BehindTheMedspeak: Don't leave your cut open to the air — it slows healing

Who knew?

Not me, certainly, after all those long years of medical training and practice.

I've been telling people to wash their cuts and scrapes with plenty of running water, then leave them open without doing anything else, since, why, since last century.

What a doofus: no wonder I went into anesthesiology instead of derm or family practice.

But I digress.

Anahad O'Connor, writing in the New York Times Science section, debunked all the beliefs about cuts that I'd held dearly as true.

Short story shorter: Do keep your cuts moist and covered — not dry and open; Don't apply antibiotic ointments or creams; and by far best of all: Do pick your scabs, as leaving the original one on until it falls off will increase the amount of scarring.

Who knew that that weird girl at summer camp, the one who would daily sit and meticulously pick at her scabs such that her legs were always covered with dripping blood, was in fact preparing for a career in plastic surgery?

Here's the column.

The Claim: Wounds Heal Better When Exposed to Air

The Facts: Most parents and school nurses have a time-honored approach to treating a small wound: clean it up, stop the bleeding and then let it get some air.

The point of this approach, as described in medical texts, is to lower the odds of infection and to speed the healing process. But over the years, researchers have found that what many people know about treating small cuts and scrapes is wrong.

Exposing a wound to the air so it can breathe is a terrible mistake, experts say, because it creates a dry environment that promotes cell death.

A handful of studies have found that when wounds are kept moist and covered, blood vessels regenerate faster and the number of cells that cause inflammation drop more rapidly than they do in wounds allowed to air out. It is best to keep a wound moist and covered for at least five days.

Another common mistake is applying antibiotic ointments, said Dr. Mark D. P. Davis, a professor of dermatology at the Mayo Clinic in Rochester, Minnesota. These ointments may keep the wound moist, he said, but they can also lead to swelling and an allergic reaction called contact dermatitis. Plain and simple Vaseline, applied twice a day, works fine.

And as awful as removing scabs may sound, it may actually be a good idea, Dr. Davis said. A small initial scab will help stop the bleeding, but if left for too long it will do more harm than good.

"You don't want it to mature too much because it increases scarring," he said. "That’s the general thinking."

The Bottom Line: Exposing a cut so it can breathe slows healing.