Cuts and Scrapes
You can get an infection whenever your skin is broken, whether it's a scraped knee or a gunshot wound. Scrapes or abrasions occur when one or more layers of skin are torn or scraped off. They happen so often they may seem unimportant, but they should be treated to reduce the chance of infection or scarring. A cut, dirty scrape or puncture wound is a good reason to review you immunizations and make sure your tetanus is up to date.
Cuts
Minor cuts damage only the skin and the fatty tissue beneath it. They usually heal without permanent damage. More serious cuts may damage muscles, tendons, blood vessels, ligaments, or nerves. These cuts should be examined by a doctor.
A puncture wound is a small but deep hole produced by a sharp object such as a pin, nail, tack, needle, tooth, or fang.
Are Stitches Needed?
Sometimes it is difficult to tell if stitches are needed. Signs that stitches may be necessary are:
The wound is deep, gapes, is very dirty or irregular, or can't be held together with a bandage.
A deep cut is located on an elbow, knee, finger, or other area that bends.
The cut is on the finger or thumb joint, palm of the hand, face, or other area on which you would like to minimize scars.
The cut occurs on a young child who is likely to pull off the bandage.
First Aid
The next time you get a cut from a nail, a knife, or even a piece of paper, follow these steps.
1. Stop the Bleeding
Clean area well. Use crushed ice to apply pressure for 20 minutes or cover the wound with a gauze pad or a thick, clean piece of cloth. Use your hand if nothing else is available.
Press on the wound hard enough to stop the bleeding. Don't let up on the pressure even to change cloths. Just add a clean cloth over the original one.
Raise the wound above heart level, unless this would be painful.
Get medical help immediately if blood spurts from a wound or bleeding does not stop after several minutes of pressure.
2. Clean the Wound
Wash the cut with soap and water. Avoid hydrogen peroxide, alcohol, mercurochrome, Merthiolate, or iodine. They are not necessary and can be very painful and delay healing.
Make sure no dirt, glass, or foreign material remains in the wound.
Call your doctor if the cut or wound does not heal in 10 to 14 days.
3. Bandage the Wound
Bandage a cut (rather than seeing a doctor for stitches) when its edges tend to fall together and when the cut is not very deep.
Use "butterfly bandages," strips of sterile paper tape, or adhesive strip bandages to keep edges together.
Apply the bandage crosswise, not lengthwise. This will bring the edges of the wound into firm contact and promote healing.
Moist wounds heal faster and with less scar tissue than dry wounds. The scab that is formed by dry healing interferes with the movement of epidermal cells. Apply bacitracin to keep the wound moist and soft.
Scrapes
Scrapes are usually caused by falls onto the hands, knees, or elbows. This exposes nerve endings, all of which carry pain impulses to the brain. Because scrapes can affect so many nerve endings, they are usually much more painful than cuts. Although most abrasions and scrapes can be treated at home, you should call your doctor if they become infected.
First Aid
It is important to carefully clean scrapes to help prevent infection. Wash your hands before washing wounds, then carefully remove all dirt and debris. Use soap and warm water to thoroughly scrub the scrape for at least 5 minutes. Liquid soap provides better cleansing penetration. Use Vaseline to remove tar from wounds and wet gauze to "tease" gravel or dirt from the abrasion. Avoid antiseptic agents such as alcohol, Merthiolate, iodine, mercurochrome, or hydrogen peroxide. They do little good and cause stinging.
Next, apply direct pressure to the scrape, using nonstick gauze or a clean cloth to hold on the scrape and stop the flow of blood. If the gauze or cloth becomes soaked with blood, do not remove it. Instead, place another clean layer of cloth or gauze directly on top and reapply pressure. Because blood takes time to clot, you may have to apply pressure for 5 to 10 minutes. Raising the scrape above the level of the heart will also help reduce the blood flow. If you cannot control the bleeding, see your doctor.
On the scalp or a fingertip, you may apply an ice pack wrapped in a towel to constrict the blood vessels and stop the bleeding. Apply the ice pack for no more than 15 minutes or until the wound begins to feel numb. After a 10-minute rest, the ice pack may be reapplied. This procedure can be repeated several times.
Within 24 hours, remove the bandage and wash the area with mild soap and running water. The wound should be washed daily with plain tap water and soap. Use antibiotic ointment to keep the skin flexible and prevent the formation of a scab, which can slow healing. Change bandages two to three times daily. Watch for signs of infection.
Decision Guide for Cuts and ScrapesSymptoms/Signs | Action |
|---|
Bleeding that stops within 10 minutes with direct pressure | Use first aid |
Shallow cut or scrape that is minor and not on face | Use first aid |
Bleeding that cannot be controlled after applying pressure for 20 minutes | See provider |
Cut caused by an obviously dirty object, such as a rusty nail or shovel point; foreign object embedded in the wound; or debris in the wound | See provider |
Tetanus booster needed | See provider |
Deep or irregular cut; cut more than half an inch long; edges of the wound are separated or gaping and cannot easily be held together with a bandage | See provider |
Large scrape, scrape that causes severe pain, scrape on face, or puncture wound in hand | See provider |
Signs of infection -- increased redness or swelling around wound | See provider |
Numbness or weakness | See provider |
Uncontrollable bleeding | Seek help now |
Unable to move fingers or toes normally | Seek help now |
Signs of shock | Emergency: Call 911 |
Puncture wound or cut on head, chest, abdomen, or over a joint | Emergency: Call 911 |
