Washing a wound or graze ‘stings’, whether you have EB or not. Wetting raw wounded areas with ‘normal’ saline solution doesn’t sting at all, like magic it’s painless.
In 1982 when their EB baby was in so much pain at bath time Martin and Anna remembered their high school biology lessons. They confirmed the exact science with pathologist Dr Graham Kemble Welch and together with EB nurse Hilda Dresdner they introduced saline bathing. Bath time became fun.
Care plans based on pain-free bathing in normal saline have been commonplace in NZ ever since.
Mixing normal saline solution
Normal saline solution is 0.9% salt (sodium chloride), that’s:
- 0.9 grams of salt / 100ml of water;
- 9 grams of salt / 1 litre of water;
- 90 grams of salt (about ½ a cup) / 10 litres of water.
To figure-out the right mix, find how much water fills the bath and then calculate the right amount of salt to add. Using a bucket with a litre measure, count the number of buckets of water it takes to fill the bath to a fixed point.
For example, if you used 10 x 10 litre buckets you would need to add 900 grams (nearly a kilo) of salt.
- Sterile saline solution, warmed to body temperature makes an ideal last rinse for wounds after a bath.
- Half a cup of salt dissolved in warm water in a clean 10 litre plastic watering can with a fine spray nozzle makes a good hand-poured saline shower!
Why saline bathing is pain-free
Our body’s cells are more-salty than fresh water, and less-salty than sea water. Water moves in or out of our cells to equalise the salinity with surrounding liquid, causing the painful stinging.
Normal saline solution is an exact match to our saltiness, so no water moves in or out of our cells – it’s painless to be in saline!
- Movement of water in or out of a cell to equalise salinity is called of osmosis.
- If our skin is intact, water movement still happens, but it doesn’t hurt.
- Taking-up water to be less salty is why we go wrinkly when we are in the bath for ages.
- Swimming in the sea makes us thirsty because we loose water trying to dilute the ocean to match us!
- Hospital burns wards often include a saline bathroom.
- Contact lens wearers use sterile saline to be gentle on eyes.