How do you treat a bruise?


Synonyms: bruise, hematoma

Bruising can result from impact injuries. This results in bleeding from small to larger ones into the tissue. Basically, this is not a bad thing and, in the case of minor events, turns out to be a bruise that turns green-yellow over the next few weeks and slowly recedes.

In the case of larger bruises, it may be that they do not regress by themselves and that you have to help with various means and procedures. In people with a tendency to bleed, for example from anticoagulant medication (heparin, Xarelto® or Marcumar®) or with haemophilia, the bruises can become very large and may need to be checked and treated by a doctor.

Basically, however, if there are no risk factors, the bruise will usually go away on its own.

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General treatment options

The so-called generally applies to the treatment of a bruise P-E-C-H rule.

  • The P stands for Break. It is important that the affected area is initially not further stressed and that the affected person pauses from his work.
  • The E. stands for ice. It helps if, ideally, it is cooled immediately. This can improve the course of the bruise.
  • The C. stands for compression, from the English "compression". It means that supporting or compressing bandages are applied. In the best case scenario, this means that less blood escapes into the tissue at the affected area and that it flows away more quickly. These dressings can be used together with heparin, Voltaren and arnica ointments, for example.
  • The last letter that H stands for Elevate. For example, if the leg is affected, in a practical example this means that the leg is put up on a chair or couch for a long time. The meaning behind this is that the blood pressure, which otherwise prevails in the leg when standing, is reduced by lying down, and so less blood is pressed from the defective vessels into the effusion. In addition, the blood can flow better out of the leg and the bruise.

About the next weeks should the effusion then regress. If this is not the case and an encapsulated effusion forms, therapy can be continued with shock wave therapy and surgical removal. But this is not the norm.

Please also read our topic: PECH rule

Treatment with heparin ointment

A helpful ointment for treating bruises is one Heparin ointment. Heparin is a medicinal substance that is present in the Process of blood clotting intervenes. When the heparin is applied to a bruise as an ointment, it is absorbed into the skin and tissues. Here it prevents the bruise from changing from a liquid to a solid state. In addition, the heparin ensures that the Bruise breaks down faster. This happens, among other things, that a better blood flow to the tissue is effected.

Ideally, this will make the bruise go away faster. Heparin ointments work well for some bruises and patients, but less or not at all for others. From experts, there are also heparin ointments on the subject different opinions. Some people say that the heparin does not even get through the skin and therefore does not work. Other opinions suggest that the heparin works very well.

In principle, one can say that it is definitely an option to try treatment with a heparin ointment. There are many manufacturers in the market. The most expensive brand does not necessarily have to be used here.

Treatment with pain reliever ointments

A bruise usually not only looks uncomfortable, it often feels like it too. Depending on the severity of the injury, the bruise just causes it complaintsif you accidentally touch it or consciously press it.
In other cases he is also noticeable calm or with everyday movements. Here the use of Ibuprofen or Voltaren® help in the form of ointments. Due to the active ingredient contained, the release of pain-promoting mediators (transmitter substances) is reduced locally at the point, that means Pain relief. In addition, the Accelerates healing.

There are many different providers for these ointments who want to outdo each other in terms of their effectiveness. The basic rule here is that the cheaper drug from the pharmacy can also help. Afterwards, a more expensive preparation can still be tried if it is not working.
Here too they go Experts' opinions differ on effectiveness. The question is whether the active ingredients get through the skin in sufficient quantities and work on the bruise.
In the case of acute pain in the first few days, it is recommended to try one of the different ointments in any case. If the pain is more severe, ibuprofen, diclofenac or paracetamol in tablet form can also be used for a shorter period of time. But this should remain the exception.

Treatment of a bruise after surgery

During a surgery it does not always happen, but it is often smaller to larger Bruising. Depending on which procedure and which procedure is being operated on Cuts set and Vessels injured. This leads to bleeding into the surrounding tissue or the body cavity. At the point where the incision was made and after the operation sewn or stapled small bruises can occur.

After a major surgery (e.g. hip joint surgery) it may be in a Muscle box bleeds, and that the bruise is too over longer distances (e.g. the thigh or lower leg) expands.
But that is usually the case not dangerous. The bruise can usually be treated well with heparin ointments, cold and elevated storage.

This is an exception Compartment SyndromeDuring this process, great pressure builds up in a muscle box, which squeezes nerves and blood vessels and causes severe pain. Here must immediately a medical treatment done to prevent permanent damage.
Otherwise, if the bruise is over several weeks not regressed and symptoms in joints, surgical removal may have to be considered.

In addition to external bruising, you can also Effusions in the abdomen arise that not visible from the outside and can only be represented with imaging techniques. Depending on where they are, there is a risk of inflammation or the pressure of vessels or other structures. With the help of ultrasound, MRI or CT, the surgeon can assess whether the bruise needs to be removed or whether it is possible to wait.

Treatment with home remedies

A wide variety of herbs, compresses and poultices are known as home remedies, which are supposed to promote the healing of a bruise.

Next to the Cool with ice cream or cool packs Quark wrap a well-functioning alternative.
Still seem lukewarm baths with arnica essence, rubbing with Brandy, Envelopes with Clay soaked wraps, Parsley, butter and onion compresses to help with bruises. A frequently mentioned substance is arnica. It can be used on the one hand as an ointment and on the other hand as globules.

Another helpful plant from nature is that Comfrey, which contains tannins that the Fight inflammation and stimulate blood circulation.
It can also be found in many home pharmacies Horse ointment. This is actually an ointment for the regeneration of muscles in horses, which contains various substances such as menthol or rosemary.
Another group of helpers from the medicine cabinet are the Schüssler salts. Different salts with different modes of action are available here to promote the healing of bruises.

Is heat or cold suitable for treatment?

If the bruise has just appeared, it should as quickly as possible with cold be treated. Cold wraps, cool packs or ice cream are ideal for this. The important thing here is that the cold not directly on the skin but rather a towel, for example, as otherwise frostbite could occur. The cold constricts the blood vessels in the affected area and it kicks not so much blood in the tissue a.
When cooling, it should be repeated in between paused for example every 20 minutes.

In the following days can warm envelopes offer through which the blood flow to the body and the Reduction of the bruise promoted shall be.

Treatment of a bruise on the knee

A bruise on the knee, caused by trauma or surgery, can affect the patient very painful be. The Protection and cooling of the knee is very important from the start. Initially, no further loads or movements should be performed.

Normally, the body produces enzymes that break down the bruise. In addition, this can of course be supported by ointments. Healing can also be accelerated with various taping variants.
An additional possibility lies in the Puncture of the knee joint. The attempt is made to remove the bruise from the knee with rinsing and suction.

If despite all these measures no improvement hires, one can Arthroscopy of the knee joint. Here, a camera can be used to precisely assess whether the problem is caused by the bruise or perhaps by an accompanying injury. Damage can also be treated directly with this procedure.

Treatment of a bruise on the thigh

Bruising on the thigh is often the result Sports injuries or in the elderly Falls. The bruises often look large and uncomfortable. The use of heparin and Voltaren ointments is recommended here. Additionally, it is important that the affected Leg up in the first few days and chilled so that the effusion does not worsen.

The effusion should be too Loss of sensitivity lead or enlarge, continue walking towards the knee and not fading away Pain drag with it, then it should Family doctor must be visited to rule out more serious accompanying injuries.

Treatment of a bruise in the eye

A bruise in the eye usually breaks down by itself.
Here but is not visible from the outside, how large the effusion is or whether relevant structures are damaged and whether the Optic nerve affected is, is seeking one Ophthalmologist important. This can carry out a more precise assessment using ultrasound.

For bruises that require treatment, be smallest cuts set around that Drain blood to be able to leave. This is done using minimally invasive methods and does not leave any permanent damage or visible scars.

See also under: Bruise in the eye

Treatment of a bruise in the ear

A bruise on or in the auricle should medically treated become. If the effusion persists too long, you can Not more all parts of the auricle have sufficient blood supply become and tissue dies.

A sterile needle is used to pierce the bruise to remove the blood runs out and the Blood circulation the rest of the tissue again guaranteed is. For small effusions and after an incision, a Printing compound be created. In the case of larger bruises on the ear, a larger window may have to be cut so that the effusion can drain.

A Examination of hearing performance should ideally be done so that damage to the inner ear that could have occurred in the course of the accident or shock can be excluded.

More information here: Bruise on the ear

How long should a bruise be treated?

The length of time it takes to treat a bruise depends heavily on the size and extent of the bruise. Smaller bruises often heal in a few weeks (1-2 weeks). Larger bruises, caused, for example, by severe impact injuries to the legs, when taking anticoagulants or after operations, sometimes take more than 4 weeks to heal completely.

Read about this too Duration of a bruise

When is an operation necessary?

The operation of a bruise is necessary if the danger there is that he to Die (Necrosis) of the affected Body region leads. So that's for example Compartment Syndrome meant.

A compartment is one that is delimited by connective tissue Muscle box. The most common bruise site to experience this problem is the Lower leg. In the case of trauma, it can Bleeding come into this muscle box. The bruise causes one Pressure increase in the muscle compartment and tissue is damaged. It is also more problematic that arteries are also squeezed and structures further towards the foot are no longer supplied and possibly die. Next severe pain, the compartment is noticeable by a rock-hard leg. In this case a Fascia splitting be performed. The muscle box is cut open so that the blood can escape and the pressure can drop. A compartment caused by a bruise can also appear in other parts of the body, such as the arm.

Other indications for bruise surgery are when it becomes too close to joints lies or if through him Nerve structures pressed (e.g. on the spine or in the head area).

Otherwise surgery may be necessary if it is one very large bruise acts, as these are sometimes isolated. Then the bruise can be cleared out.
If the bruise is easy stays too long and does not get better, a doctor should rule out the effusion infected has that there is a connection to a larger vessel or that there are further injuries to the bones.

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