New Bandages

© 2003 Jeffrey E. Isaac, PA-C

For the Wet at Heart

Adhesive bandages for minor wounds, generically known by the brand name “Band-aid”, have improved considerably in the past few years. On a recent voyage I had an opportunity to consumer test several new types, including liquid film, hydrocollodial, and the semi-permeable membrane. During my informal investigation, all were subjected to blood, sweat, tears, salt water, engine oil, solvents, cooking debris, cleaners, dirt, abrasion, and other forms of abuse. That was just the first day. It was a typical sailing trip.

For long-term use in wet conditions the clear winner was the 3M Nexcare Waterproof Bandage, which is simply a piece of sterile gauze imbedded in a semi-permeable membrane adhesive covering. One of these stayed on my big toe so well that I forgot about it for weeks. Band-aid makes a similar product called “Aqua Protect”, but I did not test these. For use in high-impact areas, like hands or foot soles, reinforcement with a regular band-aid or tape will keep them from being rubbed off.

The hydrocollidial dressings like the Curad “Hydro Heal” stuck well and were equally protective, but less long-lived. These dressings are designed to absorb exudate, keeping the wound moist to promote healing. On board they seemed to swell up quickly, looking like a large blister, and had to be changed as often as every day. I suspect the dressing was absorbing sweat or seawater.

The liquid film bandage was a bit of a disappointment. It was very easy to use for minor abrasions, just brushed on with an applicator right from the bottle. However, in 100% humidity (definition of small boat) it takes a few minutes to dry, which can seem like forever in some situations. Also, even though the solution contains an antiseptic, the same bottle and applicator really should not be used on another person.

Once dried in place, the liquid film was effective for a limited time. It did not survive frequent immersion or abrasion as advertised. A regular band-aid over it was required for protection, as was frequent re-application. This is probably better for home use.

Even the classic gauze band-aid now comes in a variety of shapes designed to wrap over fingertips, elbows, and eyelids. The new, stretchy fabric works best. These work fine in dry conditions, or for a temporary covering until you can clean a wound. I’m especially fond of knuckle bandages. Before the advent of the new combination products, I used to cover one with a Tegaderm or Bioclusive film for long-term protection from wet conditions.

Unfortunately for kids, designer graphics like dinosaurs and super-heroes only seem to come on the plastic band-aids, which are nearly useless at sea. But, I’m sure somebody is working on it. What I’d really like to see is bandages labeled with the day of the week so you’d know how long they’ve been on.

Remember, a wound needs to be properly cleaned before the application of any bandage. It will do no good to protect a wound from external contamination if you’ve trapped a bunch of bacteria inside. Also, remove any occlusive dressing from a wound that you suspect of being infected. An infection requires drainage as part of the healing process.