Wound in the tropics ?

[chillyinCanada]

Thanks to all who have responded so far, I am in West Papua, serious tropics here, at the moment I am putting sugar with betadine on it and am going to stay out of the water for a few days until it starts to heal, I'm trying to air it, stay off it and keep it clean.
Can't believe it happened on day 1, unkept slippery jetty with algae on it was the problem.
So confusing having so many contrasting opinions , medical advice relevant to tropical conditions would be appreciated.

Lots of dogs around? Cats?

How are you keeping it clean when you are walking around?

 

[chillyinCanada]

Hey Lorenzoid and thanks for the tag. I will try to help if I can. We just lost our pet today and I am low on sleep so I my thoughts might be a bit scattered.

If the OP had come to my office with this I would have told you to clean it daily with warm soapy water and keep covered with bandaid. And to stay out of any “dirty” water like streams, lakes, hot tubes and yes, the ocean. But divers being what they are I know most would ignore this advice.

It is hard to tell from the photo but I think maybe it is not too deep? Of course any break in the skin is a portal for infection.

Sites more distal to the heart do have a greater risk of infection. Age and health also play a role.

As for ointments, I usually recommend polysporin or equivalent for at least the first few days, especially if I feel there is a more than average risk of infection. But I know some dermatologists that recommend vaseline for low risk wounds. The purpose here is to decrease infection but also to keep the wound base moist. Scabs slow healing as does a dry wound. Broad spectrum antibiotics and drug resistance isn’t really a part of this discussion, yet.

As for sugar and betadine, we stopped using chemicals on wounds many years ago. If a wound is particularly contaminated I might use a half strength peroxide mix briefly. The problem with betadine, alcohol, peroxide, is they don’t know good from bad and will destroy indiscriminately. All that is needed for most wounds is clean water.

As for sugar, I have never recommended it’s use. I have seen a honey paste used for dirty, necrotic or slow to heal wounds but not routinely and not for clean cuts.

IF you choose to dive with the cut make sure you clean it very well after diving. If you can manage a waterproof dressing all the better (and yes here a sock might help protect the dressing). But absolutely keep a close eye on it and seek care early for any signs of infection.

So sorry about your loss.

 

[scubajunky17]

Not walking around much, using this Jing stuff, it's kind of scabbed over now.


QUOTE="chillyinCanada, post: 10034246, member: 416605"]
Lots of dogs around? Cats?

How are you keeping it clean when you are walking around?
[/QUOTE]

 

[chillyinCanada]

Thanks, I'm definitely going to assess over the next 24hrs, there is a little redness and swelling on the toe but it was a nasty cut and fall, rest of foot looks ok, I have access to some antibiotic biotic ointment now and can get medicine if I need it I think.

What are you using for scissors? Your 3rd toe needs some dead skin cut away too.

And for heavens sake, make sure the cutting utensil is really clean!

 

[chillyinCanada]

I am a random commenter on the internet NOT a doctor.

That said, one of the most important things you can do for a wound like that is not only keep it clean, but also debride it (remove the dead skin/tissue). Don't go crazy and damage the healing areas or remove scab, but that white mushy dead skin is just feeding bacteria. It's gotta go! Scrubbing won't be comfortable but it will reduce the chance of infection and speed healing. Warm water and soap, maybe tweezers. If it starts feeling like the whole toe or part of your foot is red/puffy/swelling/hot/getting worse EVEN A LITTLE BIT then a real infection has set in and you need real antibiotics without delay because these things can spread fast.

As for diving - probably not good for it, probably does increase the chance of weird infection, but I personally would still dive with that injury. Not saying its a good idea, make your own decision. If you do dive, make sure to protect it during the dive and clean it immediately after diving.

You don't want to be pulling the dead skin off in such a way that it pulls off healthy skin. Tweezers could work but only if dead skin not attached to healthy tissue. You don't want to be making the open wound bigger, if you know what I'm trying to say.

 

[chillyinCanada]

Debatable

I stepped on a rusty carpentry staple from an ancient piece that I was trying to refinish. (Not being careful, doh!)

Went to clinic, got it cleaned up, they checked my last tetanus shot, which turned out to be more than ten years prior, so they gave me a shot on the spot. That's where I came up with the 10 years, otherwise I'd have been none the wiser.

 

[chillyinCanada]

Have you cleaned this bit up? That looks like dead skin with something gross under it.

 

[scubajunky17]

Have you cleaned this bit up? That looks like dead skin with something gross under it.

View attachment 794767

Good spot , I think that was dead skin I flicked off the wound.

 

[chillyinCanada]

I did bring plenty of tablets and betadine etc but messed up on bandages and dressings etc, I'm very well travelled but haven't done a long trip like this for six years so I guess I wasn't on point, amazingly I also left my diver cards at home, so I was distracted as I booked with a week to go and was trying to get a dive computer and SMB, I overlooked some important kit.
The brown stuff on top is the solution that is applied.
It looked like this yesterday before it.

With regard to your dive cards, have you ever made a photo copy to send in advance to a dive booker or a liveaboard? If so, maybe you can find those.

Any chance, that whoever you're diving with has internet access to find them? I know that many dive ops at many worldwide locales can look up PADI certs. I'm not so sure about other cert agencies.

For future reference, if you're so inclined, an idea would be to keep your cards with your passport.

 

[scubajunky17]

Iv

With regard to your dive cards, have you ever made a photo copy to send in advance to a dive booker or a liveaboard? If so, maybe you can find those.

Any chance, that whoever you're diving with has internet access to find them? I know that many dive ops at many worldwide locales can look up PADI certs. I'm not so sure about other cert agencies.

For future reference, if you're so inclined, an udea would be to keep your catds with your passport.

I've had pictures of them sent, least of my concerns right now tbh