상처치료 저서- 영어

[한병인]

Preface

In theses days, we can get information on wound remedy through searching the internet. However, those information is limited to the commercialized goods. So it is not easy to find information related to adhesive plaster or gauze which is available at home easily.
Although it is not commercialized goods, many things can be used for wound treatment. Besides, to sterilize the wound is not necessary and gauze is mendatory, either. Anyone can treat the wounds well with basic knowledge on wound remedy. The purpose of this book is to prevent a disaster like the child’ burn I treated in the past with not the consumer goods but materials which are available anywhere. Therefore, I introduced dressing methods using plastic(vinyl) wrapper and kitchen plastic wrap and various emergency first aid.
I hope this book will be helpful as a guideline for wound treatment when yourselves, family and friends have an injury and recommendable to your acquaintances until a better book written by a treatment of wound expert will be published.

p. 9
Wounds Remedy
Contents

Skin PART 1
① Cross Section Structure of Skin 15
② Various Structure of Skin in Body Sites 16
③ Keratin Layers 18
④ Drugs Absorbed into Skin 19
⑤ Skin Aging 20
➅ Dirt, Keratin, Dandruff 22
➆ Keratin Layers and Scales 24

Wounds PART 2
① The Definition and Kinds of The Wounds 26
② Acute Wounds and Chronic Ones 27
③ Assortments of The Wounds Depending on The Causes 28
④ Bedsore 30

Wounds Remedy PART 3
① Remedy Types of Shallow Wounds 34
② Cure Types of Deep Wounds 36
③ The Course of Second Agglutination 38
④ Treatment Process of Deep Wounds Based on Time 39
⑤ Care Types of Acute Wounds and Chronic Ones 39

p. 10

Wounds Treatment PART 4
① The Principles of Wounds Remedy 43
② The Order of Wounds Remedy 44
③ A First-Aid Kit for Wounds Remedy 46
④ My Own First-Aid Kit 50
⑤ Correcting The Wrong Common Sense on Wounds Remedy 51

Stopping Bleeding PART 5
① Pressure 54
② Lifting Bleeding Site 55
③ Tourniquet 56

Cleansing PART 6
① Cleansing The Wounds with Water or Saline Solution 59
② Spray Cleansing 60
③ Cleansing with Soapy Water 61
④ Sterilization 62
⑤ Other Sterilization Solutions 64

Wounds Dressing PART 7
The Definition of Dressing 68
The Materials of Dressing 69
① Gauze 69
② Adhesive Tape 80
③ Plastic Film 84
④ Hydro Colloid 86
⑤ Transparent Film 89

p. 11

The Other Wounds Care PART 8
① Scalp 93
② Finger 94
③ Knee 96
④ Ankle 98
⑤ Arm 99
➅ Burn 100

The Wounds Bitten by Animals PART 9
① Dog 109
② Snake 110
③ Bee 112
Surgical Cure PART 10
① The Effects of Wound Closure 116
② Pressed Wounds(Crushing Injury) 118
③ Severed Fingers 119

Other Skin Problems PART 11 ① Keratin of Heels 122
② Finger Agnail 122
③ Lip Crack 123
④ Oral Ulcer(aphthous ulcer) 124
⑤ Cellulitis 128
➅ Athlete's Foot(ringworm) 128
➆ Retrocalcaneal Bursitis of Elbow 129

p. 12

Examples of Injury Treatment PART 12
① Adhesive Dressing 132
② Band Dressing 133
③ Plastic Film Dressing 134
④ Furunclesor boils 136
⑤ Injury Bitten by a wasp 138

p. 13

Part 01
Skin

󰊱 Cross Section Structure of Skin
󰊲 Various Structure of Skin in Body Sites
󰊳 Keratin Layers
󰊴 Drugs Absorbed into Skin
󰊵 Skin Aging
󰊶 Dirt, Keratin, Dandruff
󰊷 Keratin Layers and Scales

p. 15
① The Cut End OF Skin Structure

picture 1
각질층: horny layer, 표피: layer of the skin,
진피: the thick skin(true skin or inner skin)
피하조직: subcutaneous tissue

Skin is composed of the three layers, layer of the skin, thick skin and subcutaneous tissue. The layer of the skin is the thinnest and its thickness is 0.1-0.2mm. The thickness of an eyelid is 0.04mm and that of a palm is 1.6 mm. The layer of the skin prevents external materials from intervening as well as keeps moisture.
The thick skin is generally 0.5-4 mm, 15-40 times thicker than the layer of the skin. It is actual skin which gives tension to the skin, prohibiting the skin ripping. It is the thick skin of animal that we make use of leather.
The subcutaneous tissue provides skin with nutrition and also serves as a cushion. We cannot distinguish the thick skin from the subcutaneous tissue clearly.

p. 16

② The Various Structure of Skin in Body Sites
picture 1

Sole

When you step rough surface, you feel good rather than pain.

picture 2
The skin of the sole is the thickest in our body, especially its horny layer is thick.

picture 3

Eyelid

The eyelid tears easily when you have a boxing race.

picture 4
It’s because the eyelids don’t have the subcutaneous tissue functioning as a cushion. The skin of man’s sexual organ and scrotum don’t have subcutaneous tissue.

p. 17
picture 1

Head

The scalp doesn’t have an abrasion easily.

picture 2
It’s because hair protects the scalp.

p. 18
③ A horny layer
A horny layer coats the skin smoothly, on account of that, it keeps moisture of the skin. Consequently, it protects the skin from severe damage due to the its softness.

picture 1
각질층: horny layer
Palms and soles have the thickest horny layer.

picture 2
After in the water for a long time, you can find your palms and soles wrinkled. It’s because the horny layer absorbs water.

picture 3
In-mouth is covered with the skin called an inna(mucous membrane) that doesn’t have a horny layer. It doesn’t swell with water. Besides, chemical substances can pass through it.

picture 4
국소마취제 local anesthetics

When the local anesthetics is applied on your lips, they are dull since the lips are anesthetized.
p. 19
④ The Drugs Absorbed into the Skin.
picture 1

키미테: Kimite(patched preventive medicine for travel sickness)

After you patch a preventive medicine for travel sickness under the ear 4 hours later, you can get the efficacy of a medicine. Its effect sustains for 3 days. And you may get the side effect from patching it continuously. The drug components of these kinds of medicines are absorbed via sebaceous glands, sweat glands and hair follicles or through horny layers and cuticle layers. Although the speed of being absorbed is very slow, its efficacy of a medicine lasts long. These drug ingredients are rarely absorbed on the palms and soles where their horny layers are thick and absorbed well on the faces and the women’s genitals where their horny layers are thin. On the mucous membrane where is no horny layer, the absorbtion is done very well.

p. 20
⑤ The Skin Aging
The skin is stripped and bruised with a slight bumping as the skin aging.

picture 1.

Young Skin

picture 2.

Aged Skin

표피-진피 경계 the border between the cuticle and thick skin

With the aging, the border surface between the cuticle and thick skin gets flat. As a result of it, the bonding strength gets weak and the thickness between thick skin and subcutaneous tissue becomes thin.

p. 21
picture 1
The skin of old people’s shanks and the back of the hands are thin and glossy.

picture 2.
Using lots of steroid ointment restrains the activities of cells. It makes the skin just like aged one.

p. 22
➅ Dirt, Dead Cell and Dandruff

Fingernails are a deformation of horny layers. They are replaced in every 6 months completely. Ordinary skin is weak acidity(PH 4.5ㅡ6.5) and it’s because the skin protects itself from outer matters or bacteria. The skin changes alkali with using soaps a lot. In consequence of it, the skin resistance decreases.(Soaps are originally alkali.)

picture 1.
죽은 세포: dead cells, 표피 세포: epidermal cells
The epidermal cells are made around the thick cells, forced out continuously, and die after a month.

picture 2

Dirt

When we rub our skin in a bathroom, horny layers peel off. We call them “dirts.” We feel refresh when we rub our skin because of massage effect. In conclusion, we don’t need to peel out the horny layers that protect our skin from others.

p. 23
picture 1

Keratin

picture 2

Scurf

The keratin is dead epidermal cells which cling to the outside of the outer layer of the skin. The scurf is keratin chipped off.

p. 24
➆ The horny layer and Scales
When you don’t wash your body for a long time, the horny layers attach to your body. So it seems to be scales.

picture 1

Horny Layers

The shards of the reptiles are thickened horny layers. The drumsticks and rat tails also have them.

picture 2

Shards

The shards of fish are in the true skin layers.

p. 25
PART 2

Wounds
󰊱 The Definition and Classification of the Wounds
󰊲 The Acute Wounds and The Chronicle Ones
󰊳 The Sorts of Wounds Depending on the Causes
󰊴 The bedsore

p. 26
① The Definition and Classification of the Wounds
We call the ruptured skin a wound or a cut. According to the causes and the shapes, we divide the hurts into an abrasion, a torn wound, a cut, a burn and a bedsore. Besides, we categorize all of the wounds into the acute wounds and the chronic ones, depending on the aspects of the formation and recovery of them. We also have the other classification but this book covers only injuries could be treated at home.

p. 27
② The Acute Wounds and The Chronic Ones
“Acute wound” is a hurt which is healed without any problem, on the other hand, “chronic wound” is a hurt which out of ordinary healing process. The former generally starts from the damage of skin surface by a hard and sharp things. But the latter begins at the damage of the deep skin and spreads on the skin surface slowly like a bedsore.

picture 1

Acute Wound

Chronic Wound
picture 2
The difference can be compared to like this. “Acute wound” is just like a
asphalt road digged on the road surface, “chronic wound” is a road falling down at the underground.
In case of “acute wound”, the injury of the skin and subcutis is cured with the proper treatment and time. On the contrary, “chronic wound” is rarely recovered normally regardless of active cure. Make matters worse, the period of abrasion sustains long and epithelialization delays by the chronic stimualtion, ischemia, foreign materials and bacterial infection.

p. 28
③The Sorts of Wounds Depending on the Causes
For the people’s easy understanding, the mode below was made after boiled pork slices.

picture 1.
Abrasion

표피: the cuticle 진피: thick skin
피하조직: subcutaneous tissue, 근육: muscle
Just the outer cortical layer is damaged. Only dressing is enough.

An abrasion is chipped off outer layer of the skin. It has bleeding and exudate. It can be recovered with good dressing.

picture 2.
Torn Hurt

표피: the cuticle, 진피: thick skin, 피하조직: subcutaneous tissue
The thick skin and the husk are separated. It should be sewed.
The cuticle and the thick skin are torn together. It is a deep gash. It can’t be cured without suture.

Cut
picture 3.
The thick skin is damaged, therefore, the wound has a crack. It is difficult to be healed without sealing.

p. 29

Burn
picture 4.
The union of the cuticle and thick skin layer is ruined and serous fluid
stagnates with blister. The cuticle layer dies and breaks itself from the skin, its state is same to that of abrasion.

Bedsore
picture 5
When our skin is pressed for a certain time longer, it begins to impair from the subcutaneous tissue owing to blood circulation degradation. The cells of the true skin which draw out blood supplies from superficial fascia die. Then the cells of the outer layer of the skin die.

p. 30
④ A bedsore
picture 1

Principles of Forming a Bedsore

pressure shear friction

It is a reason of tearing skin that pressing force and friction are working together.

picture 2 picture 3
If the blood vessel of true skin and subcutaneous tissue are expanded or ripped by its being pushed, the cells of superficial fascia die then it develops into bedsores.

p. 31
picture 1

High Occurrence Frequency Sites of Bedsore

견갑골 Scapular 대전자 Greater trochanter 천골Sacrum, 뒤꿈치 Heel
In the above picture, the red sites are the highest bedsore’s occurrence frequency and yellow ones are the second site.

p. 33 The Cure of Wounds
󰊱 The Healing Ways of Flesh Wounds
󰊲 The Remedy Manners of Deep Gashes
󰊳 The Process of The Secondary Healing
󰊴 The Course of Treatments as Time Goes by
󰊵 The Recovery Methods of Acute and Chronic Injuries

p. 34
The flesh wounds are cured by epithelialization and the deep gashes are healed through inflammation, proliferation and maturation.

① The Healing Ways of Flesh Wounds
The flesh wounds includes abrasion and second-degree burn, and they are healed with the growth of epidermal cells like the picture below.

picture 1 털: hair, 삼출액: exudate 표피세포: epidermal cells, 모낭: pilar cyst
A part of the epidermis is chipped off. The exudate comes out and keeps the wounds from the germs, then it makes a damp circumstance where new cells can develop easily.

p. 35
picture 2 삼출액: exudate 표피세포: epidermal cells, 모낭: pilar cyst
The epidermal cells bring up from the pilar cyst and the epidermis layer to fill the injured site.

picture 3 딱지: scab
When exudate dries, it becomes a scab. The epidermal cells fill the hurt, going forth into among the scabs. In case that you cover the injury in order for exudate not to dry, the scar heals up faster. If you remove the scab before the epidermis grow, the exudate comes out.

picture 4 딱지: scab
When epidermal cells grow enough and cover the scar fully, the scab separate away automatically.

p. 36
② The Remedy Manners of Deep Gashes

The deep gashes are healed with the 3 ways below.
① Primary healing(primary intention): It is a way of seaming damaged skin immediately.

picture 1 일차 유합(Primary Healing)
The wound can recover faster with stitching the wound and close adhesion due to omitting contraction course. After 48 hours of suture, the wound may be wet with water because the epidermal cells grow up and they coat the skin.

picture 2
Generally, we remove the stitching fiber after 2 weeks later. The scar begins at the site where the stitching fiber is, therefore you may get rid of it earlier to prevent the scar.

p. 37
② The secondary healing(secondary intention): It is a method of cure of all opened layers can be closed by the contract and epithelialization without closing the wound.
③ The third healing or delayed primary healing: It is a method of cure in case of unclean hurt. You should clean the wound and dress it for 3~4 days in open condition to prohibit infection. Then when it is clean, the hurt can be seamed.

picture 1 이차 유합 Secondary healing
The fiber mother cells spread the fibers, narrowing the chasm of the wound.
섬유모세포: fiber mother cells
picture 2 흉터: scar
The scar happens in the last chasm of the wound, the skin is weaker than the normal one. Because it doesn’t go back to the original state.

p. 38 The Process of Secondary Healing

Secondary healing is a type of remedy. It can be done in the state of the damaged skins’ not touching each other. In the situation, connective tissues grow up from the deep hurt and fill the wound. In the course, the wound not only shrinks but also becomes epithelialization. It is secondary healing.

01) picture 1
The blood clot fills the vacant space.

02) picture 2
The granulation tissues fill the empty site. The epithelial cells grow up and
they form scabs.

03) picture 3
The wounds are contracted by myoblasts.

04) picture 4
The granulation tissues become hard, organizing the original form. Then the scar tissues form with epithelial cells.

The granulation tissues are composed of endothelial cells, fibroblasts, collagen and extracellular matrix. These cells and materials thrive and fill the defects. Then the hurts recover.

p. 39
①~③ 생략

⑤ The Remedy Modes of Acute and Chronic Injuries
Among the acute injuries, the wound that doesn’t have skin defect is cured with primary healing. But the chronic hurts is healed with secondary healing. They are principles. In primary healing, open skin attaches first and then deep tissues does. On the contrary, in secondary healing, the skin attaches after the tissues grow from deep sites.

p. 42
Part 04 Wound Remedy
󰊱 The Principles of Wound Remedy
󰊲 The Order of Wound Remedy
󰊳 A First-Aid Kit for Wound Remedy
󰊴 My First-Aid Kit
󰊵 Correcting the Wrong Common Sense for Wound Remedy

p. 43
① The Principles of Wound Remedy
· The order of wound remedy is stopping of bleeding, cleansing and
dressing.
· You should make a moisturized circumstance to make epithelial cells grow.
· If you have hurts on the several sites, you should treat the most contaminated one at last.
· When a healthy person have a small hurt, the treatment doesn’t need to be aseptic, but clean. That’s enough.

p. 44
② The Order of Wound Remedy

Stopping Bleeding
01) picture 1.

Cleansing
02) picture 2.

Suturing
03) picture 3.

Dressing
04) picture 4.

p. 46 ③ A First-Aid Kit for Wound Remedy
The items for a first-aid kit for wound remedy are below.

1) The Things for Stopping of Bleeding
· a wide string(the length should be for tying a thigh.)
· a stick stopping of bleeding
· rubber band and tongs(finger’s stopping of bleeding)
· vinyl package or poly glove(preventing the hand from being dirty with blood)

2) The Items for Cleansing
· water bottle(wide mouth of the bottle for an easy putting water)
· an injector(the sterilization is not necessary.)

3) The things for Dressing
· an adhesive tape · a pair of tweezers(a pincette)
· a bandage · a pair of scissors
· gauze(2x2 and 4x4) · Vaseline ointment

* As sterilization is rarely needed for wound remedy, an antiseptic solution is not necessary for a first-aid kit.

p. 47
picture 1
The photo below is a big first-aid kit(left) and a small one(right) for sale.

p. 48
picture 1

A Big First-Aid Kit

❶ gloves: They prohibit not only gems from adhering on the wound but also the blood from sticking on the curer’s hands.
❷ Ardocain gauze: It is a dressing material that is gauze that is applied ointment.
❸ a pair of tweezers(a pincette)
❹ a thermometer
❺ a pair of scissors

The photo below is a scene where the above board is separated from the firstㅡaid kit box.

❶ KB care: hydro colloid dressing material
❷ two bottles of liquid: It is used for putting saline solution for wetting gauze or cotton.
❸ absorbent cotton
❹ an eye bandage
❺ Povidin-iodine
❻ oxygenated water
❼ a sticking plaster
❽ ethanol
❾ elastic bandage

p. 49 picture

A Small FirstㅡAid Kit.

❶ Ardocain gauze: It is a dressing material that is gauze which is applied ointment.
❷ two bottles of liquid: It is used for putting saline solution for wetting gauze or cotton.
❸ gloves
❹ sanitary cotton
❺ tongue depressor
❻ a pair of tweezers(a pincette)
❼ a pair of scissors
The photo below is a scene where the above board is separated from the firstㅡaid kit box.
❶ a adhesive plaster
❷ band
❸ elastic bandage
❹ Povidin-iodine
❺ oxygenated water

④ My First-Aid Kit
This is my(the writer’s this book) first-aid kit in his house.
❶ a sticking plaster
❷ bandage
❸ a pair of tweezers(a pincette)
❹ a pair of scissors
❺ injector
❻ Vaseline ointment
❼ Antibacterial ointment

※ What is the reason that there isn’t antiseptic solution in the first-aid kit ?
Becasue wond remedy doesn’t nearly need sterilization.

p. 51
⑤ Correcting the Wrong Common Sense for Wound Remedy

Ⓠ Is the cure faster, if you dry the wound?
A. No. It’s faster in the moister circumstance.

Ⓠ Is the healing faster when you disinfect the hurt?
A. No. Applying the antiseptic on the hurt hinders the hurt from getting well. Because the antiseptic kills not only germs of normal skin around the hurt but also epithelial cells which comprises the skin or the fibroblast that constructs granulation tissues.

Ⓠ Shouldn’t the wound be reached to water?
A. No. It doesn’t matter. It is no problem to touching with water the directly. The wound with water may be wiped or dried. Additionally, you can remove the moisture. You may wash the eschar or exudate with water.

Ⓠ Should the gauze be changed every day?
A. No. You should change it when the surface of the gauze is wet with exudate from the wound. But when it is “red period” of bedsore, you had better not change it everyday. It’s because the epithelial cells come out with the gauze when you change the gauze to a new one. However, you had better change it in “yellow period” of bedsore, because the period has a lot of exudate.

Ⓠ Should antibiotic or tetanus injection be needed?
A. No. Antibiotic isn’t needed under the condition of good antiseptic.
Especially, the antibiotic injection is not needed. When antimicrobial injection or medicine are prescribed in a hospital, you should check whether it is necessary or not. Since it is rare that tetanus injection is
needed, you had better confirm‎ it again.

p. 53 PART 5
Stopping Blood

󰊱 Pressure(press)
󰊲 Lifting high
󰊳 Tourniquet

p. 54
① Pressure(press)
picture 1 Press the wound directly. It usually stops after 10 minutes, unless it is arterial rupture.
picture 2 Press the wound with wearing vinyl gloves not to put the blood on your hands.
picture 3 You had better press the hurt with covering gauze on top of the wound for protecting it.
picture 4. In case of the scalp, press it longer than any other sites because the scalp has a lot of blood vessels. Consequently it has much blood loss from many. You had better sew the fissure on the scalp.

p. 55
② Lifting High
picture 1 Lift the bleeding spot higher than the heart. It should be continued until the treatment starts.

picture 2. The bleeding decreases owing to the heart beat's declining, when you lie with calm mind.

If the bleeding doesn't stop with pressure or lifting high after 30 minutes, It is high possibility that the thick artery is damaged.

③ Tourniquet
picture 1. 2 First, bind the wound with a wide cloth, and tighten it with a stick. Then, fasten the wound with adhesive tape or strings.

picture 3. 4 You should tie the tourniquet on the elbow or knee for prohibiting the blood shedding.

Distal parts of the limbs from the hemostatic bandage may undergo necrosis if the bandage is too tightened or the duration prolonged. You should go to the hospital fast and should not untie the tourniquet before you arrive at the hospital.

When you are bitten by a snake, you should the tourniquet loosely. Just blocking the vein circulation is needed.

picture 5. 6. 고무 밴드: rubber band 집게: tongs

The rubber and tongs are for fingers.

p. 57 PART 06

Cleansing
󰊱 Cleansing with Water and Saline Solution
󰊲 Spray Cleansing
󰊳 Cleansing with Soapy Water
󰊴 Sterilization
󰊵 Other Disinfecting Fluid

p. 59 ① Cleansing with Water and Saline Solution
Both of clean water or saline solution are used for cleaning hurt. Saline solution can decreases pain. In case of severe contaminated wound, soapy water or disinfecting fluid is used.

picture 1. Make the gauze wet with clean water or saline solution and wipe the hurt.
picture 2. Wipe the wound from the inside outward not to contaminate
it.
picture 3. The scene where the wound is wiped with sanitary cotton wet with saline solution.
picture 4. Making saline solution.
The saline solution is made with 1 liter of water, 9 grams(2 tea spoons) of salt.

p. 60 Spray Cleansing
picture 1 Spray saline solution with an injector. It is ineffective to pour it on the hurt directly.

picture 2. Clean deep site of the wound surely.

* In deep site of the wound, the germs that live a place where is without oxygen can breed. Clostridium tetan and pseudomonas aeruginosa thrive more actively without oxygen.

picture 01. Remove the needle.
picture 02. Fill the injector with water or saline solution.
picture 03. Clean the deep site of the wound with the injector.
picture 04. You may use saline solution sap bag and set.

p. 61 ③ Cleaning with Soapy Water
You had better clean the contaminated wound with soapy water after cleaning with water. Pseudomonas aeruginosa, clostridium tetan and a rabies virus are washed well with soap because they are coated with capsules that have lot of fat.

picture
녹농균: Pseudomonas aeruginosa 파상풍균: tetanus bacillus
광견병 바이러스: rabies virus

p. 62 ④ Disinfection
Wash the contaminated wound with antiseptic solution

1) 10% Povidone-iodine(Betadine Undiluted Solution)
Among the antiseptic solutions, Povidone-iodine is the most used. It sells in 10% solution, its original purpose is to sterilize the skin around the hurt. As goods, Potadine and Betadine, are on sale. Applying 10% Betadine undiluted solution on the wound directly kills living cells as well as germs.
picture 1 picture 2 picture 3

p. 63
2) 1% Povidone-iodine Diluted Solution
10% Betadine undiluted solution is needed to dilute for 1% solution through 10 times of dilution. It is for inside of bedsores, making an effect with dry. You had better wash the Betadine with saline solution a certain time later, after sterilization. As the diluted solution also may be stimulating for living cells.

picture 1.
❶ saline solution
❷ 1% diluted solution
❸ 10% Povidone-iodine
The 1% diluted solution in the middle bottle is made from 20cc of 10% solution and 180cc of saline solution.

p. 64 ⑤ Other Disinfecting Fluid
그림1.
❶ 1% Potadine
❷ Benzalkonium choride solution
❸ 3% hydrogen peroxide
❹ saline solution

Tip * Benzalkonium choride solution and zephanon have weak sterilizing power, but they are used for infants because they are hypoallergenic. They should not be touched with mucous membrane.
* “3% hydrogen peroxide” is not used for cleansing the wound. It is for removing blood around the hurt or on the clothes.

p. 65 picture 1.
❶ boracic acid
❷ zephanon
❸ 3% hydrogen peroxide

Tip * Boracic acid antiseptic solution is dissolving boric acid in water.
Its disinfective power is feeble, but it is hypoallergenic. That is the reason
why it is used frequently in ophthalmology.
* “Chlorhexidine and hibitan” have the similar sterilizing power to alcohol,
but their effect lasts longer than alcohol. Because of that, they are used in
dentistry and for gargling.
* Alcohol is for skin sterilization, before you give a patient a shot. Because it
dries fast. You had better not use alcohol for wound disinfection, since it
causes pricking when it touches the hurt.
* “Mercurochrome” is not used any more. Mercury it has contained was proved dangerous.

p. 67 PART 07

Wound Dressing
󰊱 Gauze
󰊲 Adhesive Plaster(tape)
󰊳 Plastic Film
󰊴 Hydrocolloids
󰊵 Transparent Film

p. 68 The Definition of Dressing
picture 1 dressing=clothe

A word, “dressing” means a clothe, covering a thing as well. Likewise, “wound dressing” means protecting the hurt with covering it. Its primary purpose is to keep the wound from physical impact or stimulation and to prevent it from outer foreign material and germs’ permeation. In addition, the purpose includes epithelial and granulation tissues’ growing through maintaining moisture on the meeting site of dressing and wound.

picture 2. cells
The wound dries and scab comes out without dressing. As a result of it, in the circumstance cells can’t live well.

picture 3.
The wound get well soon in a wetting environment where the hurt doesn't dry, leading the cells to breed.

p. 69
Dressing Materials
The popular dressing materials are the items below.

① Gauze
② Adhesive plaster, Tape
③ Plastic Film
④ Hydrocolloids
⑤ Transparent Films

① Gauze
It is the most used absorbing dressing. Its merit is to be cheap and have various sizes. Additionally, it has high absorbing power for secretion of hurt that has a lot of percolate. Gauze is used as the first dressing for the wound which has much transudation. And it is also used as the second dressing for covering it. Its demerit is making the wound dry and having no defensive power for gems from outside. In addition, it adheres to the hurt, therefore it is difficult to get rid of it.
The exchange time of gauze is depending on the condition of the gauze and the wound. Too frequent change damages to epithelial tissues. You may detach the gauze after wetting it with water or physiological saline solution in a certain time when the wound is dried on the gauze.

p. 70 Ways of Gauze Dressing
(1) Dry Dressing
It is a way of covering the hurt with dry gauze. This is for an emergency or too mouch exudation of wound only.

(2) Wet-to-dry(moist-to-dry) Dressing
It is a way of covering the wound with gauze wet with physiological saline solution, and detaching the gauze when it is dry. Firstly, soak gauze in the physiological saline and take out it. Secondly, wait until the saline solution doesn’t drip any more. Thirdly, use it. Cover the hurt with second dressing such as transparent film after covering the wet gauze.

(3) Wet-to-wet(wet-to-moist) Dressing
Cover the wound with gauze soaked in physiological saline solution and exchange it with wet one before it dries. The second dressing is required. It is needed to exchange the gauze, maximum 3 times in a day to sustain a wet condition.

p. 71
2) The Kinds of Gauze
picture 1. · 2X2 gauze, 4X4 gauze
picture 2. big gauze [=burn gauze]
picture 3. roll gauze: It is used to wrap the gauze to prevent it from slipping after dressing gauze on the arm, leg and head.

p. 72 3) The way of Taping

The Method of Attaching Tape

· Cut a tape in advance.
· Attach the tape to the edge of the gauze, making an angle.
· Stick the short tape on the gauze, separately.

The Method of Detaching Tape

· Detach it slowly.
· Detach it in direction of being hairy.
· In case of detaching, except for the part of the tape attached skin.

(1) The Method of Attaching Tape

Cut a Tape in Advance.
picture 1. 01

02

Attach the tape to the edge of the gauze, making an angle.

picture 2.

A Good Way

It doesn’t detach easily under a condition making an angle between the edge of gauze and tape.

picture 3.

A Wrong Way

tape tension
The tape detaches easily owing to tape tension when it is attached roundly. In this case, the skin and be damaged.

p. 73 03

The Short Tape is Better.

A Good Way
picture 1.
Attach “short” tapes separately.

A Wrong Way
picture 2
“Long” tapes are detached easily.

04

The Reason Why We Attach the “Short” Tapes.

picture 3.
If you attach short tapes,
↓
the gauze expands and tapes are not pushed.
↓
←밀리는 방향: direction of being pushed
the tapes don’t detach.
← 밀리는 방향: the direction of being pushed

picture 4.
If you attach long tapes, ←

tapes are pulled.
↓
← 밀리는 방향: the direction of being pushed

The tapes separate
← 밀리는 방향: the direction of being pushed

p. 74
(2) The method of Detaching tape
The way of detaching tape for protecting skin.

01.

Detach the Tape Slowly.

※ Detaching is easier with a pincette.
picture 1. picture 2

02.

Detach in Direction of Being Hairy.

↗ 털이 서는 방향: direction of being hairy

picture 3

Hair on the skin has a direction of being hairy.

p. 75
picture 1.

A Good Way

털이 서는 방향: direction of being hairy
Detach the tape in a direction of being hairy. Pulling it in a bigger angle than 120˚, soaking the site between tape and skin with sanitary cotton wet with water.

picture 2

A Wrong Way

반대 방향: the opposite direction
The patient may develop folliculitis when it is taken off in the opposite direction.

03

In case of taking from the tape, leaving some parts of it

picture 3 When the tape is removed and if there is a possibility that a part of the skin separate with the tape because the skin is so weak.
picture 4 Cut it except for the part of the tape attached the skin. Attach a new tape on top of the remaining one.

p. 76
4) The Time of Exchange Gauze

picture 1
ä It is required to exchange the gauze when a exudation comes out of the
gauze. Because the germs can reproduce in the wound through the gauze.
ã It is recommend to write the date of having attached the gauze. It is helpful for you to know the time of exchange.

p. 78
5) Ointment Impregnated Gauze
It is gauze applied with ointment to compensate for demerit of gauze.

picture 1. Gauze applied with ointment keeps the transudate clinging to the gauze as well as the hurt from drying.

Ointment for Ointment Impregnated Gauze

picture 2 picture 3
Vaseline ointment is good for not having antibiotic.

picture 4. Vaseline impregnated gauze
picture 5 Nitrofurazone ointment impregnated gauze

p. 79

Examples for Using Ointment Impregnated Gauze 1

picture 1. An abrasion made by a dementia patient’s scratch on his or her own chest.
picture 2. Cover the wound with gauze applied nitrofurazone ointment.
picture 3. Cover on it with dry gauze. Plastic film(vinyl wrapper) can be used instead of dry gauze, too.

Examples for Using Ointment Impregnated Gauze 2

picture 4 A scab formed from dry necrosis tissues on the surface of a chronic hurt(bedsore).
picture 5. First, cover the wound with ointment-applied-gauze.
Second, cover on it with closing dressing.
Third, The scab gets soft. Gauze wet with saline solution can be used instead of ointment.
picture 6 The scab can separate easily when it becomes soft and suppuration site arises between the scab and skin.

p. 80
② Adhesive Plaster
Adhesive plaster can be attached directly on the small and superficial hurt. But if the patient has a diabetes or his or her whole body is in bad condition, this way should not be followed.

1) Kinds of Adhesive Plaster
① plastic ③ silk
② cotton ④⑤ paper

Cotton Adhesive Plaster

“cotton bandage” is the most used one.

p. 81
2) Adhesive Plaster Dressing
An adhesive bandage separates easily when it is adhered to the wound directly.

picture 1
I attached an adhesive bandage on the abrasion directly and detached it after 3 days. It is detached easily from the wound without its clinging to the hurt.

3) Shin Abrasion

Development of 3 Days After Having Injury

picture 2
01 picture 3, 02 picture 4, à 03 picture 5 à 04 picture 6
① Blood and transudation come out of the abrasion
② “cotton adhesive tape” was attached.
③ I detached the tape after 12 hours.
④ The hurt was cured completely 3 days later.

p. 82
4) An Agnail
picture 1
An agnail is healed with plaster tape attached after 3 days.

5) Disposable Band
A disposable band which is ointment is applied on the surface of gauze has better effect. In the picture, it is antibacterial ointment. However, Vaseline (ointment) is more effective than that.

picture 2 picture 3

p.83
6) Folliculitis

picture 1
Folliculitis develops on the shin.

picture 2
Cotton adhesive plaster is attached on top of the folliculitis site directly. When it is detached 2 days later, pustule of hair follicle is open and comes out.

7) Finger Abrasion
picture 1 The thumb has an abrasion.
picture 2 The sticking plaster is applied on it directly.
picture 3 The adhesive plaster is removed after 3 days. The wound is healed.

p. 84
③ Plastic Film
“Plastic film” means “plastic film bag” we can see easily in our lives.
First, cut the plastic film bag depending on the size of the wound.
Second, wash it with clean water and wipe or dry it up.
Third, stick the adhesive plaster to the corner of the plastic film.
Fourth, attach it on top of the hurt.
Its demerit is that it can’t absorb exudation and exchange gas. For that reason, soon after the percolate has water, the film should be exchanged. It is should be a little bigger than the hurt size and changed frequently in order to prevent the skin around the wound from festering. It is not good for the wound that has much exudation.

picture 1 Abrasion on the shin is dressed with plastic film, changed for a new one every day.
picture 2 The wound has cured 5 days later.

p. 85
I tumbled, while I was standing on my hands beside a pine tree. In the course, I got a scratch on my torso with being scratched by trunk of the tree. My top was stripped off because I stood upside down. As a result of it, abrasion came up on the skin. Through the dressing with plastic film everyday, I recovered 7 days later so much as that I didn’t need it any more.

picture 1 01
abrasion on the right torso. It was very pricking owing to the wide hurt. Early dressing can decrease the pain. Washing and sterilization were not required because of the clean wound.

picture 2
02 plastic film dressing. I covered the wound with plastic(vinyl) bag and attached it to the wound with adhesive plaster after washing it with water and drying. 1 day later, percolate came out and smelled so I changed the dressing everyday.

picture 3
03. 7 days, the wound was cured. So dressing was not necessary any longer.

p. 86
④ Hydrocolloid

picture 1
Hydrocolloid is a kind of absorbent and sealed dressing and it lasts 3~7days.

picture 2 picture 3
Hydrocolloid dressing is used a lot for abrasion on the face.

p. 87

Examples of Hydrocolloid Use 1.

picture 1. 01 Abrasion on the face
picture 2 02 Hydrocolloid of same size of the wound is attached to the hurt.
picture 3 03 It was detached 3 days later. The dressing was not required any more owing to the cure was complete. It’s better to prolong the dressing period additional 3 days if you want to keep off a scar.

p. 88

Examples of Hydrocolloid Use 2.

picture 1 The first dressing is made with coloplast.
picture 2 The first dressing is covered with plastic(vinyl) and fixed with adhesive tape since coloplast may separate easily.
picture 3 Mediform-B(Medium-B) 20X20 is for first dressing.
picture 4 Superfix is attached on top of the Mediform-B.
picture 5 Mediform-B 2 X 20 is used for the dead space or packing cavity.
picture 6 Mediform-B 2 X 20 is being inserted into the dead space.

p. 89
⑤ Transparent Films
Transparent Film is a unabsorbent and adhesive polyurethan film. “unabsorbent” means to pass oxygen but not to pass moisture and germs. The film doesn’t absorb exudate, therefore it is suitable for the wound which has a little exudation. Besides, the proper volume of percolate makes wetting circumstance. It is used in the 1-2 level of NPUAP or the 3 level of bedsores of the epidermis formative period. It lasts 3 days.

picture 1 AlDerm roll
picture 2 Tegaderm

p. 91
Part. 08

Other Wounds Treatment

󰊱 Scalp
󰊲 Finger
󰊳 Knee
󰊴 Ankle
󰊵 Arm
󰊶 Burn

p. 93
① Scalp
In case that you can’t attach an adhesive plaster on the hurt directly, because of the hair, you may attach sticking plaster on the hair. You may use bandage or towel as well.

Using Hair
01
picture 1. It is impossible to attach a sticking plaster due to the hair.
picture 2 Put the hair on top of the gauze.
picture 3 Attach the hair to the gauze with adhesive plaster.

02
Bandage

picture 4 After enclosing the head with bandage once, take a turning in the shape of ㄱ. Then wrap on the head with the bandage a time.
picture 5. Wrap the head with the bandage again and attach the adhesive tape to the bandage. It is used in hospitals.

03
Towel

picture 6 Bind the head with towel and then fix the towel with bandage.

p. 94
② Fingers

01
Narrow Bandage

Narrowㅡwideㅡbandage is used for dressing on fingers.

picture 1 In case of fingers, the dressing can come out easily.
picture 2 Bisect the end of the bandage.
picture 3 Bind the wrist with the bandage. The dressing doesn’t come out.

02
Using a Side Finger

picture 4 벤 상처- a cut wound
picture 5 Fingers move very much. Dressing with side finger makes the wounded finger more comfortable.
picture 6 Leaving a thumb and index finger is better for use.

p. 95
03
Finger Crush Injury

picture 1 The wound is swollen much and painful. Since the finger is damaged widely and capillary vessel is destroyed a lot.
picture 2 After dressing the wound, fold an aluminium splint or a piece of thick paper like the picture.
picture 3 Surrounding the finer with the splint.
picture 4 Fix the splint with adhesive tapes
picture 5 Encircle the splint with bandage.
picture 6 Lifting the wound high decreases pain.

p. 96
③ Knee
picture 1 The dressing on the knee can drop easily because knees move much.

01
Gauze

picture 2 Put the dressing on the knee while it is bending.
picture 3. The dressing isn’t adhesive tightly to the knee but it doesn’t drop when the knee is straightened. Enclose the knee with bandage or
elastic bandage in order not to the gauze separate from the wound.

p. 97
02
Roll Gauze

picture 1 Wind the bandage, leaving the both ends coming out.
picture 2 Bind the both ends of the bandage.

03
Elastic Bandage

picture 3 Begin to wind the elastic bandage on the higher part than the knee.
picture 4 Wrap the knee downward.
picture 5 Finally, fix it with the adhesive tapes.

p. 98 ④ Ankle
picture 1 01 Begin to surround the ankle with elastic bandage.
picture 2 02 Swathe the ankle toward the end of the foot with the bandage. Add some force in order not to interrupt vein’s and lymph’s flow.
picture 3 03 Wrap the ankle from the end of the foot toward the leg. Finishing encircling it to the end, stick adhesive tape to the end of
elastic bandage. Check if the blood circulation is good and the bandage is wound too tight or not.

※ The clean elastic bandage can be reused. Make a roll the bandage when you unraveling. And you can reuse the bandage conveniently.

p. 99
⑤ Arm
picture 1 01 Start binding elastic bandage at the wrist. Add adequate force in order not to interrupt vein‘s and lymph’s flow.
picture 2 02 Let the bandage pass through the thumb and index finger and wind up toward the arm.
picture 3 03 Wrap the arm until the end of the elastic bandage appears.
picture 4 04 Ending the winding up, attach the sticking plasters to the bandage. Check if the finger’s blood circulation is good and the bandage is wound too tight or not.

p. 100

⑥ Burn
picture 1

1) The Mechanism of Burn
Although the heat is removed, the heat is carried for 30 minutes to the deep skin. In a situation of higher than 70°C, the tissue is destroyed immediately. It is also demolished in 54°C within 30 seconds. Though it is lower than 44°C, if the skin is touched to the heat for a ling time, it is also destroyed.

p. 101
2) Emergency Care for a Burn
To lower heat is the first. Don’t waste time in taking off the patient’s clothes. You should use anything. Hands or feet can be cooled in water at least 30 minutes continuously. In case of arms or torso, use a towel wet with water.
picture 1 picture 2
picture 3 picture 4 picture 5

Children can lose their temperature easily. Don’t soak their whole body in order to cool it for a long time. It is a good way for them to touch the cold bricks.

picture 6

p. 102
Blister Cure

The Features of Blisters
01
picture 1
표피 outer layer 진피 dermis 물집 blister
· A blister is a state of percolate’s pool between the outer layer and the dermis.
· A blister may be bursted or untouched depending on situations.

02
In case of Bursting Blister

picture 2 It is a very big blister.
picture 3 The blisters are too big for dressing. It’s better to burst it in this case.

In Case of Untouching Blisters
03
* Palm and sole have thick skin and the blisters on them don’t burst easily. It’s better to untouch them.

p. 103
04
The Method of Bursting Blisters

picture 1 바늘: needle
Stab the lowest part of the blister with a needle and press on the upper part.

picture 2
가위로 잘라낸 틈: crevice cut with scissors
Cut the upper part of the blister and make a crevice in the blister. Then the exudation comes out.

p. 104
4) Hot Coffee
It is common for children to scald on their face and chest from pouring hot coffee. In 1994, an American old woman had a burn on her groin and buttocks severely, pouring hot coffee on her thigh. She raised a lawsuit and was compensated with about 1,000,000 US dollars.

picture 1. picture 2
People, younger than 3 and older than 60, have thin dermis. So they are
scalded easily.

p. 105
5) Burn on The Face

picture 1
It is difficult to cover a face with gauze as a face moves a lot. Apply antibiotic ointment and then if it’s dry, apply it on the scald site on the face again. Sometimes it should be applied again within 1~4 hours. However, sulfadiazine cream(silvadene) should not be applied. The skin can change to brown color.

picture 2
pressure dressing for keeping the cornea

When your eyes are pricking, it has a high possibility for the cornea
to have a burn.
First, cover the eye with gauze soaked in cold water for a moment. Second, fold the gauze in thick type and cover the eyelid.
Third, do the pressure dressing with tight adhesive plasters such as the picture. This treatment promotes renewal of the epidermis of cornea.
In this course, it is good for the both eyeballs not to move with the eyes closed. It is necessary to see a doctor in the department of ophthalmology for a medical checkup to confirm‎ the cornea has extraneous substance or inflammation.

p. 106
6) In case of Going to a Hospital
In case of a burn whose size is bigger than that of an adult’s palm, it is recommended to go to a hospital. A burn on the body site that has a hole(for examples, face, ear, sexual organ, anus) and on a hand or a foot should be healed in the hospital. It can prevent the skin contracting in the process of the hurt’s recovery in advance.

p. 107
PART 09

Wounds Bitten by Animals

󰊱 Dogs
󰊲 Snakes
󰊳 Bees

p. 109
Wounds bitten by animals have the danger of tetanus. It is necessary to wash it with water and soap thoroughly and not to suture the wound. Since tetanus germs grow well in a closed site. It applies to the hurt bitten by a human as well.

① Dogs
The dog is a meat-eating-animal. Its teeth are very sharp, therefore the wound is frequently deep and torn. But rabies is very rare because most of the dogs which have rabies die within 10 days. When you touch the dog, it is often for you to be bitten by it. Since the dog which has rabies is frightened from the pain, the dog can bite you if you touch it.

p. 110
② Snakes

Poisonous Snake
picture 1
The hurt bitten by a poisonous snake has a fang’s mark.

Non-Poisonous Snake
picture 2
After 15 minutes of being bitten by a snake and if you have these symptoms below, it is a poisonous snake.

· The hurt is swollen.
· Your mouth is dry.
· You have a headache or nausea.

But after 8 hours of being bitten by a snake and if you have no symptom, it is a non-poisonous snake.

The fact revealed recently.
* It is found to cut the bitten site with a knife or suck with a mouth makes the
poison spread more. Applying an ice pack is also revealed to be ineffective.

p. 111
If you think it’s a poisonous snake, bind a leg with a band. The binding should be feeble enough to be pressed slightly. It makes venous blood stay only in the leg, preventing its inflow to the center of the body. For an early 1-2 hours, you should bind the wound continuously and unbind for 1 minute then rebind it for 5 minutes. In the course, increase the unbinding time and decrease binding time gradually.

※ Never bind tightly like a tourniquet

picture 1

Fix the hurt with a splint, lower than the heart. The patient should take a rest.

p. 112
③ Bees

picture 1

The Feature of Bee’s Sting
01
When a bee stings, a part of its body separates from the bee. Therefore the bee dies soon.

picture 2.
The root of sting that is stuck in the skin has a poison pocket. The sting detached from the body does contraction exercise with it(sting) stuck into the skin for considerable period.

picture 3
02
The Way of Picking Out the Sting

If you take it out on the side, the poison doesn’t come out.

picture 4
When you pick up it with a pincette, the poison pocket is pressed and the poison comes out.

p. 113
The Method of Catching a Bee

picture 1 ① Don’t be embarrassed when a bee comes indoor.
picture 2 ② Protect your body with a long-sleeve-clothe, gloves, a cap and a mask.
picture 3 ③ Cover the bee with a plastic cup.
picture 4 ④ Insert a piece of tick paper under the cup slowly.
picture 5 ⑤ Insert the paper to the end for closing the cup completely.
picture 6 ⑥ Carry the cup outside the building, open the paper and release the bee.
p. 114
04
Catching a Wasp and Cockroach

picture 1 ① It is very difficult to catch a cockroach sitting on the blind by covering it with a cup.
picture 2 ② I caught a wasp with a big plastic bag and released it out of a
window.
picture 3 ① I covered a cockroach crawling on the wall by covering it with a cup.
② I trapped the cockroach in the cup by covering a lid of the cup swiftly. I treated it on the street outside.

p.115 Part 10

Surgical Treatment
󰊱 The Effect of Wound Suture
󰊲 Crush Injury
󰊳 Finger Cutting

p. 116
① The Effect of Wound Suture
Wound suture makes the cure fast, omitting the shrinking step in the process of recovering.

01
A Torn Hurt

picture 1 섬유모세포: fibroblast 삼출액: percolate

Percolate is liquid coming from inside and outside of cells after the skin is injured. It contains various cells that recover the wound. Among them, fibroblast is important.

picture 2
02

When You Get Well Naturally

Fibroblast spreads fibers and narrows the chasm in the wound.

picture 3 흉터: scar
The last gap of the wound has a scar and is weaker than the normal skin because it doesn’t go back to original state.

p. 117
picture 1, picture 2, picture 3, picture 4

03
When you stitch a stitching fiber

picture 1, 2
â
picture 3, 4

Suturing and closing the wound makes recovering fast since it omits contract process. After 48 hours of sewing, it is no matter for the wound to get wet. Since the epidermal cells grow and coat the skin. It is usual to remove a suture 1-2 weeks later, but earlier removal is accepted for preventing a scar. Since the site where the stitching fiber is has a scar.

04
The Cases of Wound Suture

picture 5 a torn wound in the lower jaw
picture 6 after suture
picture 7 buried suture(a way of suture without a scar)

p. 118
② Crush Injury
picture 1 Sometimes this kind of wound happens when your finger gets caught in a door or it is hammered by mistake.
picture 2 A crush injury is healed by V-Y flap.

p. 119
③ Cutting a Finger

01
A Partial Cut

picture 1.
You should be cautious to protect the finger being cut any more.
picture 2. Wrap the wound with gauze and bolster it up with a splint.
The splint may be used of a thick paper.
picture 3. Wind around the splint with bandage and go to a hospital for an
operation.

02
Carrying a Completely Cut Finger

picture 4
After wash the cut finger with water or saline solution, wrap it with gauze wet with saline solution. Without saline solution, clean water can be used. But in that case, wring water out of the gauze surely. If you don’t do that, the wound can be swollen by water.

picture 5
Put the cut finger in the plastic bag and bind the bag for keeping it from water.

picture 6
Put the bag in the ice and carry it to the hospital where suturing surgery is possible.

p. 120
03
A Finger Partly Cut

picture 1 It is partly cut and loss of the tissues is less, accordingly it has a high possibility of recovery through the surgery.

04
A Finger Cut Completely (1)

picture 2 picture 3

It is a state of a bending tendon(ligament) and a stretching tendon are pulled out, and the joining is very difficult.

05
A Finger Cut Completely (2)

picture 4 picture 5
The joining is comparatively well done owing to its less tissue loss.

p. 121
Part 11

Other Skin Problems
󰊱 Heel’s Keratin
󰊲 Finger’s Agnail
󰊳 Lip Crack
󰊴 Mouth Ulcer (Aphthous Ulcer)
󰊵 Cellulitis
󰊶 Athlete's Foot (Ringworm)
󰊷 Olecranon Bursitis

p. 122
① Heel’s Keratin
picture 1

In winter, heel’s keratin split easily. It is better to remove it when the keratin is dry. It is not good to get rid of the keratin when it’s swollen with water in a bathhouse. It is difficult to remove the swollen keratin with water as it becomes like a sponge in water.

② Finger’s Agnail
This wound is from tearing off the agnail with a nail. Agnail should not be removed by riving. It’s better to attach adhesive plaster on the agnail for 2 –3 days. If you want to remove it, taping the site after cutting it with a nail clippers.

picture 2 picture 3

p. 123
③ Lip Crack

picture 1
Chapped lips are caused by cold or dry climate. You can have a lip crack after 1-2 days you have had a cold wind in winter or you lick your lips less with your tongue resulting from your sick mouth.

p. 124
④ Mouth Ulcer (Aphthous Ulcer)
When you have a mouth ulcer, it is difficult to eat foods or talk because of the pain. Once it happens, it usually lasts longer than 2 weeks. So it is painful.

1) Aftach
Aftach is adhesive plaster which is attached to the oral ulcer. Like the picture in the next page, it adhesives the best and last the longest when it is attached to the ulcer inside of mouth. On the contrary, it doesn’t attach to the site where salivates and detaches easily on the movable site like a tongue. Usually, if you attach it before going to sleep, it becomes sticky next morning. Therefore, it detaches easily. It decreases pain while it is attached.

p. 125
An Example of Oral Ulcer Treatment

picture 1 ① I had an ulcer in my mouth.
picture 2 ② I attached Aftach before going to bed.
picture 3 ③ I took off Aftach with the end of a finger. When the finger is
damp, Aftach attaches well to the end of the finger.
picture 4 ④ I took Aftach near the ulcer.
picture 5 ⑤ I covered the ulcer with Aftach.
picture 6 ⑥ I attached Aftach on the ulcer.

p. 126
2) The Sites of Oral Ulcer’s Outbreak

picture 1 ① Oral ulcer outbreaks the most inside of lips. Sometimes biting inner part of the mouth by mistake causes oral ulcer. When several ulcers develop, they are very painful.
picture 2 ② Occasionally, oral ulcer happens under the tongue where the salivate. For that reason, Aftach separates from the mouth easily picture 3 ③ It arises on the tongue(the flat of the tongue) at times. Tongue moves very much, consequently Aftach detaches soon.
picture 4 ④ oral ulcers often grow in several places in the mouth. They are sore a lot.
picture 5 ⑤ Once in a while, it is formed on the lips.

※ According to my experience, Albothyl, Steroid, Colchicin, Propolis, Oramedy ointment and Touchmed ointment don’t have so much efficacy of a medicine.
I recommend sticking Aftach to the ulcer now and then when you are going to sleep as well as some kinds of food like meat, milk, eggs and porridge. It makes the ulcer less smarting to put on Lidocaine injection with an injector. You can use it when you have a meal.

p. 127
3) Oramedy Ointment
Anointing Oramedy ointment before you go to sleep can decrease the ointment loss washed away with saliva. Wait for the saliva being dry with your mouth open and breathing. Then put on the ointment on the ulcer with a metal chopstick. Using a cotton swab isn’t good as it absorbs the ointment.

p. 128
⑤ Cellulitis
Cellulitis is an abrasion happens on and under the skin.
picture 1 picture 2

A cellulitis happened on one of my big toes. It seemed that the germs invaded the big toe, its nail having stimulated the surrounding skin. You should protect the skin through attaching adhesive plaster around toes. Dressing with gauze is bulky, so it can be pressed by a shoe. Therethrough, only adhesive plaster should be sticked. Applying Povidone-Iodine every day is helpful. Wearing slippers instead of other shoes makes less stimulus. Antibiotics or injection is not needed because the range of abrasion is small.

⑥ Athlete's Foot (Ringworm)
picture 3

I had an athlete’s foot on my sole. Although I applied ointment for some months it didn’t work. So I took medicine. After 2 weeks later, my liver level went high. I stopped taking medicine and began to apply the ointment again. When I applied the ointment, I used spatula. You had better this kind of tool if possible, as the finger absorbs the ointment when you use your finger.

p. 129
⑦ Olecranon Bursitis

I had olecranon bursitis since I had spent a lot of time writing a book with lying my face down on the floor. As a result of it, I had abrasion on my right elbow. It is certain that it is an abrasion considering it is warmer than the surrounding skin when I touched it. Since then, I hadn’t laid my face down any more and I was cautious that the elbow and other things would not touch together. As time goes by, its size became smaller and it disappeared 10 days later.

picture 1 picture 2

p. 131
PART 12

Cases of Wound Cure
󰊱 Adhesive Plaster Dressing
󰊲 Band Dressing
󰊳 Plastic Film Dressing
󰊴 Boil
󰊵 Wound Bitten by a Wasp

p. 132
① Adhesive Plaster Dressing
It is a wound on my shin. I sticked adhesive tape on the wound directly and left it for 3 days. When it is dirty, I changed the adhesive tape to a new one. Sometimes the wound recovers automatically with forgotten to the tape detached.

picture 1 ① Wipe the bloodstain with tissue.
picture 2 ② Attach the adhesive tape to the wound directly.
picture 3 ③ Leave the wound with the adhesive tape for 3 days.

p. 133
② Band Dressing
It is a small tape with a small gauze. It has lots of demerits of gauze except for its only merit, convenience for small hurt.

picture 1 ① Abrasion on the top side of the foot
picture 2 ② Apply the antibacterial ointment on the gauze of the band.
picture 3 ③ Attach the band on the wound.
picture 4 ④ The picture of band attached on the wound
picture 5 ⑤ 3 days later
picture 6 ⑥ After 5 days, it is recovered entirely.

p. 134
③ Plastic Film Dressing
My integument and thick skin of the little finger got stripped off. It’s very pricking. I applied antibiotic ointment on the hurt and dressed it with a plastic film(plastic wrapper). I changed it to a new one every day and It was healed totally after 15 days.

picture 1
preparation materials: plastic film(plastic wrapper), scissors, adhesive plaster

picture 2 soon after having an injury(Sep. 14th. 2016)
picture 3 10 hours later(Sep. 15th. 2016)
picture 4 18 hours later(Sep. 15th. 2016)
picture 5 48 hours later(Sep. 16th. 2016)
picture 6 plastic film dressing
picture 7 2 days later(Sep. 16th. 2016)

p. 135
The Examples of Plastic Film Dressing(continuation)

picture 1. 3 days later(Sep. 17th. 2016) the scene I was washing the hurt with tap water.
picture 2. 4 days later(Sep. 18th. 2016) The skin around the wound festered and it is demerit of plastic film. However, there is no problem for recovery, since the wound is small.
picture 3 5 days later(Sep. 19th. 2016)
picture 4 6 days later(Sep. 20th. 2016)
picture 5 11 days later(Sep. 25th. 2016)
picture 6 15 days later(Sep. 29th. 2016) It is recovered completely.

p. 136
④ Furunclesor boils
It is pus pocket which rises easily around hair follicle and its reason is staphylococcus. When you make a dish with a hand that has furunclesor boils, it causes food poisoning. Because the poison of staphylococcus comes to the food.

picture 1
April. 11th

① I had a furunclesor boil on my back.

picture 2
② After disinfecting a needle with soapy water I poked the furunclesor
boils with the needle. It bursted.

picture 3 ③ I wiped the pus with tissue.

picture 4 ④ I anointed antibacterial ointment on the wound using a chopstick.(When you use a cotton swab, the ointment is absorbed into the cotton)

Examples of Furunclesor boils Cure (continuation)
p. 137

picture 1
April. 11th.

⑤ I attached the adhesive tape on top of the furunclesor boil directly and changed it to a new one every day.

picture 2
April. 14th.

⑥ After 3 days, a hole poked with a needle was healed up and the pus disappeared. Because the skin is still weak and itchy, scratching with hand may cause a wound. Accordingly, I decided to attach the adhesive plasters some days longer.

April. 18th.
picture 3
⑦ 7 days later, the furunclesor boil was healed. I didn’t need to use the adhesive tapes any longer.

picture 4
틀린 방법: The Wrong Method
⑧ reference: The ointment can be infected when you touch the antibiotic ointment tube with the wound or apply the ointment to the hurt with a finger. On that account, you should use a chopstick or another tool as before.

p. 138
⑤ Wound Bitten by a Hornet or a Wasp
On a Sunday, while I was going down the stairs in the church with many people, my forearm was bitten by a hornet. It was much more painful than the hurt bitten by a bee. And the speed of the appearing flare and swelling was faster than that of a bee. The hornet flew away and I took a rest on a sofa in a lounge. I asked another person to take me to an emergency room in case that I would have Anaphylacitc Shock. I sat on the sofa for an hour but I had no dizziness, nausea. Therefore, I went back home.

picture 1 ① 10 minutes later, the ache and flare began.
picture 2 ② 20 minutes later, the flare got bigger.

Examples of Hurts Bitten by Hornet(continuation)
p. 139
picture 1 ③ 60 minutes later, the flare became bigger and more swollen.
picture 2 ④ 4 hours later, the pustule was forming.
picture 3 ⑤ In order to get rid of the pustule, I pierced it with a needle
washed in soapy water. Tearing the skin makes the pus come
out easily.
picture 4 ⑥ The skin doesn’t tear with the needle’s passing through since the skin is durable. I made 2 holes and dressed the wound.
picture 5 ⑦ 2 weeks later, the wound was healed but the scar lasted more than 4 weeks.