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Information from Your Family Doctor
Cuts, Scrapes, and Stitches
Am Fam Physician. 2004 Jun 1;69(11):2647-2648.
How should I clean a wound?
The best way to clean a cut, scrape, or puncture wound 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 because it can cause irritation. Clean tweezers with rubbing alcohol and use them to remove any bits of dirt from the wound.
Ask your doctor if you should use a stronger cleaning solution, such as hydrogen peroxide or an antiseptic. These things may irritate some wounds.
What about bleeding?
Bleeding helps clean out wounds. Most small cuts or scrapes will stop bleeding in a few minutes. Wounds on the face, head, or mouth sometimes bleed a lot because these areas have a lot of small blood vessels.
To stop the bleeding, press firmly but gently on the cut with a clean cloth, tissue, or piece of gauze. If the blood soaks through the gauze or cloth, do not take it off. Just put more gauze or another cloth on top of what you are already using, and keep pressing.
If the wound is on an arm or leg, raising the arm or leg above the level of your heart will help slow the bleeding.
Should I use a bandage?
Leaving a wound uncovered helps it stay dry and heal. If the wound is in a place that will not get dirty or be rubbed by clothing, you do not have to put a bandage on it.
If the wound is in a place that will get dirty or be rubbed by clothing, cover it with a bandage or with sterile gauze and adhesive tape. Change the bandage each day to keep the wound clean and dry.
Some wounds, such as scrapes that cover a large part of the body, should be kept moist and clean. This will help reduce scarring and make healing go faster. Bandages for large wounds are called occlusive (say: oh-clue-sive) or semiocclusive bandages. You can buy them in drug stores. Your doctor will tell you if this kind of bandage is best.
Should I use an antibiotic ointment?
Antibiotic ointments (such as Neosporin) help wounds heal by keeping out infection and by keeping the wound clean and moist. If your child has stitches, your doctor will tell you whether you should use an antibiotic ointment. Most cuts and scrapes heal without antibiotic ointment. But it can make healing go faster and help reduce scarring.
What should I do about scabs?
Nothing. Scabs are like bandages made by the body. They protect wounds from dirt. It is best to leave them alone and not pick at them. They will fall off when the time is right.
When should I call my child's doctor?
Call your child's doctor if the wound is deep, if you can't get the edges to stay together with a bandage, or if the edges are ragged. Your child's doctor may want to close the wound with stitches or skin adhesive. These things can help reduce scarring.
Call your child's doctor if:
The wound is ragged.
The wound is on your child's face.
The edges of the cut stay wide open.
The cut has dirt in it that won't come out.
The cut is very sore or red.
The cut is leaking a thick, creamy, grayish fluid.
Your child has a temperature over 100°F.
The area around the wound feels numb.
Your child can't move without pain.
You can see red streaks near the wound.
It is a puncture wound or a deep cut and your child has not recently had a tetanus shot.
The cut bleeds in spurts, blood soaks through the bandage, or the bleeding does not stop after 10 minutes of firm, direct pressure.
How do I take care of stitches?
You usually can wash an area that has been stitched after one to three days. Washing off dirt and the crust that forms around the stitches helps reduce scarring. If the wound leaks clear yellow fluid, you may need to cover it with a bandage.
Your child's doctor may want you to rinse the wound with water and put on a clean bandage 24 hours after getting stitches. Be sure to dry the area with soft pats of a clean towel after washing. You may want to hold the wound above your child's heart for the first day or two to help keep the swelling down, reduce pain, and speed healing.
Your child's doctor also may suggest using a small amount of antibiotic ointment to prevent infection. The ointment keeps a heavy scab from forming and may reduce the size of a scar.
Stitches usually are taken out in three to 14 days, depending on where the cut is located. Areas that move, such as over or around a joint, need more time to heal.
What is skin adhesive?
Skin adhesive (such as Dermabond) is a way to close small wounds without stitches. Your child's doctor will put a liquid film on the wound and let it dry. The film holds the edges of the wound together. You just leave the film on your child's skin until it falls off (usually in five to 10 days).
It is important not to scratch or pick at the adhesive film on the wound. If the doctor puts a bandage over the adhesive, be careful to keep the bandage dry. Your doctor will probably want you to put on a clean bandage every day.
Do not put any ointment on a wound that has skin adhesive on it. Ointment could make the adhesive get loose and fall off too soon. Your child also should keep the wound out of sunlight and away from tanning booth lamps.
Keep an eye on the wound. If the skin around it becomes very red and warm to the touch, or if the wound opens up again, call your child's doctor.
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Copyright © 2004 by the American Academy of Family Physicians.
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