Health: First Aid

dress for success Transparent film – moisture-retentive dressings

By Bob Washer

MANAGING MINOR soft tissue injuries such as cuts, open blisters, burns and abrasions can be a challenge at the best of times. In outdoor environments associated with activities such as canoeing and kayaking, the constant contact with water increases the risk of wound infection.

Providing a physical barrier to external sources of contamination is an important step in the wound management process. Dry dressings such as sterile gauze are easy to apply and inexpensive, but they may actually retard healing by allowing the wound surface to dry out. A dry crust or scab inhibits wound resurfacing by impeding the free migration of skin cells across the edges of the wound.

Optimal wound healing requires moisture

Think of the wound environment and the external environment as two separate universes. The body produces all the moisture a wound needs as long as it can remain covered and protected.

Transparent film

Transparent film is a category of moisture-retentive or occlusive dressing. Transparent films are actually sterile semi-permeable membranes that function very much like Gore-tex TM . Fluids cannot pass through the clear film, but sufficient quantities of oxygen get through to keep the wound healthy and prevent the growth of anaerobic bacteria.

Transparent film dressings are extremely useful for outdoor applications because they: • Protect against contamination • Lower infection risks • Reduce pain in partial-thickness wounds (because dressing changes aren’t traumatic and films insulate and protect sensitive nerve endings) • When properly applied, stay stuck (even when wet) • May be left in place for several days, reducing the overall cost and bulk to be carried on extended trips; • Are completely transparent, allowing visual assessment of the wound so that early signs of infection will be obvious.

Bloody wounds could best be managed with an application of gauze first, which will adsorb blood and excess fluid. Once the bleeding is arrested, the original dressing can be replaced with a transparent film.

Tips for applying film dressings • Ensure that the skin around the wound is clean and dry. Alcohol applied to the surrounding skin will dissipate moisture and remove any remaining oils. • Application of tincture of benzoin to adjacent healthy skin will provide a sticky surface to keep things in place for days. • Apply the film dressings carefully so there are no wrinkle channels to allow leakage of fluids or entry of bacteria. • Keep in mind, like Saran Wrap, – once it sticks to itself it’s done.

Follow the basic principles of wound management when dressing a wound: • Ensure that wounds are as clean as humanly possible before applying a dressing. Clean the wound with disinfected or treated water to remove all foreign material and debris that predispose the wound to infection. A small amount of topical antibiotic will reduce bacterial growth.

Tincture of benzoin will protect the skin and provide a sticky surface.

Apply film carefully to avoid wrinkle channels allowing entry of bacteria.

Waterproof barrier allows for visual assessment of the wound.

• Monitor the wound for signs and symptoms of infection such as: o Local pain, tenderness and throbbing o Redness and swelling o Induration (abnormal firmness of the tissue around the wound) o Fever and flu symptoms, which will indicate a more serious systemic infection. Most pharmacies and medical supply stores carry transparent film. Ask the store manager or pharmacist. There are many manufacturers but the brands listed below are widely available in Canada.

FILM DRESSINGS

Opsite (Smith & Nephew), Ployskin II (Kendall), Tagaderm (3M) —Bob Washer is an avid outdoorsman and director of Sirius Wilderness Medicine. He has written numerous articles on wilderness medicine and can be reached at 1-877-982-0066. Excerpt of article that appeared in Rapid Magazine vol 1 issue 2 w w w . O t t a w a O u t d o o r s . c a (spring 1999)

ULTIMATE

Ultimate Play: Zone Offense – In Theory

Mocking what’s “supposed” to happen but rarely does in zone defence. This play will capitalize on the common defense zone mistakes. Follow carefully.

Zone O cup: has the disc on one side, dumps and hits the easy swing across the fi eld up yards — swing has to be wide, wide.

Right Popper (5): cuts in and the defence hammer-stopper on that side will probably easily cover you

(6) Deep: as soon as the deep sees the disc swing, he moves on a shallow angel to the far side -- odds are really, really strong that the (6) Deep defender will stay with you ‘cause you’re still the deep threat

(4) Middle Popper: the key is that as soon as you go deep, the middle-middle will think you belong to the deep, and will let you go. (4) busts deep for a huck from the swing (2), and with the deep defender on the other side of the fi eld, you should be wide open. That’s the theory at least, and you’ll probably fi nd most often it works! :)

WHEN YOU CUT, you run to an open space on the fi eld in an attempt to receive a pass. This is done by some combination of running as fast as you can and faking to make the defender think youʼre running to a different area. Therefore, cuts should accomplish one of three things: 1. Gain yardage 2. Move the disc to a better position on the fi eld 3. Maintain possession

Most passes should be type 1, where the receiver is relatively far downfi eld. Type 2 passes will get the frisbee away from the sideline or else go to an unmarked thrower. Type 3 passes should be for high stall count dumps or else for weaker throwers. Usually you want a handler making the type 3 cuts.

Know Your Thrower

One of the fi rst things to remember when cutting is who are you cutting for. It is not much use being ten metres free on the break side if the thrower is a beginner who is not even going to try to break the force. If you have a thrower who likes to throw the break throw, sometimes an effective cut consists of heading straight for the break side, assuming your defender will be a few steps behind. This is more effective the more your defender marks on the open side. Try and know what throws the thrower likes and make your cuts accordingly. Defender Proximity

The closer you get to the defender the more diffi cult it is for them to react to your movement. If you make your cut out in front of them, the defender can see which way you are going and take a step to the side to be right with you. If you run right up close to the defender and break to one side or the other, then by the time the defender can start moving you will be past them.