Cuts
Topic OverviewCauses of cutsCuts 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 accidentally cut themselves with household or work items,
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. Cuts can be caused by: - Blunt objects that tear or crush the skin (lacerations). These cuts are more common over bony
areas, such as a finger, hand, knee, or foot, but they can occur anywhere on
the body. Blunt object injuries usually cause more swelling and tissue damage
and leave jagged edges, so problems with healing may
occur.
- Sharp-edged pointed objects pressing into and slicing the skin
tissue (incised wounds). Sharp object injuries are more likely to cut deeper
and damage underlying tissue.
- Sharp-edged objects piercing the skin
tissue (stab or
puncture wounds).
- A combination of blunt and sharp objects that tear, crush, and slice the skin tissue.
Types of cutsSome types of cuts are more serious and need medical
evaluation and treatment. 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
edges.
- Cuts that may scar and affect the appearance or function of
a body area. A cut on an eyelid or lip which doesn't heal well may interfere
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 underlying tissues.
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 of the injury often means there is a
large amount of bleeding or that damage to deeper tissues is present.
- 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 underlying tissues and blood vessels. Crush injuries have a high risk of
infection.
- Cuts with a known or suspected object, such as glass or
wood, in the wound.
Injury to the skin may also break small blood vessels under the skin
and cause more swelling and bruising than you would expect. What to do if you get a cut?When you
have a cut: - Stop the bleeding with direct pressure to the wound.
- Determine if other tissues, such as
blood vessels, nerves, tendons, ligaments, joints, bones, or internal organs,
have been injured.
- Determine if treatment by a
doctor, such as stitches, staples, or skin adhesives, is needed.
- Clean the wound and remove any dirt or debris to
prevent infections, both
bacterial skin infections and
tetanus ("lockjaw").
- Determine whether you
need a
tetanus shot.
Cuts to the head or face may appear worse than they are and
bleed a lot because of the good blood supply to this area. Controlling the
bleeding will allow you to determine the seriousness of the injury. Check your symptoms to decide if and when you
should see a doctor. Check Your SymptomsDo you have a cut? Cuts are open wounds that slice or tear through the skin. How old are you? Less than 12 years Less than 12 years 12 years or older 12 years or older Do you have a puncture wound? This is a wound caused by a sharp, pointed object going through the skin. Puncture wounds are deeper and narrower than cuts. Is there a cut to the eyeball? Is the wound more of a scrape than a cut? Do you have a deep wound in your head, neck, chest, or belly? A deep puncture wound in any of these areas could damage the internal organs. Yes Deep puncture wound to head, neck, chest, or belly No Deep puncture wound to head, neck, chest, or belly Are you having trouble breathing (more than a stuffy nose)? Yes Difficulty breathing more than a stuffy nose No Difficulty breathing more than a stuffy nose How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine? 8 to 10: Severe pain Severe pain 5 to 7: Moderate pain Moderate pain 1 to 4: Mild pain Mild pain Has the pain lasted for more than 8 hours? Yes Pain for more than 8 hours No Pain for more than 8 hours Is the pain getting worse? Do you have a wound on your arm, leg, hand, or foot that is more than just a scratch? For an arm or leg wound, is the skin below the wound (farther down the limb) blue, pale, or cold to the touch and different from the other arm or leg? This may mean that a major blood vessel was damaged and that blood is not reaching the rest of the arm or leg. Yes Skin is blue, pale, or cold below an arm or leg injury No Skin is blue, pale, or cold below an arm or leg injury Can you move the area below the injury normally, even though it may hurt? Yes Able to move limb normally below injury No Unable to move limb normally below injury For an arm or leg wound, is there any numbness, tingling, or loss of feeling around the wound or below the wound (farther down the arm or leg)? This may mean that a nerve was damaged. Yes Numbness, tingling, or loss of feeling around or below an arm or leg injury No Numbness, tingling, or loss of feeling around or below an arm or leg injury Do you think you may have a fever? Are there red streaks leading away from the area or pus draining from it? Do you have diabetes, a weakened immune system, peripheral arterial disease, or any surgical hardware in the area? "Hardware" includes things like artificial joints, plates or screws, catheters, and medicine pumps. Yes Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area No Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area Is the wound deep enough that you can see the bone, muscle, or tendon? Muscle looks dark and thick, and tendon and bone looks white and shiny. Yes Muscle, tendon, or bone is visible No Muscle, tendon, or bone is visible Were you able to clean the wound well? You may not be able to clean the wound if it is deep, hurts too much, or has an object stuck in it. Yes Able to adequately clean wound No Unable to adequately clean wound Is there an object stuck in the wound, and you can't get it out? You may not be able to remove it because of where or how deep the wound is or because it causes severe pain. Is the object large or small? Large means things like a nail or piece of wood that is at least 2 in. (5.1 cm) long and anything bigger than that. Small means things like a pencil tip or a small splinter or sliver. Large Large embedded object Small Small embedded object Is the cut or wound more than 0.25 in. (0.6 cm) deep and 0.75 in. (2.0 cm) long with sides that gape open? Wounds like this often need stitches. If you need stitches, it's best to get them within 8 hours of the injury. Yes Cut more than 0.25 in. (0.6 cm) deep and 0.75 in. (2.0 cm) long with sides that gape open No Cut more than 0.25 in. (0.6 cm) deep and 0.75 in. (2.0 cm) long with sides that gape open Is the wound on the face? Are you worried about scarring? Yes Worried about scarring Many things can affect how your body responds to a symptom and what kind
of care you may need. These include: - Your age. Babies and older
adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.
- Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.
- Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
able to take care of this problem at home. - Try home treatment to relieve the
symptoms.
- Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
Symptoms of infection may
include: - Increased pain, swelling, warmth, or redness in or
around the area.
- Red streaks leading from the area.
- Pus draining from the area.
- A fever.
To clean a wound well: - Wash your hands first.
- Remove large
pieces of dirt or debris from the wound with cleaned tweezers. Do not push the
tweezers deeply into the wound.
- Hold the wound under cool running
water. If you have a sprayer in your sink, you can use it to help remove dirt
and other debris from the wound.
- Scrub gently with water, a mild
soap, and a washcloth.
- If some dirt or other debris is still in
the wound, clean it again.
- If the wound starts to bleed, put
direct, steady pressure on it.
If a chemical has caused a wound or burn, follow the instructions on the chemical's container or call Poison Control (1-800-222-1222) to find out what to do. Most chemicals should be rinsed off with lots of water, but with some chemicals, water may make the burn worse. Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in adults are: - Diseases such as diabetes, cancer, heart disease,
and HIV/AIDS.
- Long-term alcohol and drug
problems.
- Steroid medicines, which may be used to treat a variety
of conditions.
- Chemotherapy and radiation therapy for
cancer.
- Other medicines used to treat autoimmune
disease.
- Medicines taken after organ transplant.
- Not
having a spleen.
You may need a tetanus shot depending
on how dirty the wound is and how long it has been since your last shot. - For a dirty wound that has
things like dirt, saliva, or feces in it, you may need a shot if:
- You haven't had a tetanus shot in the past 5
years.
- You don't know when your last shot was.
- For a clean wound, you may
need a shot if:
- You have not had a tetanus shot in the past 10
years.
- You don't know when your last shot was.
Pain in adults and older children - Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.
- Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
there.
- Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.
Pain in children under 3 years It can be hard to tell how much pain a baby or toddler is in. - Severe pain (8 to 10): The
pain is so bad that the baby cannot sleep, cannot get comfortable, and cries
constantly no matter what you do. The baby may kick, make fists, or
grimace.
- Moderate pain (5 to 7): The baby is
very fussy, clings to you a lot, and may have trouble sleeping but responds
when you try to comfort him or her.
- Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds
when you try to comfort him or her.
Some types of facial wounds are more likely to leave a scar than others. These include: - Jagged wounds on the face.
- Cuts on the eyelids.
- Cuts to the lips, especially if they cut through the edge of the lip.
Stitches or other treatment may help prevent scarring. It's best to get treated within 8 hours of the injury. With severe bleeding, any of these may
be true: - Blood is pumping from the wound.
- The
bleeding does not stop or slow down with pressure.
- Blood is quickly soaking through bandage after bandage.
With moderate bleeding, any of these may
be true: - The bleeding slows or stops with pressure but
starts again if you remove the pressure.
- The blood may soak through
a few bandages, but it is not fast or out of control.
With mild bleeding, any of these may be
true: - The bleeding stops on its own or with
pressure.
- The bleeding stops or slows to an ooze or trickle after
15 minutes of pressure. It may ooze or trickle for up to 45 minutes.
Symptoms of difficulty breathing can range from mild to severe. For example: - You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
- It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).
Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care. - Call your doctor now to discuss the symptoms and
arrange for care.
- If you cannot reach your doctor or you don't have
one, seek care in the next hour.
- You do not need to call an
ambulance unless:
- You cannot travel safely either by driving
yourself or by having someone else drive you.
- You are in an area
where heavy traffic or other problems may slow you down.
Seek Care TodayBased on your answers, you may need care soon. The
problem probably will not get better without medical care. - Call your doctor today to discuss the symptoms
and arrange for care.
- If you cannot reach your doctor or you don't
have one, seek care today.
- If it is evening, watch the symptoms and
seek care in the morning.
- If the symptoms get worse, seek care
sooner.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Put direct, steady pressure on the
wound until help arrives. Keep the area raised if you can. Puncture Wounds Scrapes Eye Injuries Home TreatmentMinor cuts usually can be treated
at home. If you do not have an increased chance of getting an infection, do
not have other injuries, and do not need treatment by a doctor or a tetanus shot, you can clean and bandage a cut at home. Home treatment can help
prevent infection and promote healing. The American Red Cross recommends that everyone use blood and body fluid precautions with first aid treatment. Treat bleedingStop the bleeding with direct pressure
to the wound. Nonprescription products are available to be applied to the
skin to help stop mild bleeding of minor cuts, lacerations, or abrasions.
Before you buy or use one, be sure to read the label carefully and follow the
label's instructions when you apply the product. After you have
stopped the bleeding, check your symptoms to determine if and
when you need to see your doctor. Clean the woundClean the wound as soon as possible
to reduce the chance of infection, scarring, and tattooing of the skin from
dirt left in the wound. - Remove large pieces of dirt or other debris from the wound with cleaned tweezers. Do not push the tweezers
deeply into the wound.
- Wash the wound for 5 minutes with large amounts
of cool, clean water. Some nonprescription products are available for wound
cleaning that 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, which can harm the tissue and slow
healing.
Stitches, staples, or skin adhesives (also called liquid stitches)Determine if your wound needs to be closed by a
doctor with stitches, staples, or skin adhesives. Your doctor
will tell you how to
take care of your stitches or staples and when to
return to have them removed.
Skin adhesives usually do not need to be removed, but your doctor may wish to
see you to check on the wound. Be sure to carefully follow your doctor's
instructions. If you are unsure of how to care for your wound or have
questions, call your doctor for instructions. Consider applying a bandageMost cuts heal well and
may not need a bandage. You may need to protect the cut from dirt and
irritation. Be sure to clean the cut thoroughly before bandaging it to
reduce the risk of infection occurring under the bandage. - Select 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, and follow the label's instructions when you apply
the bandage.
- If you use a cloth-like bandage, apply a clean bandage
when it gets wet or soiled to further help prevent infection. If a bandage is
stuck to a scab, soak it in warm water to 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, a visit to your doctor may be needed.
- 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 purchase one to help hold the skin edges
together.
Tetanus- Determine whether you need a
tetanus shot.
- You may have a localized
reaction to a tetanus shot. Symptoms include warmth, swelling, and redness at
the injection site. A mild fever may occur. Home
treatment can help reduce the discomfort.
Pain reliefElevate the injured area on pillows anytime you
are sitting or lying down. Try to keep the area at or above the level of your
heart to reduce swelling. Medicine you can buy without a prescription Try a nonprescription
medicine to help treat your fever or pain: |
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Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine. | Safety tips Be sure to follow
these safety tips when you use a nonprescription medicine: |
---|
- Carefully read and follow all
directions on the medicine bottle and box.
- Do not take more than
the recommended dose.
- Do not take a medicine if you have had an
allergic reaction to it in the past.
- If
you have been told to avoid a medicine, call your doctor before you take
it.
- If you are or could be pregnant, do not take any medicine other
than acetaminophen unless your doctor has told you to.
- Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.
| Symptoms to watch for during home treatmentCall your doctor if any of the following occur during home treatment: - Signs of infection
- Signs
of loss of function
- Signs of decreased blood
flow
- Pain gets worse.
- Symptoms become more severe or more frequent.
PreventionTo prevent cuts, it is important to
practice safety when using blunt or sharp objects: - Pay close attention to what you are
doing.
- If you become distracted, set the project aside until you
can pay attention to it.
- Know how to use the object
properly.
- Have good lighting so you can see what you are
doing.
- Wear gloves whenever possible to protect your
hands.
- Wear other safety gear, such as glasses or boots, as
appropriate.
- Hold a sharp object away from your body while using
it.
- Carry the object with the dangerous end away from
you.
- Shut the power off and use safety locks on your power tools
when you are not using them.
- Store dangerous objects in secure
places away from children.
- Teach children about safety, and be a
good role model.
- Do not use alcohol or drugs when you are handling
sharp objects.
Be sure to have a tetanus shot every 10 years. Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. Questions to prepare for your appointmentYou can help your
doctor diagnose and treat your condition by being prepared to answer the
following questions: - What are your main symptoms? How long have you
had your symptoms?
- How and when did the injury occur? Have you had
any injuries in the past to the same area? Do you have any continuing problems
because of the previous injury?
- What object caused the injury? Was
there or is there an object in the cut?
- What home treatment
measures have you tried? Did they help?
- What nonprescription
medicines have you tried? Did they help?
- What prescription and
nonprescription medicine do you take?
- Was your injury caused by
abuse?
- Were drugs or alcohol involved in your
injury?
- When was your last
tetanus shot?
- Do you have any
health risks?
CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Adam Husney, MD - Family Medicine Specialist Medical ReviewerH. Michael O'Connor, MD - Emergency Medicine Martin J. Gabica, MD - Family Medicine Current as ofMarch 20, 2017 Current as of:
March 20, 2017 Last modified on: 8 September 2017
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