bleeding and tweezers had to do.

Hart -
(backpackerchick) - MLife

Locale: Planet Earth
Bismuth on 10/05/2009 16:30:51 MDT Print View

On the subject of bismuth, this is the active ingredient in Pepto-Bismal. It is much studied and known to have antimicrobial properties in the gut. This is the first mention I've seen of it being used topically. Would probably throw it in with all the other antibiotic ointments as far as initial wound management goes -- probably doesn't matter either way. Certainly, no substitute for cleaning with water and a little gentle soap.

Gordon Smith
(swearingen) - MLife

Locale: Portland, Oregon
Antiseptic vs Antibiotic on 10/05/2009 16:59:10 MDT Print View

Backpacker Chick writes:
"Despite the evidence to the contrary, there are those of us (me included) who think we need a little smear of antibiotic ointment -- this probably isn't going to hurt us."

To be clear, I did not mention antibiotic ointment in my post. My understanding is those ARE recommended to be applied to a wound once it is clean. I am talking about antiseptics such as alcohol or peroxide used for initial sterilization. Irrigation with clean water should be used for initial cleansing instead of those.

G

Edited by swearingen on 10/05/2009 17:01:00 MDT.