Antiseptics and germicides are stocked in two out of three homes: Germolene and Savlon being two of the most commonly bought products. Some people seem to feel that they are behaving irresponsibly if they do not smother any minor abrasion with an antiseptic cream or douse any injured area with disinfectant. In fact there is very little point in using these products other than to make ‘nurse’ and ‘patient’ feel that something useful has been done.
Betadine consists of a type of iodine. Dettol contains chloroxylenol. Hibitane consists of chlorhexidine gluconate. Savlon Antiseptic Liquid contains chlorhexidine gluconate and cetrimide and TCP Liquid Antiseptic contains chlorine, phenol, iodine and salicylic acid. (There is also a TCP First Aid Gel which contains the liquid antiseptic in a gel basis.) Betadine is also available as an aerosol spray, a gargle and mouthwash, an ointment, a scalp and skin cleanser, a shampoo, a skin cleanser foam, a vaginal douche, a vaginal gel, vaginal pessaries and an antiseptic paint, and these different preparations are all based on the same formula.
There isn’t much to choose between any of these antiseptic liquids. They are all useful for cleaning wounds, grazes, cuts and abrasions and although they won’t by any means eradicate all infecting organisms they will almost certainly do more good than harm. I suggest you choose the cheapest.
Incidentally, anyone who watches cowboy films will know that alcohol can also be used as a liquid antiseptic. Personally, I would prefer to allow my alcohol to work from the inside but I suppose that in an emergency it could be used to help clean a dirty wound. If you get a cut while trapped in a Spanish airport, for example, you may be wiser to wash the wound with duty-free alcohol than with water.
Iodine solutions are excellent antiseptics but they usually stain everything brown and so are not popular with white-skinned people.
There are hundreds and hundreds of different antiseptics used in the many creams that are available for use at home. To list them, differentiate between them, and to review their individual properties and disadvantages would take up several hundred pages and prove very boring. It would also be a complete waste of time since I do not intend to recommend any of them.
Cetrimide is one of the most popular antiseptics for use in antiseptic creams. It is inactivated by soap and may cause skin problems if used repeatedly. It is the basis ofBactriau Antiseptic Cream, Cetavlon, Cetrimax Antiseptic Cream, Family Antiseptic Cream, Medicaid, Savlon Antiseptic Cream and Sterling Health Antiseptic Cream.
Acriflex contains 0.1% aminacrine hydrochloride which is a dis- to kill all sperms. A man with a high sperm count may have plenty left even after the spermicidal cream has killed off many millions of sperm.
So don’t use any spermicide by itself.
Spermicides are available as creams, pessaries, aerosol foams, gels, foaming tablets and impregnated soluble films. They should be put into the vagina a few minutes before intercourse (enough to allow time for them to spread around but not enough to allow time for them to leak out) and replaced at hourly intervals if intercourse is prolonged or repeated.
One of the best-known spermicides available today is Cfilm, a small square of spermicidc-impregnated film which, it is said, can be placed cither inside the vagina or on top of the penis. According to the Handbook of Contraceptive Practice published by the Department of Health and Social Security this product ‘is relatively ineffective and should not be advised’. So I won’t.
Apart from the fact that they are messy, that they taste nasty and that they are not very effective there isn’t anything wrong with spermicides. They should keep for about a year, but keep them in the refrigerator if the weather is hot and keep an eye on the expiry dates. If you keep pessaries in the fridge do make sure that no one makes a jelly or decorates a cake with them. It has happened.
These days almost everything is obtainable in an aerosol or spray can. For example, Bidex Spray contains chlorhexidine hydrochloride. Since much of the value in using an antiseptic cream lies in the rubbing and cleaning rather than the cream itself, it does seem to me that antiseptic sprays are rather pointless. They are also an expensive way to apply antiseptics to skin, furniture and friends. Incidentally, sprays intended for use by people with muscular aches have exactly the same disadvantage – it is the rubbing that often helps.
Ointments to promote healing
There are several ointments to help promote natural healing processes. Antipeol and St James Balm contain very similar ingredients: zinc oxide, ichthammol, salicylic acid and urea. Boots Pink Healing Ointment contains zinc oxide, methyl salicylate, liquefied phenol and menthol.
I can see no reason why any of these ointments should assist in the repair of damaged skin.
Plasters and dressings
Sticking plasters can be useful. If you have a cut and you want to do something messy or dirty, a plaster can provide protection. If you have a graze or sore spot that you keep knocking a plaster can help guard against further damage. Plasters can help hold together the two edges of a small cut while initial healing takes place.
But sticking plasters can also delay healing. Waterproof plasters which seal off a wound prevent natural recovery and medicated plasters do nothing to speed up healing.
Choosing a sticking plaster shouldn’t be too difficult. The only really important criterion is price. Individually wrapped plasters are better because they’re less likely to become infected before they are used. A box of assorted sizes gives you some choice. Medicated plasters (such as Germolene Medicated Plasters) are not worth buying, since in my view, the only useful purpose for a sticking plaster is to provide mechanical protection.
Use a plaster for short-term protection but take it off as soon as you can.
If a blood vessel is damaged but the skin isn’t broken and the blood which escapes from the broken blood vessel can’t get out of your body the result is a bruise. The official medical term for a bruise, by the way, is an ecchymosis. It is the accumulating blood which causes both the swelling and discolouration associated with a bruise.
There are products on the market which are sold to help treat bruises. Most, such as Bru^off, contain an antiseptic. Other treatments include the use of leeches, which suck out the accumulating blood and reduce the swelling, and such old-fashioned remedies as the application of raw steak.
A cold compress applied to the injury site before the bruise develops may produce vasoconstriction and therefore reduce the amount of swelling. Otherwise there is not much to be done.
Nine out of ten of the really serious burns which involve people in their own homes are caused by clothes catching fire. Once a dress or nightdress is burning there is a very great risk of the person wearing that piece of clothing being severely burned. So try to prevent burns.
Make sure that children’s clothing, particularly night clothing which tends to be loose and therefore easy to drag against a fire, is made of non-inflammable material. Little girls may look prettier in nightdresses but they are safer in pyjamas if you have an open fire in the house.
Keep hot liquids, kettles and teapots well out of reach of small children. Despite many warnings thousands of children are burned each year by reaching up on to a table and pulling a vessel containing hot fluid over themselves. These burns can often be very damaging.
When someone is burnt put out any flames by wrapping the patient up tightly in a coat or blanket. Then cool them down as quickly as you can. The obvious way to do this is by immersing them in water. Run a bath or shower and keep the burned parts covered with cold water for ten minutes. Do this before calling for help. If you can cool down the burned parts you may help reduce the amount of damage. If there isn’t a bath or shower handy use a cold compress or ice pack.
There are a number of myths about ways to cope with burns. Let me deal with some of the best-known.
Do not put butter or any other sort of oil on a burn. It won’t help and may make things worse.
Do not cover a burn with a cottonwool dressing. Little bits of cottonwool will stick to the burn and have to be picked off piece by piece. It isn’t necessary to cover a burn as a first-aid measure.
Do not open any blisters which form. Leave them alone and try not to burst them.
It is worthwhile being able to differentiate between a first degree burn and a second degree burn.
A first degree burn may be extremely painful but it won’t cause scarring and it will usually heal by itself. The skin is reddened but not blistered. Sunburns and scalds caused by steam are usually first degree burns.
First-aid treatment of a superficial, first degree burn is extremely simple. All you need to do is to keep cold running water on the burned tissues for five or ten minutes and then leave the burn alone.
A second degree burn always blisters. The blisters are caused by the accumulation of fluid from the blood vessels deep in the tissue which have been damaged by the burn. If treated carefully second degree burns can still heal by themselves and shouldn’t produce scars. A fairly small second degree burn can be treated at home. Clean the skin by patting with a gauze pad that has been dipped into a liquid antiseptic. Then cover it with a clean, dry dressing. Wrap the dressing on fairly firmly. If clothing is stuck to the burn then you must see a doctor. It is, incidentally, a good idea to remove all rings and bracelets if it is a hand that is burnt. Fingers may swell up later. Examine the burned area daily and if you are not certain that it is healing well then ask for advice.
If you haven’t any sterile dressings then use recently washed and ironed handkerchiefs or teatowels. Make sure that the material doesn’t moult. If it does the little bits of cloth will stick to the burn.
Any type of burn that is more serious than the ones I have described is a third degree burn and you will definitely need professional help. If the skin is obviously severely damaged then it is essential to get the patient to hospital as soon as possible. A second degree burn that has affected more than two or three square inches of skin should be seen by a doctor.
There are many branded creams available for the treatment of burns. Most contain an antiseptic. A/Hex Burn and Wound Cream, Ayrtons Burn Cream and CtipalBurn Aid all contain aminacrine .
Burne^e is an aerosol which contains mepyramine maleate and benzo-caine. Mepyramine maleate is an antihistamine and benzocaine is a local anaesthetic.
I suggest that you stick to the simpler methods of treatment I have described.
When to ask for medical advice
If a cut or wound bleeds profusely or doesn’t stop bleeding within half an hour it should be attended to by a doctor. Any cut which is more than an inch long will certainly need stitching as will any cut which gapes and which cannot be held together with sticking plaster. Smaller cuts on the hands or face should be attended to by a professional since careful stitching can reduce the amount of subsequent scarring.
A superficial burn which involves more than two or three square inches of skin should be seen by a doctor. Any burn which has caused such severe damage that there is bleeding or weeping from it should be attended to professionally.