By Buck Tilton

In the big food chain, big meateaters munch smaller meateaters and humans find themselves, except for an occasional bear attack, comfortably at the top of the order and ready to eat anything. But then there's the invisible world of microorganisms in which you might be the food of invading germs. Infected wounds are a major cause of wilderness adventures ending sooner than planned. Proper wound cleaning almost equals the prevention of infection.

The best method of wound cleaning is mechanical irrigation and the best irrigation fluid is clean fresh water or a solution of diluted povidone-iodine. You can carry povidone-iodine solution in your first aid kit or prepare it by adding an ounce of povidone-iodine to a liter of the cleanest fresh water you can find. Shake it up and wait at least five minutes to allow the iodine time to disinfect the water completely. A teaspoon of salt dissolved in this solution increases its effectiveness. (Warning: This solution is not safe to drink.) Draw the solution up into an irrigation syringe. Hold the syringe 2 to 4 inches above the wound and perpendicular to the wound, and push down on the plunger forcefully. The wound should be tipped allowing the solution to run out. Repeat until at least half a liter of solution has been forced through the wound. If visible contaminants are left imbedded in the wound, they should be carefully removed with tweezers. The tweezers should be disinfected before use. Then continue irrigation with the second half of the liter of solution.

Without an irrigation syringe, you can put the solution is plastic bag, punch a pinhole in the bag, and squeeze the solution out forcefully. Or you can melt a pinhole in the center of the lid of a water bottle with a hot needle, and squeeze the water out forcefully. Irrigation has proven a better method of wound cleaning than scrubbing or soaking unless you're dealing with a scrape and not a cut in which case a good scrub still works best. Scrubbing of abrasions should be vigorous and often requires three to four people . . . one to scrub and several to hold the patient down. Scrubbing can be accomplished with clean fresh water and a gauze pad, but detergents are better, helping to lift out germs and debris. Good agents for scrubbing include Ivory Soap, Green Soap Sponges, Betadine Scrub, Hibiclens and Klenz Gel Blu. If detergents are used, follow scrubbing with a thorough flushing with clean fresh water.

© 1999 Buck Tilton; All Right Reserved