Jocelyn Zhang - Wounds and Healing

Wounds and Healing

This is not a cable placed in the Grand Canyon, but a microscopic picture of scar tissue and stitches.

Background

My husband Jeffrey, is a hardworking and optimistic person. His biggest hobby is cycling, and he has won many trophies and medals. Sunday, September 5, 2021, was my birthday. Jeffrey went out early to ride and planned to come back at noon to celebrate with me. However, when he got home, I couldn't see his face clearly. He was bleeding in many places all over his body. I was shocked but I knew I had to take him to the hospital right away.

We were fortunate that the doctor in the emergency room was very patient and carefully clean up his wounds. The stitching process took a long time. Jeffrey kept holding my hand and joking with me. But I cried because I love him so much and couldn't bear to see him suffer.

We just moved to a new city, and he just started to work as the foreign principal of a bilingual school. It was hard to imagine how this accident would affect our life. Jeffrey told me it was okay and everything would be fine. I knew that anxiety would not solve the problem. Maybe trying to understand and participate in this process will help me face it more bravely.

Jeffrey won the annual championship of the Shanghai Heros Cycling Race.

Some photos below may cause discomfort.

Phenomena Event

A big open wound is a phenomenon that is difficult to ignore. The color of blood and unnatural movements will quickly attract attention. Under normal circumstances, you may not realize how important healthy skin is. It is the largest organ of the human body. It not only protects internal tissues, but also shapes our appearance. Observing the changes in the wound every day became my important task. The process of wound healing is very miraculous. What I saw with my own eyes really made me realize the power of life.

This is the diagram I drew the next day, showing the location and size of the wound. Two photos of him in the emergency room.

Misconceptions

I have never touched a person with so many wounds before. Although I am not a trained nurse, for the following month, I took on the responsibility of treating the wound twice a day. In the process, I realized some misconceptions I had before.

1. Keep the wound as dry as possible. Water will cause inflammation.

2. The recovery time of large wounds will be longer than that of small wounds.

Conceptual Change

My conceptual change mainly came from discussions between me and Jeffrey. He has a good knowledge of biology, and we also checked the information or videos online to learn more. The real result convinced me to change my original belief.

He explained to me that inflammation is a natural process of wound healing, but can get worse by water loss or bacteria infection. The wound itself needs to be kept moist, because water is essential for cell growth. We carefully selected liquids with disinfectant ingredients, including hydrogen peroxide, physiological saline, and iodine solution. After trying them for a few days, we thought the 0.9% physiological saline was the best. It can be applied quickly without causing skin discomfort and irritation. Every day I carefully observe the color and appearance of the wounds to determine if there is an infection. This was the priority of the initial stage of healing.
Jeffrey had two large abrasions on his left arm. Each treatment requires a lot of medicine to cover it all. At first I thought that these two wounds would take longer to heal. As a result, a small wound on the right wrist took much longer. I realized that the skin cells grow in layers. The two wounds are large in size but shallow in depth. As long as the nutrition is adequate, all the underlying cells can actively divide. On the contrary, if the area is small but the wound is deep. The surface cells cannot be reorganized upwards until the underlying cells are repaired, so the actual time taken is longer.

Nature of Science

Scientific Knowledge is Based on Empirical Evidence

All my experimental data comes from my observations and records of Jeffrey. Since this is an experiment that cannot be repeated or compared, I can only rely on personal experience. In the first 10 days, I took pictures of the wounds on his face. It can be seen that the dark purple area around the eyes was very obvious in the first four days, and the entire left half of the face was also swollen. When cleaning the stitches, yellow dead dander fell off. The abrasion on the left cheek was sunken due to missing skin tissue and looked dark blue.

Science is a Human Endeavor

Wound healing is a scientific process, but here I also want to praise the power of people. I want to thank the doctor who tried his best to minimize the damage. He must be constantly carrying out inquiry in his mind, trying to find the best solution from his own knowledge and experience. I want to thank Jeffrey for showing me the power of recovery. He encouraged me to use him as a research object and observe the wounds carefully. He answered all the questions I asked patiently. I also want to thank myself for being brave to learn things I don't understand and taking care of my family with my heart.

The same doctor took out the stitches on the 7th day. Our son was holding Jeffrey's hand.

These are the photos from Day 2 to Day 6.

Science and Engineering Practices

Asking Questions & Defining Problems

My initial essential question was how to help Jeffrey recover. Based on this, I extended two focuses. When I think deeply, I will ask more specific questions.

How can I treat the wound to help it heal?

What are the types of wounds?

What is the process of wound recovery?

What nutrition and environment does the injured tissue need to heal?

What conditions will delay the healing of the wound?

How can we prevent scars?

What is the mechanism of scar formation?

What factors can cause scar formation?

How to prevent scars during wound healing?

How can the scars that have been formed be removed after the wound has healed?

Constructing Explanations and Designing Solutions

In the process of actual treatment, I constantly encountered new challenges. For example, gauze sticks to the skin, the medicine leaks out and wets the clothes, and the tape is not sticky enough or too sticky. One of the most troublesome things is how to cover the wounds on the face.

The human face has a very subtle curvature, plus Jeffrey's wounds are near the eyes. I can't block his vision, and I have to cover the wound as much as possible to prevent it from being exposed to the air. The gauze is breathable but needs to be fixed with tape. It is very uncomfortable to stick the tape on the nose or hair. I also tried hydrocolloid dressing. Its color looks more natural, but it's thicker so it can't fit on the face. And the fluid from the wound will quickly let it fall off.

The final method we took was to choose a thinner hydrocolloid dressing, cut it into a specific shape, and then stabilize it with a mask. I am proud that I continued to construct explanations and design solutions. During that time, I almost bought all kinds of dressings in the drugstore.

This was the sixth day of injury, which happened to be Teacher's Day. Jeffrey and the Chinese principal distributed flowers to teachers at the school gate. We used glasses and masks to cover the wounds on the face. The wound on the left arm was fixed with fishnet stockings. The wound on the right wrist was fixed with an elastic bandage of skin color. We are grateful that the school still published these photos.

Crosscutting Concepts

Cause & Effect: Scar Forming Mechanism & Explanation

Scars are part of the body's natural healing process after tissue damage. When the skin is injured, the tissue breaks down, which causes a protein called collagen to be released. Collagen accumulates in damaged tissues, helping to heal and strengthen wounds.
There are different kinds of scars. Most scars are flat and pale. However, in cases when the body produces too much collagen, scars can be raised. Raised scars are called hypertrophic scars or keloid scars.
Some scars can have a sunken or pitted appearance. This kind of scarring occurs when underlying structures supporting the skin (for example, fat or muscle) are lost.

Sense Making and Discourse

After taking the stitches out, Jeffrey's face recovered quickly. On the 13th day, almost all the bruises disappeared. The scar under his left eye is still obvious, but the stitches above his left eye and on the ears are almost invisible. He started using a scar removal cream called Dermatix Ultra on the 10th day. Its main ingredients are Cyclic and polymeric siloxanes and vitamin C ester. It helps wound healing through closed hydration. Avoid scar skin inflammation caused by water loss, thereby inhibiting the proliferation of hair cell tubes and reducing collagen deposition.

We also discussed surgical methods to remove the scars. In general, a permanent treatment is one that completely resurfaces the topmost layers of skin. Removing a scar with a laser treatment operates under this principle to gradually lighten, tighten, and fade a scar over time. Generally speaking, laser scar removal requires 1-3 treatments. Each treatment varies from 5 minutes to 2 hours depending on the area and type of disease.

These are the photos from Day 8 to Day13.

Becoming an Inquiry Teacher

I have always been a teacher who likes to encourage students to explore the unknown. This inquiry investigation is more like a self-growth to me. There is a problem in my life that I cannot choose to escape. Actively understanding and responding made me realize my resilience. As a teacher, we must always maintain a learner's mentality. We may all be pupils in front of life. But what is valuable is people's curiosity and desire to solve problems. This makes me more convinced that my students are also born with the ability to question.

My task is how to let them see that they are connected to their surroundings. When you feel the desire to learn more, nothing can stop your inquiry. I will also share my personal experience with students to encourage them to face difficult problems positively. I am very happy to see Jeffrey recovering well. He is still very excited about cycling and positive about life.

Two months after the accident, Jeffrey and our son were cleaning the bicycle together.

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