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All-in-One Wound Cream

Antibiotic local anaesthetic cream for wounds
  (+11, -4)
(+11, -4)
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Several ideas in one here. Inspired by recent events on a bushwalk of mine, whereby I ended up several kilometres form the car with a well smashed and bleeding ankle and a character-building hobble back to the car using a series of branches as crutches. A little pain relief goes a long way, and I reckon a morphine syrette or similar would have helped enormously. Over the counter products are not even worth taking with a decent injury.

First product: A topical antibiotic antiseptic cream that contains a powerful local anaesthetic. Applied to the wound and then covered, this would go a long way to aiding and comforting the injured until appropriate medical attention can be delivered.

Second product: A wound dressing with the above paste already infused into the gauze. For rapid dressing of wounds when you don’t have time to fiddle with all the kit and apply antiseptics and creams and all that. Just whip the dressing open, peel off the plastic from the cream-infused gauze, and apply.

Obviously we have to be concerned about possible allergic reactions, or perhaps toxicity if several dressings are used, but these issues should be all surmountable with product disclosure statements and instructions.

-I couldn’t see anything like these products in the health section, please let me know if I’m echoing here.

-wellsey

Custardguts, Oct 18 2006

Neosporin Drug Information http://www.drugs.com/mtm/N/Neosporin.html
[webfishrune, Oct 19 2006]

Neosporin on Wikipedia http://en.wikipedia.org/wiki/Neosporin
[webfishrune, Oct 19 2006]

[link]






       Does neosporin act as a topical antiseptic [21 quest]?   

       I think there may be liability issues with such a product and reactions to it.   

       Righto.   

       I live in Australia, and here, from what I can tell, antibiotic creams (such as Bactoban) are prescription only. My chemist did not know of any anaesthetic creams or other products that I could obtain without prescription, and certainly not combinations. This could be a shortcoming with him, I'm not sure.   

       Thanks for the links, I really was unaware of this.   

       I would ask as to the potency of the product, as I was referring to something powerful enough to be useful in a trauma case. I was referring to a wound dressing, not band-aid. Anything small enough to bang a bandaid onto won't be incapacitatingly painful, unlike a large laceration, tear, or compound fracture.   

       I'll happily [marked-for-expiry] if someone can attest to the potency of the products you describe.   

       -Hell, maybe I'm just WIBNI-ing for morphine syrettes to be available under the right circumsances too.
Custardguts, Oct 19 2006
  

       "cuts and scrapes" aren't exactly what I had in mind. Mine was a 6 inch laceration that went through my boot and looked and felt pretty bad, combined with a pretty bad set of ankle ligament tears that'll have me in physio for the next few months. I imagine a break or fracture would be fairly comparable, if slightly less painful. I do bushwalking and hunting, and have seen and heard of several such incidents from friends where you're far enough away from your vehicle that the best option would probably be to sit down and pop your epirb. I chose to get myself out, but it would have been better off with an anaesthetic of some sort.   

       I see this as being useful for trail riders, hikers, anything where you're a long way from help. Painkillers (tablets) strong enough to help tend to mess you up and prevent you from helping yourself too much. I would not have taken the emergency codeine I carry with me in those circumstances unless I was going to sit down and wait for the cavalry. You'll generally want to keep your head straight in an emergency, hence the desire for topical or local anaesthetic.
Custardguts, Oct 19 2006
  

       Neosporin works well and has a mild anaesthetic effect, not a powerful one.   

       <aside> I don't believe there's a pain so great that you can't continue in a survival situation. You'd have to be severly disabled, or lack the will. </aside>
Shz, Oct 19 2006
  

       [shz] of course. I agree totally. I did get out, remember? I really don't think what I did was extreme or special at all, either; I only had a few k's to hobble. I'm not talking it up, it just happened, and inspired this idea. I'm alluding to something for making that sort of thing easier, or to provide comfort to someone in a trauma situation.   

       Maybe my priorities are wrong. You'll drag you arse through hell for you or a mate, and if this sort of thing is superfluous, why take any pallative medications at all.
Custardguts, Oct 19 2006
  

       //I'm not talking it up// Sorry, I wasn't insinuating that you were. I thought I heard a 'sometimes can't be done without' undertone with mention of carrying painkillers. Just an <aside>.   

       Seems what you have invented is somewhat baked, just not strong enough for your specs. Gets a + from me, though. I can see its usefulness.
Shz, Oct 19 2006
  

       please look up definitions for anaesthetic, antiseptic, and antibiotic, as all three are quite separate. "they both do the same thing on a wound"... Please don't EVER let me rely on you to apply first aid, or continued care.   

       I want a product that sterilises the wound (antiseptic), numbs pain (anaesthetic), and prevents/cures further infection (antibiotic). There are a variety of separate chemicals available: say Mupirocin for the antibiotic, chlorhexedine for the antiseptic, and perhaps benzocaine as the anaesthetic. I know almost nothing about anaesthetics, so I really don't know what would be suitable for topical use.   

       Perhaps the use of normally very chemically active antiseptics in the cream would affect the other two ingredients, I don't know.   

       No magic here, just need someone with a medical background to work out the specifics, or viability of such a product.   

       I thought a single product for the treatment of wounds away from medical care was a rather good idea, and supplying it prepackaged and applied to a wound dressing would sell quite well.   

       Fuck it. [marked-for-deletion] magic. Lets see if it goes away now.
Custardguts, Oct 19 2006
  

       If you disagree with the previous commentator - and, frankly, so do I - why don't you just say so? They can't tell you what to do.
jutta, Oct 19 2006
  

       Sorry jutta, just having a hugely bad day and thought I'd bite back, normally I'm a wee bit more reserved.   

       I really do disagree with the implied magic MFD, and I'm wondering why he's pushing the issue. And for whatever reason, I actually do care.
Custardguts, Oct 19 2006
  

       Ah, sorry about your bad day. Which gives me an idea - maybe along with the antiseptic and antibacterial ointment there should be a mild antidepressant as well.
jutta, Oct 19 2006
  

       Let's face it - if the idea were for 'stronger drugs' then it's really a "let's all". However, the novelty, in my opinion, comes from the packaging/delivery of the first aid.   

       You wouldn't need an all-in-one wound cream... you could use a cream dispenser like a stripey toothpaste. One chamber with antiseptic/anaesthetic and another with antibiotic. I don't have any expertise in this area but I know of a couple of creams that have local anaesthetic (or light analgesic) & antiseptic properties. I don't know about antibiotic cream though.
Jinbish, Oct 19 2006
  

       For those who, like me, do not live as far toward the edge as old [custardguts] appears to, an EPIRB is an Emergency Position Indicating Radio Beacon. I googled it.   

       Where I live you just sit down and bleed quietly for 10 minutes until the next hiker comes along or 20 minutes if the first hiker is unfriendly.   

       P.S. I think the idea is a good one.
squeak, Oct 19 2006
  

       Some comments:   

       1) The laws on which medicines are allowed without prescription are more relaxed in the USA than in most of the western world. In the UK, most of Europe, Australia etc. you cannot generaly buy topical anaesthetics, antibiotics of any description or strong painkillers without a prescription.   

       2) You should NEVER put creams on an open wound, ever. There are some exceptions to this rule but generally these excepetions should only be applied by trained medical staff in a treatment, not a first-aid setting. Only water should be used for wound-washing in a first-aid setting. Preferably a clean, sterile gauze or an amubulance dressing or failing that an improvised bandage should be used as a wound covering.   

       3) There are not any topical local anaesthetics that are powerful enough for this kind of injury and by definition, application to an open wound is NOT topical, it is internal and topical treatments should NEVER be applied to broken skin. For a local anaesthetic to be effective it would most likely need to be injected into the wound. This is the method that is used in hospitals when stiching wounds etc. For this you would use something like lignocaine (lidocaine in the US).   

       4) You can get morphine syrettes on prescription from your doctor. Go to him/her and discuss the activities you are involved in and why you need this and a sympathetic doctor should prescribe it for you. NEVER administer these to someone else, never use when it is suspected there is a spinal or head injury or if consciousness seems impaired or speech is slurred etc.
webfishrune, Oct 19 2006
  

       Um, the distinction between antibiotic and antiseptic, as far as I can see, is that antiseptics are "external use only", while antibiotics are less toxic and can be eaten or injected.   

       If you're just applying it to a wound then this distinction isn't relevant[1]. Which (on re-reading) is I think what 21 Quest was saying. Your interpretation of his/her post as saying anaesthetics where the same as well is perhaps not what they meant.   

       Personally I don't think it advisable to make antibiotics available without perscription. And for the purposes of your idea (which is basically first-aid) you don't really need one; an antiseptic would be sufficient.   

       Perhaps you supply the dressing with a test kit, so you can make sure you're not going to react adversely before you set out on your hiking trip.   

       [1] Then again, looking at what webfishrune has posted in the mean-time, perhaps it is.
Loris, Oct 19 2006
  

       //You should NEVER put creams on an open wound, ever.// I agree you should clean the wound first, but why not?   

       From the warnings on Walgreens' (generic) Bacitracin Ointment (antibiotic cream): "In case of deep or puncture wounds, animal bites, or serious burns: Stop [using] and ask a doctor if the condition persists or gets worse".
Shz, Oct 19 2006
  

       //webfishrune, you are a whacko.//   

       No need to be confrontational. Is this the best way to argue your point, by trying to insult people? Not exactly inteligent debate is it? Could this be why you seem to have had several "bullet and stabbing wounds"?   

       This is the advice that is given with reference to first-aid treatment. You should see a trained professional for advice before using creams on open wounds. I do know what I am doing here, I am trained in this field and have taught first aid. However, I don't need to justify this to you, I know my advice is correct but if you disagree you are perfectly entitled to your opinion. I was simply trying to offer useful advice to others based on my knowledge and training. If you don't agree, thats fine.   

       //they heal just a quick as you like//   

       My advice was in no way related to healing times but to safety and correct practice.   

       Neopsoprin in particular is prone to causing alergic reactions and this is one of the reasons it (and similar products) are not avaliable over the counter in the UK. (see link).   

       On checking the guidelines for Neosporin from the manufacturer (Pfizer), it is also stated that Neosporin should not be used "to treat a deep cut, an animal bite, or a serious burn." It also states "Call your doctor for instructions on how to treat these more severe skin injuries." Furthermore, it states to only use for "minor cuts, scrapes, or burns on your skin." This seems pretty conclusive to me. See links for more details.   

       Feel free to put whatever creams, ointments and potions on yourself that you like but please don't do it to anyone else. At worst you could cause them harm or you could get yourself sued if they have an adverse reaction to the cream causes more harm than good. Standard first aid practice is not to use creams on wounds. During treatment by a trained professional or on their advice, as I have already stated this rule may be overridden but if you are not trained (doctor, nurse, paramedic etc) or under a trained persons advice, you should not do it when administering first-aid to others.   

       //shows what you know..//   

       Likewise.   

       Hey, have a good day, chill out. :-)
webfishrune, Oct 19 2006
  

       I'd heard this advice before - similarly, severe burn injuries can be made worse with the application of creams etc.   

       As for the antibiotic/antiseptic debate, I think the method by which the compund kills bacteria is the difference. Antiseptics generally destroying cells by surrounding them in strong solvents, while antibiotics have a more subtle action, allowing them to be safely injected or injested.
zen_tom, Oct 19 2006
  

       //but why not?// (ok, I shall explain ;-) )   

       Because many topical preparations contain ingredients (both active and inactive) that are not intended to make their way under then skin (sub-dermal) into the blood stream, etc. Some preparations are fine on the skin but are actually too strong for the underlying more sensitive tissues and can actually burn these tissues, causing more damage or making the wound take longer to heal.   

       Also, when you do get to hospital, the first thing the staff will want to do is have a clean wound to work with, with no other agents in there, so they will clean all of your carefully applied creams out again. This is also applicable because the cream you have used may have a bad reaction with other products they may need to use. The absorbtion of the active ingredient into the blood stream is also rather unpredicatable with creams and this may affect the dosage of stronger, more effective antibiotics or treatments they may wish to administer.   

       Infection does not take hold immediately, the first priorty is to make the casualty safe and get them to treatment. For most injuries, it will not take days to get the casualty to assistance and if the wound is covered there is very little risk of infection, certainly in most situations not life-threatning. First-aid is about treating injuries or coping with incidents in the first instance it is not about after-care and infection control. Stronger, more effective, oral or intravenous antibiotics can be administered by a doctor anyway. The effect of these creams is only very mild compared to treatments administered by a doctor and only really suitable for minor injuries that can be treated at home and do not require medical attention. (bites, stings, minor injuries)   

       These "treatments" are big business and the drug companies try to sell them to you on some perceived benefit. In most circumstances the evidence that they help is tentative at best. Most injuries are best treated with plain old water, despite what drug companies may tell you.   

       Unfortunately, because in the USA you have to pay for your medical care, unlike here in the UK I feel that possibly people try to treat injuries at home that really should have medical attention and this may have some bearing on peoples willingness to treat moderate to serious injuries with these type of preparations rather than seeking proper advice.   

       Another long anno, appologies to those who are not interested.
webfishrune, Oct 19 2006
  

       Long but informative - thanks! Beware the warning label. Usually they are overdone to avoid litigation; Seems my example is underdone.
Shz, Oct 19 2006
  

       //webfishrune, I thought we was friends! Why you tripp'n? I was only pulling your chain, I didn't realize it was attached to your nads. //   

       Heh, i did wonder if you were trolling when typing it, but sod it, decided to post it anyway. If you say you were, my appologies for biting and for the sense of humour failure. (just don't put cream on the bite, :-) ) At least some found it informative, I hope I didn't bore you all too much.   

       We are friends phlish, you sarcastic git you :-), no offence taken.   

       I'm probably far to serious today, work, stress, work, stress, work, arghhhhhhhhhhhhhh!
webfishrune, Oct 19 2006
  

       After all of the debate, [+] for the idea in principle, whether it be for minor injuries or for supervised, prescribed use. However, the authors injury would not, in my opinon, be a suitable candidate for this treatment.
webfishrune, Oct 19 2006
  

       //Anything small enough to bang a bandaid onto won't be incapacitatingly painful, unlike a large laceration, tear, or compound fracture.//   

       The four puncture wounds I receved from a dog 4 days ago were quite incapacitatingly painful(during the bite my body froze up if that counts), two of the four turned into lacerations as I yanked my hand from the dogs mouth. I can tell you now, the punctures hurt more than the lacertions. Possibly the "magic wrap" should be laden with alchol that goes into the blood stream and intoxicates the one in pain. This would take the heat off until somebody with some "real" medical knowledge could arrive, and it would sterlize the wound.
Chefboyrbored, Oct 19 2006
  

       The thing I found that worked really well the last time a big dog bit me is to smash the butt end of your six pack into the side of his head and, as he hauls ass yelping for his dog house, pound two of the beers while pressing the wound between the remaining four.   

       Good times.   

       //My kid lascerated his third toe (underneath where it bends) last night,// plish, are you holding back on an idea for children who wont stop running in the house? Spike strips for hallways?...Curious.
Chefboyrbored, Oct 20 2006
  

       Good God jutta, I think you might have landed on an extremely brilliant, and most likely very doable, given a few years, idea.   

       A fast acting-topical antidepressant. (Sorry custard, to go off topic, but I got excited when I read her comment, being a gourmand of antidepression meds since age 7).   

       Does this exist on the bakery I wonder. I know it doens't in the real world. Patch form, but fast acting.   

       The stats on the number of depressed people who suicide on their antidepressant meds is staggering. Other than aspirin, the tricylics were as deadly a med as you could consume in large quantities. Lazy Shrinks used to write thier clients 6 refills, and before computers tracked Rx's, the consumer could get all six filled in one day, and it would be goodbye cruel world.   

       But a patch, how many, and how well absorbed, if it's meant to be transdermal, could one chew, before throwing up?   

       Of course we could add some of the product you were thinking of, [custard], for those who may have recently tried death by razor blade. Slap a patch on it, and be on your merry(er) way.
blissmiss, Nov 25 2006
  

       I adore [Chefboyrbored]'s idea of using topical alc(o)hol for pain control! And [webfishrune] is right about the topical local anaesthesia, it sucks. Neosporin's painkilling ability is minimal to none and the number of people who suggested that it bakes this idea makes me wonder how so many people avoided pain worse than from a lightly grazed knee.
stilgar, Nov 26 2006
  
      
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