Cuts, Scrapes and Stitches: Caring for Wounds

By Roland Larrabee, M.D.

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 or 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.

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.

Most wounds heal quicker if covered with an adhesive strip (Band-Aid) or with sterile gauze and adhesive tape. Change the bandage each day after cleaning the wound 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.

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 antibiotic ointment, but it can speed healing and help reduce scarring.

What do you 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.

You can close small cuts yourself with special tape, called butterfly tape, special adhesive strips, such as Steri-Strips, or with tissue adhesives. Call your doctor if your wound is deep, if you can't get the edges to stay together or if the edges are jagged. Your doctor may want to close your wound with stitches or skin adhesive. These things can help reduce the amount of scarring.

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 5 years.
• The cut bleeds in spurts, blood soaks through the bandage or the bleeding doesn't stop after 10 minutes of firm, direct pressure.