Jared was slicing a bagel with a sharp knife. As the knife slid through the bottom of the bagel, it cut open his hand. Blood began gushing from the deep cut. Jared grabbed a towel and applied pressure, trying to squeeze the edges of the cut together. But 15 minutes later the wound was still bleeding. Jared’s mom took him to the emergency room for stitches.”
Jared dreaded the stitches. But, fortunately, the ER doctor had a better idea. “We can use a skin adhesive to hold the cut shut,” the doctor told Jared. “It works as well as stitches.
The Skinny on Skin
The skin adhesive used on Jared’s cut is just one of many new treatments available for skin injuries. All are designed to help these injuries stop bleeding and heal faster, better, and with less pain than such wounds used to cause.
The skin is the largest organ of the body, and it is very important to properly treat any injuries to it. Otherwise, skin cannot perform its vital functions, which include serving as a protective shield against the environment. “The skin is your first line of defense against the outside world,” says Doris J. Day, M.D., clinical assistant professor of dermatology at New York University Medical Center. The skin guards against heat, cold, light, and infection. It also regulates body temperature; stores water, fat, and Vitamin D; and senses painful or pleasant stimuli. “It also is an aesthetic organ–it helps you present yourself to the outside world, and it gives important clues about the health of the rest of the body. Often doctors can diagnose underlying medical problems just by looking at the skin,” says Dr. Day.
Each layer of skin performs a different function. The thin outer layer known as the epidermis mostly protects the rest of the body from the environment. The melanocytes, a type of cell in the epidermis, produce melanin. Melanin is a pigment that darkens the skin to protect it from sunlight. The middle layer of skin, the dermis, contains blood vessels, lymph vessels, hair follicles, sweat glands, and collagen. Collagen is the protein that gives the skin strength and resilience. The deepest layer of skin, the subcutaneous layer, is made of fat and collagen cells. It conserves body heat and protects the body’s interior from injury.
Injuries and Treatments
An injury to any of these layers of skin can interfere with its ability to protect the body from infection and harm. It can also result in scars or other disfigurements. Common types of skin injuries include blisters, cuts, scrapes, burns, and bites. These can damage any or all layers of skin, depending on severity. They can come from heat, sharp objects, ultraviolet radiation, rubbing, or excessive pressure.
Choosing one of the new products or treatments available depends upon the type of injury. Consider the following situations:
Instead of using stitches, a doctor can apply skin adhesives to close a wound. Often this is less painful than stitches and hold the edges of the wound together just as well. The adhesive wears off as the wound heals. Adhesive bands also can be placed on top of a minor cut to hold the edges together as it heals.
There are a variety of gels and patches that keep out bacteria and keep a wound moist to allow better healing. Because low-adherent dressings do not stick to the wound, they are more comfortable and promote faster healing. Film dressings consist of a thin polyurethane membrane coated with a layer of adhesive. They let in water and oxygen but not bacteria. This keeps a wound moist and infection-free. Amorphous hydrogels are designed to be used with a secondary dressing to keep a wound moist. Hydrocolloids consist of a gel with a polyurethane or foam backing. Again, their purpose is to keep wounds from drying nut.
Alginates, however, are made from seaweed and are absorbent. They are used on wounds that are releasing a great deal of fluid. Polyurethane foam dressings also are used to absorb blood and other fluids from a wound.
Liquid bandaids permit faster healing and stop the bleeding of minor cuts and scrapes. The liquid bandaid creates a breathable seal that keeps out bacteria and water but keeps in moisture to help healing. It also helps reduce pain and stays on hard-to-cover areas such as finger and elbows. The liquid bandage sloughs off as the wound heals.
Serious burns require a doctor to surgically removed the burned skin and then to protect the exposed tissue. Laboratory-grown skin cells or artificial skin may be used for protection. The artificial skin not only protects the area but also promotes the regrowth of normal skin. It looks like a plastic wrap and consists of two layers. One layer is composed of collagen and a sticky sugar molecule that helps the skin regenerate. The second layer is a flexible silicone sheet that mimics the epidermis. Artificial skin is left in place for two to four weeks. During this time, the patient’s own skin reforms.
To help minimize scars left by a skin injury, doctors now use laser treatments. There are several different types of lasers used to remove different types of scars. The pulsed-dye laser, for example, flattens raised scars and removes redness. The carbon dioxide laser is best for vaporizing and removing shallow scars with irregular borders. Doctors administer a laser using a handheld wand-like device. It focuses an intense beam of light on one spot on the skin. Different wavelengths of light and different intensities are used for different procedures. Usually it takes several sessions with a particular laser to achieve desired results. Experts say it is important to choose a physician who is experienced, in order to get the best results and to minimize discomfort and other adverse effects.
Even with all the sophisticated new treatments available for skin injuries, researchers continue to search for newer and better products. One thing scientists are working on now is improving artificial skin to help heal serious burns. Several researchers are trying to build a new artificial skin that will induce the growth of new blood vessels as well as skin cells in the dermis layer.
Another line of research involves testing a new drug that reduces inflammation and speeds healing of wounds. The drug works by preventing dying cells from killing off live cells, thereby stopping the spread of the injury and reducing swelling and scarring.
Most current research into new treatments for skin injuries focuses on creating an environment that maximizes healing. “Researchers are looking at new enzymes and immunomodulators that help wounds heal,” says Dr. Day. “For example, new types of bandaids do more than just cover and protect. They contain substances to actually make the wound heal faster and minimize scarring.”