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Outdoor First Aid

Cut Yourself in the Backcountry? This Is the Key to Avoiding Infection.

Irrigation is the most important step you can take to prevent a cut from going south.

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Get the latest on treating backcountry illnesses and injuries in our monthly first aid column.

As an ER doctor, I’ve seen wounds treated with a fantastic variety of home remedies, from coffee grounds to turmeric powder and crushed tomato—and once, delicately covered with the thin membrane from the inside of an eggshell. Plenty of interesting choices, but when resources are limited on the trail, the options are a bit more rustic. You’ll eventually slice your calf or skin your knee scrambling up a scree slope this summer, and then wonder how wise it would be to rinse the grime out with your leftover sports drink, or some bourbon, or maybe just river water.

Copious irrigation, especially in wounds contaminated with dirt, grass, or other debris, speeds the healing process and prevents infection. In the past, we’ve heard about using solutions like iodine, hydrogen peroxide, or rubbing alcohol to irrigate wounds. But most of these options have few proven benefits. Specifically, hydrogen peroxide can injure deep tissues and should be avoided (and bourbon is best enjoyed otherwise).

As usual, keep it simple. Any potable water can serve to irrigate an open wound—studies have shown that irrigation with tap water does just as well as sterile solutions at preventing infection. In the wilderness, water disinfected via boiling, chlorine or iodine treatment, filtration, or UV filters can be used to safely cleanse a wound. Pouring it on straight from the river or ocean risks the introduction of dangerous bacteria. 

Large volumes of water work best, combined with the careful removal of visible bits of debris. Plan to use up to a liter of water to irrigate most wounds. Pressure matters too: Something like a plastic bag with a tiny hole cut in the bottom corner can provide reasonable pressure if it’s filled and then squeezed. Holes in the cap of a squeezable plastic bottle provide adequate force as well. Intermittent pulses help to wash away stubborn bits of debris more effectively than a single gush of fluid. 

Once a wound has been thoroughly cleaned, a dry dressing and some antibiotic ointment help to keep things protected. Complicated injuries like burns from campfires or stoves warrant close observation for signs of infection and relatively prompt medical attention. 

The eggshell idea may hold some promise, and has been used as a traditional remedy in Ecuador. A group of researchers recently investigated the usefulness of the membranes in protecting experimental wounds. They discovered that in the first few days, membrane-covered wounds healed faster than untreated controls. Their finding may be an inspiration for drug companies—but seems pretty awkward as I imagine searching through my medical kit for the dozen eggs I stashed in there. For now, I’ll stick with meticulous wound care and plenty of clean water.


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