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  • Cuts, Scrapes, or Bruises (Skin Injury)

    Definition

    • Cuts, lacerations, gashes and tears. These are wounds that go through the skin to the fat tissue.
    • Scrapes, abrasions, scratches and floor burns. These are surface wounds that don’t go all the way through the skin.
    • Bruises. These are bleeding into the skin from damaged blood vessels. They occur without a cut or scrape.

    FIRST AID Advice for Bleeding:

    • Put a gauze pad or clean cloth on top of the wound.
    • Press down firmly on the place that is bleeding.
    • This is called direct pressure. It is the best way to stop bleeding.
    • Keep using pressure until the bleeding stops.
    • If bleeding does not stop, press on a slightly different spot.

    First Aid Advice for Shock:

    • Lie down with the feet elevated.

    First Aid Advice for Penetrating Object:

    • If penetrating object still in place, don’t remove it. Reason: Removal can increase bleeding.

    When Sutures (stitches) are Needed

    • Any cut that is split open or gaping needs sutures.
    • Cuts longer than ½ inch (12 mm) usually need sutures.
    • On the face, cuts longer than ¼ inch (6 mm) usually need to be seen. They usually need closure with sutures or skin glue.
    • Any open wound that may need sutures should be seen as soon as possible. Ideally, they should be checked and closed within 6 hours. There is no cutoff, however, for treating open wounds to prevent wound infections.

    Cuts Versus Scratches: Helping You Decide

    • The skin is 2 mm (about 1/8 inch) thick.
    • A cut (laceration) goes through it.
    • A scratch or scrape (wide scratch) doesn’t go through the skin.
    • Cuts that gape open at rest or with movement need closure to prevent scarring.
    • Scrapes and scratches never need closure, no matter how long they are.
    • So this distinction is important.

    When to Call Us for Cuts, Scrapes, or Bruises (Skin Injury)

    Call 911 Now (your child may need an ambulance) If:

    • Major bleeding that can’t be stopped. See FIRST AID
    • Deep cut to chest, stomach, head or neck (such as with a knife). See FIRST AID.

    Call Us Now (night or day) If:

    • You think your child has a serious injury
    • Bleeding won’t stop after 10 minutes of direct pressure. See FIRST AID.
    • Deep cut and can see bone or tendons
    • Skin is split open or gaping and may need stitches
    • Pain is SEVERE and not improved 2 hours after taking pain medicine
    • Age under 1 year old
    • Dirt in the wound is not gone after 15 minutes of scrubbing
    • Skin loss from bad scrape goes very deep
    • Bad scrape covers large area
    • Cut or scrape looks infected (spreading redness, red streak)
    • You think your child needs to be seen urgently

    Call Us Within 24 Hours (between 9 am and 4 pm) If:

    • You think your child needs to be seen, but not urgently
    • Very large bruise after a minor injury
    • Some bruises appear without any known injury

    Call Us During Weekday Office Hours If:

    • You have other questions or concerns
    • No tetanus shot in over 5 years for DIRTY cuts
    • No tetanus shot in over 10 years for CLEAN cuts
    • Doesn’t heal by 10 days

    Parent Care at Home If:

    • Minor cut, scrape or bruise

    Care Advice for Cuts, Scrapes, or Bruises (Skin Injury)

    Cuts, Scratches and Scrapes:

    • Use direct pressure to stop any bleeding. Do this for 10 minutes or until the bleeding stops.
    • Wash the wound with soap and water for 5 minutes. Try to rinse the cut under running water.
    • Caution: Never soak a wound that might need sutures. Reason: It may become more swollen and harder to close.
    • Gently scrub out any dirt with a washcloth.
    • Cut off any pieces of loose skin using a fine scissors. Clean the scissors first with rubbing alcohol.
    • Put an antibiotic ointment on such as Polysporin. No prescription is needed. Then, cover it with a Band-Aid or dressing. Change daily.

    Liquid Skin Bandage for Minor Cuts and Scrapes:

    • Liquid skin bandage seals wounds with a plastic coating. It lasts up to 1 week.
    • Liquid skin bandage has several benefits compared to other bandages (such as Band-Aid). Liquid bandage only needs to be put on once. It seals the wound and may promote faster healing and lower infection rates. Also, it’s water-proof.
    • Wash and dry the wound first. Then, put on the liquid. It comes with a brush or swab. It dries in less than a minute.
    • You can get this product at a drugstore near you. There are many brands of liquid bandage. No prescription is needed.

    Bruises:

    • Use a cold pack or ice bag wrapped in a wet cloth. Put it on the bruise once for 20 minutes. This will help to stop the bleeding.
    • After 48 hours, use a warm wet wash cloth. Do this for 10 minutes 3 times per day. This helps to reabsorb the blood.

    Pain Medicine:

    • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed. See Dose Table.

    What to Expect:

    • Small cuts and scrapes heal up in less than a week.

    Call Your Doctor If:

    • Bleeding does not stop after using direct pressure to the cut
    • Starts to look infected (pus, redness)
    • Doesn’t heal by 10 days
    • Your child becomes worse

    Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

    Author and Senior Reviewer: Barton D. Schmitt, M.D.
    Copyright 1994-2013 Barton D. Schmitt, M.D.

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