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Cuts, scrapes & puncture wounds
can often be treated at home

By: Darla Vanheerde, M.D.

It’s spring. Bicycles are out of the garage and into the street. The grass needs to be raked and the garden weeded. The hedges are calling for a trim, and the kids are bugging you to build them a tree house. Sound like tasks for an ordinary average spring day? You bet. But they are tasks brimming with the risk of a cut, scrape, or puncture wound.
Cuts involve injury to the skin and layers beneath it (depending on the seriousness of the cut). Minor cuts damage the skin and the fatty tissue beneath it. Serious cuts can penetrate muscles, tendons, blood vessels, ligaments, and nerves, and should be treated by a medical professional Scrapes are usually caused by a fall onto the hands, knees, or elbows. The skin of the injured area is scraped, however the injury does not usually penetrate beneath the skin tissue. Puncture wounds involve a hole (often deep) in the skin caused by a sharp object such as a pin, nail, tack, or tooth. Cuts, scrapes, and punctures can often be scary because they seem to involve a large amount of blood. The fingers, toes, and scalp are three parts of the body that tend to bleed a lot. These are also parts of the body that are frequently injured.
If it has been more than 10 years since your last tetanus shot, you should get one as soon a possible after receiving a cut, scrape, or puncture wound. Tetanus, or lockjaw, is a serious nerve ailment caused when bacterial spores enter the body. You don’t have to wait for an injury to get your tetanus booster. It’s preferable to stay up-to-date with immunizations. While cuts, scrapes, and punctures are three different types of injuries, their treatment is very similar. For cuts and scrapes, constant, direct pressure to the site to stop the bleeding is recommended as soon as possible after the injury occurs. Mild to moderate bleeding can usually be slowed or stopped within 15 minutes. A scrape may ooze clear, yellowish, or blood tinged fluid for one to several days. With a puncture wound, you want to make sure the object causing the wound has been completely removed from the injured area. As long as the injury is not bleeding excessively, allow the wound to bleed for five minutes in order to clean itself out. Then, apply constant, direct pressure for 15 minutes, as described above for a cut or scrape. With any wound, if you are unable to stop the bleeding after applying constant, direct pressure for 15 minutes, you should contact a medical professional for assistance. Scrapes are usually surface wounds that involve a lot of nerve endings (making them very painful) but not going very deep. Cuts and puncture wounds go deeper into the skin and may require stitches. In general, stitches may be needed in wounds that are: more than a quarter of an inch deep, gaping, jagged, over a joint such as an elbow or knee, or in a spot where scarring should be minimized – such as the face. If you suspect that stitches are needed, it’s important to seek medical attention as quickly as possible. Your risk of infection increases the longer the wound remains open.	It’s important to clean cuts, scrapes, and punctures as soon as possible to reduce the risk of infection and scarring by washing the wound for five minutes with mild soap and running cool water. There are nonprescription products available to numb the wound to make cleaning less painful. Be sure to read the label carefully to insure correct product use. Most scrapes, cuts, and punctures will heal well without a bandage. However, if the wound is likely to come into contact with dirt or other irritants, you may elect to apply a bandage. There are a number of bandage products available, including liquid skin bandages and gauze bandages. Butterfly bandages work well to hold the skin of a cut or puncture wound together. Using an antibiotic ointment may help to keep a gauze bandage from sticking to the wound. Change the bandage often, especially if it becomes soiled or wet. Your injury may be further complicated by swelling and bruising. Use an ice pack to reduce both symptoms. A non-prescription pain reliever may help to increase your comfort. Make sure to read labels thoroughly and follow dosage instructions carefully. As your injury is healing, it is important to watch for signs of infection. These include increased pain, swelling, redness, warmth, and red streaks around the wound. There may be pus draining from the wound. Lymph nodes may be swollen, and you may experience fever or chills. If any of these signs are present, contact your health care provider for treatment. Spring is a time to get outside and be a part of the action. Sometimes, this leads to an accidental cut, scrape, or puncture. If you experience an unexpected injury, remember to stop the bleeding, wash the wound thoroughly, bandage if needed, monitor for infection, and seek medical attention if you think stitches or a tetanus shot are needed.
**************** Dr. VanHeerde is a board certified family practice physician at Raiter Clinic in Cloquet.