- Carefully disinfect hands, for example, with the drug “Octenisept”, then generously treat damaged skin with antiseptic, such as “Prontosan” (or any antiseptic used in the BE). Preferably, the gel “Prontosan” or liquid for washing wounds “Prontosan.”
- Once blistering has occurred, the blister should be punctured with a sterile needle. If using a needle or scalpel, be very careful not to poke directly towards the patient. Instead, slide the needle or scalpel carefully in a parallel direction with the skin. You will be far less likely to jab your child, and it allows the blister to drain through the slit. When using a needle or scalpel, your goal is to make a small tear in the blister. Avoid simply making a small hole, as this will close up quickly. If you want to pierce the next blister with the same needle, it must be carefully disinfected, but it is better to use a new needle for each new blister. This may prevent the accumulation of fluid and pressure and may thus prevent the blister from extending.
- Complete and gentle drainage of the fluid, accomplished by leaving the roof of the blister intact and by covering the affected area with white petrolatum–impregnated gauze, helps to promote an environment most optimal for healing. If the blister repeatedly refills with fluid, it should be drained several times. Adult patients can pump liquid directly from the blister using a syringe. The method that you prefer, should be the most convenient for you and safe for the patient.
- Again, carefully treat the area with “Prontosan.”
- Now we need to apply contact wound dressing (“Mepitel”, “Urgotyul”, “Atrauman”, “Adaptik”, “Gidrotyul”, “Branolind. The bandage should be pre-cut to a larger size than the size of the wound, the edge of the wound dressing should lie on the surrounding healthy skin.
- Apply on the wound necessary cream or ointment (“Sudocrem”, “Bepanten” or its equivalent, “Pantoderm”). The best results are achieved when they are used together (best mix). Please note that to apply the cream or ointment should be:
– OVER THE CONTACT BANDAGE “Mepitel” – so the bandage will not slip or slide. Penetration of medication will be achieved through the porous structure of the bands,
– UNDER THE BANDAGE, if you use “Urgotyul”, “Atrauman”, “Adaptik”, “Gidrotyul”, “Branolind.”
- On top of the contact bandage, apply a secondary dressing “Mepileks” (or similar absorbent sponge dressing). In extreme cases, gauze (“Medikomp”, “Mesorb” or “Mesoft”), dressing “Zetuvit E”, “Urgosorb” or “Pad silkofiks.”
- If the wound is on the moving parts, to create additional protection, you can apply a foam patches even larger (“Mepileks Transfer”, “Mepileks Light” or plain “Mepileks”). Hold the hand on the pad, from the heat of hand it attaches better. If the area is uneven (these patches don’t stick to your skin strong as usual), then above should put soft bandages (such as “Peha-Krepp”, “Roltom-Soft”, “Shtyulpa”, “Lastotel”). Then put a bandage “Peha-Haft” or a conventional adhesive tape. JUST OVER Bandages! If necessary, attach “Tone-superelastic”.
All dressings can stay on the wound for several days. But it must be checked periodically.
- Medical gloves (e.g. latex or vinyl gloves) are not recommended for handling an EB child’s skin. They tend to grab the skin and can actually cause more damage. Minimize the risk of infection by frequently washing your hands, and if gloves must be used, lubricate them with an ointment such as petroleum jelly. Gloves are handy for coating bandages with ointments during the set up process.
- Scrupulous cleansing of wounds and frequent dressing changes are very important to
- prevent overt infection. The use of anti-bacterial washes, ointments, modified Deacon’s
- solution (2 tsp regular strength household bleach/1 gallon water), or wet soaks should be
- directed by a physician.
- it is a good idea to rinse an area with clean water once the bandages are removed,
- especially if the bandages must be kept on for protection during the bathing process. A
- clean turkey baster works great for this job.
- if netting is not available, a section of rolled gauze can help bind bandages in place.
- After wrapping the affected area, leave a 6 inch tail of gauze hanging. Cut this tail up the
- center lengthwise, and then twist and wrap the 2 strips around the limb. Tie the 2 strips
- in a knot to secure them.
- Preparation “Octenisept”, which is also often used for treatment of wounds, contains alcohol and can cause pain in the processing of an open wound. Use it only for the processing of their hands and medical needles.