Dealing with severe burns & wounds without medical help

[Sekwo]

I many disaster situations, people will suffer severe wounds, and for example, severe burns will be common after a nuclear exchange as seen on civilians attacked by the US in Hiroshima and Nagasaki.

The big difference, with a nuclear war, and many shtf situations, is that there may be no medical help at all for a considerable time, long enough that serious wounds, whilst not in themselves life threatening, could in the time when no medical help is available, become gangrenous and so deadly.

I've been researching the subject and whilst I've found plenty of "first aid" books that deal with the initial treatment of serious injuries in the hours before the casualty is seen by a medic, and I've read some medical texts (mainly military), on medics dealing with severe injuries after that period, I've yet to find anything on the long term treatment of severe wounds and burns by the non-medically competent.

In particular, medics will perform a process called "debridement", which is basically hacking off any flesh that may be dead or contaminated. Military medics are particularly zealous with the process, because in a military context the wounds are usually infected with some nasty flesh-eating bugs. So, I understand that might be something that has to be done in a SHTF situation to an open wound.

But, my question regards 3rd degree burns. These are burns that kill the entire thickness of the skin. In normal life, these require medical treatment: the dead skin is removed (debridement) and then I suppose they have to have skin grafts. But, in a shtf situation, there is no way that is possible, so I've been trying to find out which of the two likely options would be best: to remove the dead skin and leave an open wound, or to leave the dead skin and perhaps have a festering gangrenous wound.

[bigpaul]

if you leave an open wound then infection can get in.

[Sekwo]

(21 July 2023, 10:27)bigpaul Wrote: if you leave an open wound then infection can get in.

But according to the military medical text I was reading, there was a major problem with closing DEEP wounds too early, because there was a high chance of bacteria that caused gangrene, and that was deadly. Apparently (before antibiotics) they started doing swabs to determine which bacteria were present and only closed the wound when the type that caused gangrene had disappeared.

The situation was particularly bad in the trenches, where the soil was contaminated by the bacteria that decompose flesh. Any wound was likely to have these present. So, they would cut out about 5mm of flesh around the wound and then leave it open typically for 4days to a week. Obviously by "open" I mean with bandages to keep it as clean as possible, but air could get to it through the bandage.

I'm not sure what this means in a non-military SHTF situation. But I'm thinking, if the wound may have cut off the blood supply and killed parts of the muscle, it is a good idea to leave the wound open so we can see what is happening and remove anything that is dead before it starts festering. I presume when it starts looking "healthy" and is "healing"... it can be closed.

However, the situation with burns is quite different. A severe burn starts by being infection free. So, even if the skin is dead, it is a barrier against infection. So, common sense, says we leave it in place ... but at some point the dead skin will start to promote infection and has to be removed ... or perhaps it naturally falls off?

My guess is that the "right" action in the situation is to apply some kind of anti-bacterial, anti-fungal cream to "preserve" the dead skin as a barrier. But that's just a guess.

[bigpaul]

honey is good for a wounds barrier.

[Sekwo]

(21 July 2023, 12:29)bigpaul Wrote: honey is good for a wounds barrier.

That's not a bad idea ... we'd probably be resorting to treatments that these days medics would laugh at.

[bigpaul]

I have consulted my first aid manual and it says you should not break the burnt area.medics may laugh at some of the old treatments but they wont be around post SHTF .
before we had big pharma all we had were natural remedies and will again.
many modern treatments are based on these old treatments. willow bark for pain relief instead of asprin for instance.

[Sekwo]

(21 July 2023, 16:36)bigpaul Wrote: I have consulted my first aid manual and it says you should not break the burnt area.medics may laugh at some of the old treatments but they wont be around post SHTF .
before we had big pharma all we had were natural remedies and will again.
many modern treatments are based on these old treatments. willow bark for pain relief instead of aspirin for instance.

I read ... I forget ... but something sciency ... written when antibiotics were still rare on the use of anti-septics. The author was against their use. Apparently they got better results by letting the natural bacteria come in to protect the wound. It's probably how the old fashioned remedies worked ... they encouraged the good bacteria which stopped the harmful ones.

[bigpaul]

modern medicines only treat part of the problem, not the whole body, that in turn causes side effects that need more medicines which cause more side effects and so on.
the old natural remedies treated the whole body.