Cuts

Overview

Cuts are open wounds through the skin. Normally the skin is under slight, constant tension as it covers the body. A cut is a forceful injury to the skin. Many people cut themselves by accident with household items, work items, or yard tools or when operating machinery. Children often are cut during play and sports activities or from falls while riding wheeled toys, such as bikes, scooters, or skateboards. Most cuts are minor, and home treatment is usually all that is needed.

Types of cuts

Some types of cuts are more serious and need to be checked and treated by a doctor. These more serious cuts include:

• Long or deep cuts.
• Cuts that open with movement of the body area, such as a cut over a joint. A cut over a joint may take a long time to heal because of the movement of the wound's edges.
• Cuts that may scar and affect the way a part of the body looks or functions. A cut on an eyelid or lip that doesn't heal well may cause problems with function or leave a noticeable scar.
• Cuts that remove all of the layers of the skin (avulsion injuries), such as slicing off the tip of a finger. An avulsion injury may take a long time to heal.
• Cuts from an animal or human bite. Infection is more likely with a bite injury.
• Cuts that have damage to tissues under the cut. Injuries to nerves, tendons, or joints are more common with cuts on the hands or feet. Slight swelling, bruising, and tenderness around a cut, bite, scrape, or puncture wound is normal. Swelling or bruising that begins within 30 minutes after the injury often means there is a large amount of bleeding or that deeper tissues are damaged.
• Cuts over a possible broken bone. Bacteria can get into a cut over a broken bone and infect the bone.
• Cuts caused by a crushing injury. With this type of injury, the cut may have occurred when the skin split open from the force of the injury. The force of the injury may also damage tissues and blood vessels under the cut. Crush injuries have a high risk of infection.
• Cuts that have or are thought to have an object still in the wound. For example, the object might be glass or wood.

Injury to the skin may also break small blood vessels under the skin. This can cause more swelling and bruising than you would expect.

Self-Care

Minor cuts usually can be treated at home. Home treatment can help prevent infection and promote healing.

Try these tips for treating a cut.

• Stop the bleeding.

  Apply direct pressure to the wound.

  Nonprescription products can be applied to the skin to help stop mild bleeding of minor cuts, lacerations, or scrapes. Before you buy or use these products, be sure to read the label carefully. Follow the label's instructions when you apply the product.

  Cuts to the head or face may look worse than they are and may bleed a lot because of the good blood supply to these areas. Controlling the bleeding will help you see how serious the injury is.

• Clean the wound as soon as you can.

  This lowers the chance of infection, scarring, and tattooing of the skin from dirt left in the wound. (If dirt or other debris is not removed from a cut, the new skin will heal over it. The dirt can then be seen through the skin and may look like a tattoo.)

  • Use cleaned tweezers to remove large pieces of dirt or other debris from the wound. Don't push the tweezers deeply into the wound.
  • Wash the wound for 5 minutes with large amounts of cool, clean water. Some nonprescription products for wound cleaning can numb the area so that cleaning doesn't hurt as much. Be sure to read the product label for correct use.
  • Don't use rubbing alcohol, hydrogen peroxide, iodine, or Mercurochrome. They can harm the tissue and slow healing.
• Check to see if other tissues have been injured.

  These tissues include blood vessels, nerves, tendons, ligaments, joints, bones, and internal organs.

• Apply a bandage, if needed.

  Most cuts heal well and may not need a bandage. You may need to protect the cut from dirt or irritation. Be sure to clean the cut thoroughly before bandaging it. Cleaning reduces the chance that you'll get an infection under the bandage.

  If you use a bandage:

  • Choose the bandage carefully. There are many products available. Liquid skin bandages and moisture-enhancing bandages are available with other first aid products. Before you buy or use one, be sure to read the label carefully. Follow the label's instructions when you put on the bandage.
  • If you use a cloth-like bandage, apply a clean bandage when it gets wet or soiled. This will also help prevent infection. If a bandage is stuck to a scab, soak it in warm water. Soaking it will soften the scab and make the bandage easier to remove. If available, use a nonstick dressing. There are many bandage products available. Be sure to read the product label for correct use.
  • Watch for signs of infection. If you have an infection under a bandage, you may need treatment from a doctor.
  • Apply a thin layer of petroleum jelly, such as Vaseline, lightly to the wound. It will keep the bandage from sticking to the wound.
  • Use an adhesive strip to hold the edges of a wound together. Always put an adhesive strip across a wound to hold the edges together, not lengthwise. You can make a butterfly bandage at home or buy one to help hold the skin edges together.
• Treat pain and swelling.

  Prop up the injured area on a pillow anytime you sit or lie down. Try to keep the area at or above the level of your heart to reduce swelling.

If you are concerned that the injury is more serious, you may need to be checked by a doctor to see if you need stitches or a tetanus shot.

Need for stitches

To determine whether you need stitches, stop the bleeding and wash the wound well. Then pinch the sides of the wound together. If the wound's edges come together and it looks better, you may need stitches. If stitches may be needed, avoid using antiseptic until after a doctor checks the wound.

• Most cuts that need treatment should be stitched, stapled, or closed with skin adhesive within 6 to 8 hours after the injury.
  • Some cuts that need treatment can be closed up to 24 hours after the injury. Your risk of infection increases the longer the cut stays open.
  • Sometimes a wound with a high risk of infection won't be stitched until after 24 hours, or won't be stitched at all, so it can be cleaned well to prevent infection.
• A cut from a clean object may be stitched 12 to 24 hours after the injury depending on the location of the cut.

Need for a tetanus shot

To decide if you need a tetanus shot after a wound, first decide if the object that caused the wound was dirty or clean. An object is dirty if it has dirt, soil, spit, or feces on it. A clean object does not have dirt, soil, spit, or feces on it.

You will need a tetanus shot if:

• Your wound was caused by something that was clean and your last tetanus shot was longer than 10 years ago.
• Your wound was caused by something that was dirty and your last tetanus shot was longer than 5 years ago.
• You are not sure if your wound was caused by something clean or dirty and your last tetanus shot was longer than 5 years ago.
• You are not sure when you had your last tetanus shot.
• You did not get the first series of tetanus shots (primary vaccination series).

If you need a tetanus shot, call your doctor to arrange for a shot.

Some people may need tetanus immunoglobulin (IG) for a wound that is at high risk for developing tetanus. The immunoglobulin is usually only needed if you have not (or do not know if you have) completed the tetanus primary vaccination series.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

• New or worse signs of infection, such as redness, warmth, swelling, pus, or a fever.
• New loss of function near the wound.
• Decreased blood flow, such as cool, pale skin near the wound.
• Pain gets worse.
• Symptoms occur more often or are more severe.

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