Dr. MJ Bazos MD,
Patient Handout
Cuts,
Scrapes and Stitches:Caring for wounds
How should I clean a
wound?
The best way to clean a cut,
scrape or puncture wound (such as from a nail) is with cool water. You can hold
the wound under running water or fill a tub with cool water and pour it from a
cup over the wound. Use soap and a soft washcloth to clean the skin around the
wound. Try to keep soap out of the wound itself because soap can cause
irritation. Use tweezers that have been cleaned in isopropyl alcohol to remove
any dirt that remains in the wound after washing. Even though it may seem that
you should use a stronger cleansing solution (such as hydrogen peroxide or an
antiseptic), these things may irritate wounds. Ask your family doctor if you
feel you must use something other than
water.
What about
bleeding?
Bleeding helps clean out
wounds. Most small cuts or scrapes will stop bleeding in a short time. Wounds on
the face, head or mouth will sometimes bleed a lot because these areas are rich
in blood vessels. To stop the bleeding, apply firm but gentle pressure on the
cut with a clean cloth, tissue or piece of gauze. If the blood soaks through the
gauze or cloth you’re holding over the cut, don’t take it off. Just
put more gauze or another cloth on top of what you already have in place and
apply more pressure. If your wound is on an arm or leg, raising it above your
heart will also help slow the bleeding.
Should I use a
bandage?
Leaving a wound uncovered
helps it stay dry and helps it heal. If the wound isn’t in an area that
will get dirty or be rubbed by clothing, you don’t have to cover it. If
it’s in an area that will get dirty (such as your hand) or be irritated by
clothing (such as your knee), cover it with an adhesive strip (Band- Aid) or
with sterile gauze and adhesive tape. Change the bandage each day to keep the
wound clean and dry. Certain wounds, such as scrapes that cover a large area of
the body, should be kept moist and clean to help reduce scarring and speed
healing. Bandages used for this purpose are called occlusive or semiocclusive
bandages. You can buy them in drug stores without a prescription. Your family
doctor will tell you if he or she thinks this type of bandage is best for
you.
Should I use an antibiotic
ointment?
Antibiotic ointments (such as
Bacitracin) help healing by keeping out infection and by keeping the wound clean
and moist. A bandage does pretty much the same thing. If you have stitches, your
doctor will tell you whether he or she wants you to use an antibiotic ointment.
Most minor cuts and scrapes will heal just fine without anitbiotic ointment, but
it can speed healing and help reduce scarring.
What should I do about
scabs?
Nothing. Scabs are the
body’s way of bandaging itself. They form to protect wounds from dirt.
It’s best to leave them alone and not pick at them. They will fall off by
themselves when the time is right.
When do I need
stitches?
You can close small cuts with
special tape, called butterfly tape, or special adhesive strips, such as
Steri-Strips. You may need stitches if the wound is deep, the edges won’t
stay together or the edges are jagged. If the
wound
doesn’t close easily, call your
doctor. Stitches can help reduce the amount of scarring. Stitches are usually
removed in three to 14 days, depending on where the cut is located. Areas that
move, such as over or around the
joints,
require more time to heal.
How do I take care of
stitches?
You can usually wash an area
that has been stitched in one to three days. Washing off dirt and the crust that
may form around the stitches helps reduce scarring. If the wound drains clear
yellow fluid, you may need to cover it. Your doctor may suggest that you rinse
the wound with water and rebandage it in 24 hours. Be sure to dry it well after
washing. You may want to keep the wound elevated above your heart for the first
day or two to help lessen swelling, reduce pain and speed healing. Your doctor
may also suggest using a small amount of antibiotic ointment to prevent
infection. The ointment also keeps a heavy scab from forming and may reduce the
size of a scar.
Do I need a
tetanus shot?
Tetanus is a serious
infection you can get after a wound. The infection is also called
“lock-jaw,” because stiffness of the jaw is the most frequent
symptom. To prevent tetanus infection when the wound is clean and minor,
you’ll need a tetanus shot if you haven’t had at least three doses
before or haven’t had a dose in the last 10 years. When the wound is more
serious, you’ll need a tetanus shot if you haven’t had at least
three doses before or if you haven’t had a shot in the last five years.
The best way to avoid tetanus infection is to talk to your family doctor to make
sure your shots are up to date.
Call
your family doctor if any of the following things occur
- The wound is jagged.
- The wound is on your face.
- The edges of the cut gape open.
- The cut has dirt in it that won’t come
out.
- The cut becomes tender or inflamed.
- The cut drains a thick, creamy, grayish
fluid.
- You start to run a temperature over
100°F.
- The area around the wound feels numb.
- You can’t move comfortably.
- Red streaks form near the wound.
- It’s a puncture wound or a deep cut and you
haven’t had a tetanus shot in the past five years.
- The cut bleeds in spurts, blood soaks through the
bandage or the bleeding doesn’t stop after 10 minutes of firm, direct
pressure.