Use wound care ointment before or after scabbing

Conventional wound care ointments that promote healing are preferred before scab formation, while special care ointments that lighten scars and soften scabs need to be used after scab formation or after the scabs fall off. There is no need to stick to the same time, and it must be flexibly judged based on the effect of the ointment and the wound status.

The little girl who just joined the team last month was riding an electric scooter to go to work. When she turned a corner, she hit a curb and scratched a big patch on her left knee. It was oozing with blood and stained with some sand. She carried it to the company and did not dare to smear anything. She said she would wait until the scabs formed before applying the scar removal cream at home. As a result, by the time I got off work, the wound had already formed a layer of hard dark brown scab. It hurt when I pulled it when I walked. It was still swollen the next day, and there was yellow pus oozing from the scab. I accompanied her to the community hospital. The doctor softened the scab with saline and removed it, applied some antibacterial nursing ointment, and applied a hydrocolloid dressing. He specifically asked her to change the dressing every day for the past two days. The nursing ointment should be applied before the new wound had grown and scabbed, and then she could use her own scar removal ointment after the scab was completely grown and gone.

Don’t mention it, many people still cling to the old idea that “wounds need to be dried and scabbed to heal quickly.” In fact, this is a result of poor medical conditions in the early years and the lack of suitable dressings to block bacteria, so they had to rely on drying and scabbing to isolate the wound from the outside world. The concept of wet healing has long been popularized in clinical practice: in a humid and pollution-free environment, the crawling speed of epidermal cells is 1.5-2 times that of a dry scab environment, and there will be no scarring or pigmentation problems caused by scabs pulling on new tissue. Applying regular care cream before scab formation is equivalent to adding a breathable "protective shield" to the exposed wound surface. Dust and bacteria from outside cannot touch the wound surface, and it can also lock the growth factors in the tissue fluid exuded from the wound itself, so that it will not be dried and inactivated by the wind as soon as it seeps out. Many mild care creams also have some analgesic and antibacterial effects. Applying it to a newly injured wound can instantly relieve most of the burning sensation.

Interestingly, there are also many people who insist that "you can only apply nursing cream after the scabs have formed." In fact, they are not talking about the same kind of cream at all. If you are using a silicone-containing scar cream or anti-proliferation care cream, you must wait until the scabs have completely fallen off and the wound has grown 100% before applying it. Otherwise, the ingredients in the cream will irritate the delicate tissue that has not yet grown, and may easily cause redness, swelling, ulceration, and slow down the healing process. Another situation is that you did not handle it well in the early stage, and the wound has formed a thick and hard scab. It usually hurts when you touch it. There is even a dull pain under the scab. If you suspect there is effusion, you can also apply a thin layer of scab softener after the scab has formed. The nursing ointment allows the hard scab to slowly be soaked and softened, and then fall off naturally, which is much better than having to pick it with your hands. According to my best friend who has worked in the emergency dressing room for 5 years, the probability of scarring by hard picking the scab is at least three times higher than waiting for it to fall off naturally.

She usually encounters patients who carry a bunch of Internet celebrity care creams and ask how to use them. The judgment criteria given are very simple: first read the efficacy of the cream instructions, and if it says "promoting healing", "wound protection" and "wound care", as long as your wound has no obvious active bleeding and has been treated with normal saline/iodine After the skin is clean, just apply it directly before scabs form. A thin layer is enough. After application, you can cover it with sterile gauze or hydrocolloid dressing. There is no need to leave it to dry. If it says "light scars," "remove hyperplasia," or "soften scars," wait until the scabs are gone before applying it to the skin. Do not apply it to wounds that have not yet healed.

There is really no need to put care ointment on any wound. For example, if it is just a small cut with paper, and two drops of blood will freeze on its own, just put a band-aid on it. There is no need to apply care ointment. Some people apply erythromycin and mupirocin ointment to any wound. These are antibiotic ointments. If there are no clear signs of infection, do not use them indiscriminately. Instead, it will make the wound too greasy and affect normal healing.

To put it bluntly, there is no black-and-white standard answer when it comes to when to use nursing cream. First figure out what the thing in your hand is for, and then look at the state of your wound. If you are really unsure, just find a dressing room in a community hospital and ask. It only takes two minutes, and it is more cost-effective than messing around until you leave a scar in the end, right?