Technical presentation describing the process of wound care management using magnesium sulphate paste, which is a safer alternative to using hydrogen peroxide and an effective way of treating injecting related injuries. This presentation has been developed by Mat Southwell a technical consultant working for Coact - www.co-act.info - who are a cooperative of specialists in community mobilisation with people who use drugs.

1. Wound care management
Technical Video:
Using Magnesium
Sulfate Paste to treat
an injecting related
injuries
Mat Southwell
Coact Consultant and harm reduction specialist
3 November 2018

2. • Feel the area around the wound. Is it hotter than
surrounding area? Is the wound weeping puss? If yes
then encourage the person with the wound to see a
doctor or nurse for a specialist assessment. If
necessary the person can be prescribed antibiotics.
• You may need to address the person’s fear of
judgement or exposure as this may be a barrier to
them seeking help from a health care professional.
Highlight the risk of leaving a wound untreated.
Offering to accompany the person to their health
care appointment can support engagement.
• Review the person’s injecting practice and
encourage hygienic injecting practices - hand
washing, swabbing injecting sites, avoiding re-using
injecting equipment and not keeping and cooking
up old filters.
Assessment

3. Treatment options
• The failure to treat injecting related injuries leads to people
unnecessarily having limbs amputated and in the worst case
scenario dying of septicaemia. Septicaemia is also known as
blood poisoning. It happens when an overwhelming bacterial
infection poisons your blood.
• Traditionally people have been encouraged to use hydrogen
peroxide to treat wounds. Hydrogen peroxide is an effective
option for cleaning wounds but it can leave the person with
serious scaring. Hydrogen peroxide is also a toxic substance
that needs to be carefully managed.
• This video promotes a safer and effective wound care
management strategy using Magnesium Sulfate. Bridge Hope
and Health Organisation in Afghanistan save the lives of their
peers with hydrogen peroxide. Don’t stop using hydrogen
peroxide until you have set up new protocols, secured access
to magnesium sulfate and re-trained your staff and peer
workers.

4. Equipment
• Antibacterial hand wash or soap
and water
• Fresh tap or unopened bottled
water
• Cotton wool buds and / or cotton
wool
• Magnesium sulfate paste or powder
that can be mix with water to make a
paste
• Dressing pads with a shiny film on
one side to prevent the wound
sticking to the dressing.
• Surgical tape
• Bandage
• Cost of equipment around £5

5. Wash your hands
• Washing your hands is key to preventing bacteria
spreading from your hands to the person’s wound.
• If you are washing your hands with water then it
is important to also use soap. The soap ensures that
the dirt and bacteria is loosened from your hands so
it can be washed away by the running water.
• You can use an alcohol handrub, which is easy to
carry with you and use in settings without running
water.
• Use the recommended method of cleaning your
hands to make sure you remove all the bacteria.

6. • It is good to dress your wound after you
have had a shower or bath.
• Flush the wound with freshly drawn tap
water or open and use a new bottle of still
water.
• Make sure to wash the water container
with washing up liquid / soap and water to
remove any bacteria.
• It is not necessary to use saline solution /
salt water.
• You can clean the wound gently with a
cotton bud or cotton wool.
• Pat dry the wound with cotton wool or
give it a little time to dry before applying
the magnesium sulfate.
Cleaning the wound

7. Applying the magnesium sulfate paste
Stir the magnesium
sulfate paste with
cotton wool bud
Spread the magnesium
sulfate paste onto the
wound with cotton wool
bud
Cover the wound with
the magnesium sulfate
paste
TOP TIP:
Don’t put the
contaminated
cotton bud back
into the pot of
paste once it has
touched the
wound. Only put
clean buds into
the pot of paste.

8. • Magnesium sulfate – also known as Epsom salts - is a
drawing paste to help treat minor skin infections
• The paste combines finely ground Epsom salts with water
and glycerin, to make the product smooth, and phenol, to
prevent a growth of bacteria.
• The way magnesium sulphate heals the skin is by forming
a "second skin" that allows injured tissue beneath it to
heal. The mineral absorbs water.
• The cooling, white paste helps the skin heal so it pushes
areas of infection up and out.
• Magnesium sulphate pastes also stimulate circulation in
the skin. At the same time the paste is helping the skin
get rid of the infection, it promotes formation of new
healthy tissue.
• Magnesium sulfate paste is not expected to cause side
effects.
How does Magnesium
Sulfate work on wounds?

9. Applying the dressing
Open the dressing
Apply the dressing shiny
side down onto the wound
so it doesn’t stick to the
wound.

10. Taping the dressing in place
Open the surgical tape
Tape the dressing in
place with surgical tape
Tape the dressing securely
in place

11. • Secure the taped dressing in
place with a bandage.
• The padded dressing and the
bandage help protect the wound
from being knocked and injured.
• They also prevent the wound
from sticking to the injured
person’s clothes.
Apply bandage

12. All done!
• Normally the wound should be
re-dressed every second day.
• However if the bandage is
heavily soiled and the wound is
weeping lots of puss then it may
need to be re-dressed every day.
• The bandage can be washed
and re-used.
• If the wound continues to
weep heavily and if the wound is
hotter than the surrounding area
then a course of antibiotics may
be required so the person with
the injury should see their
doctor.

13. People who inject drugs are exposed to risks of
infection with blood borne viruses, overdose and
primary healthcare problems. Safer injecting
strategies can help manage the risks and reduce
the harm associated with injecting. It is important
for people who inject drugs to learn and practice
safer injecting strategies and to manage quickly
any health problems.
Warning Statement

14. Mat Southwell On Drugs
• Coact Consultant and harm reduction
specialist
• matsouthwell@co-act.info
• www.facebook.com/mat.southwell
• www.co-act.info