Nursing wounds

As Terrie M. Williams reports in her article "Sunbathing Seals of Antarctica" [10/03], Antarctic seals apparently appreciate the causal connection between warmth and healing. That same connection has taken centuries to be applied systematically to the clinical care of human wounds, but recent studies are documenting how warming modifies tissue responses needed for healing. The benefits include increased blood and oxygen flow to the wound, improvement in local immune responses to control bacteria, increased proliferation of the cells necessary for healing, and the reduction of enzymes and other factors that inhibit repair in chronic wounds. Other principles of wound treatment include cleansing with a solution that does not harm cells (in most cases, normal saline solution) and the use of moist dressings. So the seals also benefit from their saline environment.

JoAnne D. Whitney

School of Nursing, University of Washington

Seattle, Washington

TERRIE M. WILLIAMS REPLIES: JoAnne D. Whitney is quite right that flushing with seawater is critical for wound healing in marine mammals. Indeed, as marine mammal veterinarians are well aware, the wounds most prone to infection are punctures that heal from the outside in. For that reason, veterinarians often leave small skin wounds open rather than suturing them closed and risking infection. In Antarctica, cold-induced vasoconstriction also makes healing inordinately slow--a fact that was not lost on those of us in the research team, as we nursed our own small nicks and cuts for months.

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