Our protective armor, skin, is the largest organ in the body. But armor only, skin is
not. This highly dynamic network of cells, nerves, and blood vessels serves the body in
diverse ways.
Clearly, skin's protective function is paramount, providing internal organs and tissues
with a physical barrier from the environment and the dangers therein: toxins, heat and
cold, and disease-carrying microbes. But skin also plays an important role in preserving
fluid balance and in regulating body temperature and sensation. Nerves buried deep within
skin allow us to sense the presence of potentially harmful invaders, such as bees. Immune
cells resident in skin help the body prevent and fight disease.
For these reasons, the loss of skin due to burns or trauma can deal the body a severe
blow, impairing or even eliminating the many vital functions this organ performs.
In spite of recent advances in the basic mechanisms of wound healing, knowledge of
factors involved in the development and treatment of chronic wounds and their prevention
remains limited.
A number of reports have established that the application of growth factors to acute
experimental wounds in animals enhances healing. However, it is unclear what role growth
factors play in chronic wounds. Indeed, recent clinical trials of topical application of
single growth factors to pressure, venous and diabetic wounds have not been very
encouraging. It should be appreciated that growth factors are multifunctional with both
stimulatory and inhibitory actions depending upon cellular context.
In normal skin, the basal cells are attached to the basement
membrane and lose anchorage upon skin injury. The signals responsible
for epidermal migration after wounding are unknown, but keratinocytes
begin to migrate toward the site of injury. The "tractor tread"
hypothesis, whereby keratinocytes stop at the wound bed with
progressive climbing of proximal cells over the now resting cells has
gained wide acceptance as a model of keratinocyte migration.
Investigations of the epidermal edge of venous ulcers has shown that
the epidermis displays mitotic activity, resulting in increased
epidermal thickness at the edges of chronic wounds. This has led to the
hypothesis that a fundamental defect exists in the chronic wound
situation, perhaps a failure of cells to adhere to one another or
their substrates. There has been substantial recent information on the
signals for keratinocyte movement and substrate requirements at least
in the context of acute injury. The concept that the extracellular
matrix is an integral part of keratinocyte migration
has also received experimental support. Migration enhancing and
inhibiting molecules found in extracellular matrix and/or in wound beds
have been described.
For the last several years, evidence has suggested that chronic wounds may be growth
factor deficient or represent a microenvironment hostile to the repair process. More
recently, however, there is new evidence suggesting that wounds may not necessarily be
deficient in growth factors, but that the stimulatory action of the peptides may be prevented from being expressed.
Scrapes and abrasions are superficial injuries to the skin and mucous membranes.
Although scrapes and abrasions are relatively minor injuries, like all open wounds they
are painful and highly susceptible to infection. Following an abrasion or scrape, a
physician should be consulted about antitetanus injections. If dust and grit are left in
the wound, scars may form on the skin. Any foreign matter should be removed before the
wound has healed.
Clean the abrasion with soap and water, and rinse thoroughly. If the victim has other
injuries or extensive abrasions, summon medical aid. Do not remove any scabs that may form
over the injury. They will fall off when the wound has healed. If scabs are removed before
the wound has fully healed, the abrasion may begin to bleed again.
The list below includes wound care medications and other helpful items. Remember, if
you have a serious injury or illness, you should seek professional medical attention.
- Analgesic - preferably acetminophen
- Antacid
- Anti-inflammatory - preferably Ibuprofen
- Calamine lotion
- Expectorant cough syrup
- Decongestant (pseudoephedrine)
- Ointment
- Antiseptic solution (Hydrogen Peroxide)
- Petroleum jelly
- Sunscreen (SPF-15 or higher)
poultices and/or washes.
See also: Wounds
