Overview
Your skin is your body's largest organ and plays a big role in keeping you
healthy. It helps to regulate your body temperature and acts as a barrier
to keep body fluids in and bacteria out. The skin also acts as a first-alert
system to the world around you by warning of potential problems when you feel
heat or pain.
Causes
Cuts and scrapes happen when your skin is accidentally broken or worn away.
This can be the result of a fall, banging against a hard object, or being cut
by something sharp.
We all get cuts sometimes, but some people are more prone to these injuries
than others. Children, for instance, almost always have some sort of minor skin
damage just from playing. Others more likely to get cuts and scrapes include
older people or those who have delicate skin because of certain illnesses or
medications.
Symptoms
How can you tell if your cut or scrape is healing properly? If you
keep the area clean, the chance of infection is low. Some signs of infection
to watch for include:
- discharge or pus coming from the cut or scrape
- fever
- increased pain
- redness, swelling, or warmth in the affected area
If any of these signs appear, your injury needs a doctor's attention. To stop
the infection from spreading, treatment most often consists of an antibiotic
cream or ointment (such as mupirocin, bacitracin, or fucidic acid)* or a prescription
for oral antibiotics.
Certain people need to take special care if they get cuts or scrapes because
their injuries won't heal easily. These include:
- people who have weakened immune systems because they are taking similar
medications or are in chemotherapy
- people who take medications (such as prednisone) that make the skin dry
and fragile
- people who take medications (such as warfarin) that decrease blood clotting
- some people with diabetes
If you are in any high-risk category, find out what special precautions you
should take if you injure yourself.
Treatment
How are cuts treated?
The most important thing to remember when dealing with a cut or open wound
is to keep it clean. To prevent infection, make sure that anything that
touches the scrape or cut is as clean as possible. This is not always easy,
as bacteria are on almost everything in our environment. However, most medical
supplies are sterilized and free of bacteria that may cause infection.
The first step in treating a cut is to control or stop the bleeding by applying
firm and even pressure that is not too hard - you don't want to cut off the
circulation. Resist the temptation to keep checking to see if the blood
has stopped; you might disturb the healing process. Wait a few minutes before
looking. If there's a lot of blood and it's coming through the padding you're
using, don't remove the padding; cover it with another cloth or pad and continue
to apply pressure. This allows clotting to continue undisturbed. If the bleeding
doesn't stop, keep applying pressure and get the cut checked by a doctor.
Many people, especially children, are distressed at the sight of blood and
may feel queasy and lightheaded. However, the sooner you can cover the wound
and slow down the blood flow, the easier the injury will be to deal with.
Remember, many minor cuts - especially to the head and face - bleed a lot more
than you might expect, since the blood vessels are more dense in these areas
of the body than in most others. If you've been able to control the blood flow,
check the cut to see if it needs medical attention.
Cuts that require medical attention include the following signs:
- they are deep (doctors usually are more concerned with how deep a cut is
rather than how long it is, because of the concern that deeper tissues like
blood vessels, nerves, or tendons may be damaged)
- they expose any muscle tissue (red) or fat tissue (yellowish)
- they stay open if you let go of the sides of the cut
- they are on a joint or in an area where healing might be difficult (stitching
might be needed to keep it closed)
If no medical attention is needed, treat the cut in the following way:
- Cleanse the cut with sodium chloride (salt) 0.9% and sterile water. If
this is not available, use a mild soap and water to cleanse. This process
helps remove any debris and bacteria from the cut. Avoid using cotton or wool
to clean the cut because fibres may get into the wound and cause infection.
- Cover the wound with a moist dressing (cloth bandage). If you are not sure
what type of dressing to use, ask your pharmacist for a recommendation.
- You can use astringents, alcohol, and antiseptics on the area surrounding
the cut, but it is best to avoid using them directly on or in the cut, as
they can disrupt the natural healing process.
- Dress the wound with a topical antibiotic such as Polysporin to help prevent
infection and keep the wound moist.
Stitches or glue?
Medicine has made many advances over the past few years, and there are several
alternatives to stitches. A special tape or even glue can be used to close some
wounds.
Stitches: The advantage to stitches is that the doctor can line up the
edges of the cut squarely and cleanly, and the stitches keep the edges in place
while the cut heals. This is particularly important if the cut is on a part
of the body that moves a lot. If the wound is jagged or uneven, stitches are
usually preferred.
Some stitches dissolve on their own, while others need to be removed after
a few days. The disadvantage of stitches can be the stress, especially to children,
of having the area frozen and the stitches put in. Removing stitches is painless,
however. The most you might notice is a "tugging" feeling as the thread
is pulled through the skin.
Some people are concerned that stitches will increase scarring. The reverse
is usually the case. Stitches allow for better definition of the wound edges
and decrease the biggest cause of scarring, which is the gaping of the wound.
Steri-strips: Sometimes, a cut is deep enough to need some help, but
not deep enough for stitches. Also, if a cut is on the face, doctors may try
to avoid using stitches to minimize scarring. In this case, steri-strips or
butterfly strips may be used. These strips are very fine, thin, and sticky and
act like stitches. They usually stay on for a few days and then fall off on
their own. The disadvantage is that they may not stay on long enough for certain
cuts. Encourage children to not pick them off.
Skin Super Glue: A new addition to the emergency room is skin glue.
It is being used more and more when stitches can be avoided, especially on cuts
where you want to minimize scarring. The advantage is that the glue goes on
quickly and painlessly. The disadvantage is that it can't be used on areas that
bend a lot, such as your knuckle or other areas of high tension.
How are scrapes treated?
Scrapes, unlike cuts, are not deep wounds, but they're still painful because
they can cover a large, sensitive area of skin. The most important part
about treating a scrape is cleansing. To treat simple scrapes:
- Cleanse the scrape with sodium chloride (salt) 0.9% and sterile water.
If this is not available, use a mild soap and water to cleanse.
- Cover the scrape with a moist bandage or dressing.
- If there's debris inside the scrape (such as gravel or glass) that you can't
remove, have it checked by a doctor and cleaned properly.
- Dress the wound with a topical antibiotic such as Polysporin to help prevent
infection and keep the wound moist.
Scrapes should be cleaned regularly while they're healing to keep the scab
from getting too hard. A thick, hard scab can result in a more obvious scar.
You may want to use an antibiotic ointment, usually available without a prescription,
while the scrape is healing. If you want to cover the scrape, some bandages
contain antibiotic padding too. In addition, some commercial gauzes are available
that have a coating to keep them from sticking to the wound. This makes removing
the dressing a lot easier and leaves the scab intact.
Scrapes or lacerations are injuries to the skin and thus remove the barrier
that protects us from potential infections with bacteria, including Clostridium
tetani, also known as tetanus. People with skin injuries should ensure that
their tetanus vaccinations are up to date.
*All medications have both common (generic) and brand names. The brand name
is what a specific manufacturer calls the product (e.g., Tylenol®).
The common name is the medical name for the medication (e.g., acetaminophen).
A medication may have many brand names, but only one common name. This article
lists medications by their common names. For more information on brand names,
speak with your doctor or pharmacist.
Other tips:
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