Skin Injury

Skin Injury

Is this your symptom?

  • Cuts and Scratches: Surface cuts or scratches that only go partially through the skin. They rarely get infected. Deep cuts, called lacerations, go through the skin.
  • Scrapes: An area of surface skin that has been scraped off. This often happens to the knees, elbows, and palms.
  • Bruises: These result from a direct blow or a crushing injury. There is bleeding into the skin from damaged blood vessels. There is no cut or scrape.

Types

  • Cut - Shallow: Shallow cuts (scratches) only go part way through the skin. They rarely become infected. A scratch is an injury to the skin by a sharp edge. For example, scratches can be caused by fingernails, a sharp nail, a piece of metal, or a branch of a tree or bush. A paper cut is a scratch from the edge of a piece of paper. A shallow cut or scratch can usually be treated at home. Making sure the wound is clean is the most important thing.
  • Cut - Deep: Deep cuts (lacerations) go through the skin. A laceration is caused by cutting the skin with the sharp edge of an object. This can happen from a knife, a razor, a piece of glass, or the sharp edge of a piece of metal. Making sure the wound is clean is very important. Stitches may be needed.
  • Scrape: This happens when an injury scrapes off the top layer of the skin. Examples are when people "scrape" their elbow or "skin" their knee. A rug burn is a type of scrape. Abrasion is the medical term for a scrape. Pain and bleeding are usually mild. A scrape can usually be treated at home. Making sure the wound is clean is the most important thing.

When Are Stitches Needed?

  • Any cut that is split open or gaping most likely needs stitches. Cuts longer than ½ inch (12 mm) most often need stitches. On the face, cuts longer than ¼ inch (6 mm) most often need stitches.
  • A doctor should look at any open wound that may need stitches. A doctor should be seen regardless of the time passed since the injury.

When Can Liquid Skin Bandage Be Used?

Liquid skin bandage can be used for small shallow cuts. It can also be used on scratches and scrapes. Liquid skin bandage has many benefits when compared to a regular bandage.

  • It only needs to be put on minor cuts and scrapes once.
  • It helps stop minor bleeding. Liquid skin bandage seals the wound and may help it to heal faster.
  • It also lowers infection rates.

However, liquid skin bandage costs more than adhesive bandages (Band-Aids).

  • Instructions: After the wound is washed and dried, spray or swab on the liquid. It dries in less than 1 minute and most often lasts a week. You can bathe as normal.
  • Examples: Band-Aid Liquid Bandage, New Skin, Curad Spray Bandage, and 3M No Sting Liquid Bandage Spray.

What is Tetanus?

  • It is a rare infection caused by bacteria found in places like dirt and soil. These bacteria enter through a break in the skin. They then spread through the body.
  • Tetanus is often called "lock jaw." This infection causes very serious symptoms such as trouble breathing and severe muscle spasms. Even with treatment in a hospital, a person can die from tetanus.
  • A tetanus shot protects a person from getting tetanus. It can also protect a person from other kinds of infections.

When Does an Adult Need a Tetanus Shot?

  • Clean Cuts and Scrapes: Tetanus shot needed every 10 years. People with clean minor wounds need a tetanus booster if their last booster shot was more than 10 years ago. Minor wounds include a surface scrape or a cut that occurs while washing dishes. If it is more than 10 years since last tetanus shot, get one in the next 72 hours (3 days).
  • Dirty Cuts and Scrapes: Tetanus shot needed every 5 years. People with dirty wounds need a tetanus booster if it has been more than 5 years since their last booster shot. Dirty wounds include those contaminated with soil, stool, and saliva. They also include more serious wounds from deep punctures, crushing, and burns. If is more than 5 years since last tetanus shot, get one in the next 72 hours (3 days). When in doubt, assume that the wound is dirty.

Pain Scale

  • None: No pain. Pain score is 0 on a scale of 0 to 10.
  • Mild: The pain does not keep you from work, school, or other normal activities. Pain score is 1-3 on a scale of 0 to 10.
  • Moderate: The pain keeps you from working or going to school. It wakes you up from sleep. Pain score is 4-7 on a scale of 0 to 10.
  • Severe: The pain is very bad. It may be worse than any pain you have had before. It keeps you from doing any normal activities. Pain score is 8-10 on a scale of 0 to 10.

When to Call for Skin Injury

Call 911 Now

  • Major bleeding (nonstop bleeding or spurting)
  • Knife wound (or other deep cut) to the chest, stomach, back, neck, or head
  • You think you have a life-threatening emergency

Call Doctor Now or Go to ER

  • Severe pain
  • Bleeding that won't stop after 10 minutes of direct pressure
  • Cut causes numbness or loss of feeling
  • Cut causes weakness (can't move finger or toe)
  • Skin is split open or gaping and may need stitches
  • Dirt in the wound is not gone after 15 minutes of scrubbing
  • Skin loss from bad scrape goes very deep
  • Cut or scrape looks infected (redness, red streak, or pus)
  • You think you have a serious injury
  • You think you need to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Several bruises occur without any known injury
  • Very large bruise follows a minor injury (2 inches or wider, 5 cm or wider)
  • Diabetic with any cut or scrape on foot
  • No past tetanus shots
  • Last tetanus shot was over 5 years ago, for DIRTY cut or scrape
  • Last tetanus shot was over 10 years ago, for CLEAN cut or scrape
  • You think you need to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Minor cut, scrape, or bruise

Care Advice for Minor Cut, Scrape, or Bruise

  1. What You Should Know:
    • Cuts and scrapes are types of skin wounds. Bruises are the result of injuries that cause blood vessels to leak without breaking the skin.
    • Cuts and scrapes can become infected, so need to be taken care of.
    • You can treat minor skin injuries at home.
    • Here is some care advice that should help.
  2. Treatment of Minor Cuts, Scratches, and Scrapes:
    • Use direct pressure for 10 minutes to stop any bleeding.
    • Wash the wound with soap and water for 5 minutes.
    • Gently scrub out any dirt with a washcloth.
    • Cut off any pieces of dead loose skin using small sharp scissors. Clean the scissors with rubbing alcohol before and after use.
    • Put on an antibiotic ointment, covered by an adhesive bandage (Band-Aid) or dressing. Change daily.
    • Another option is to use a liquid skin bandage. This only needs to be put on once. Avoid using ointments with this.
  3. Treatment of Minor Bruise:
    • Cold Pack: For pain or swelling, use a cold pack or ice wrapped in a wet cloth. Put it on the sore area for 20 minutes. Repeat 4 times on the first day, then as needed.
    • Heat Pack:
      • If pain lasts over 2 days, apply heat to the sore area. Use a heat pack, heating pad or warm wet washcloth. Do this for 10 minutes, then as needed.
      • For widespread stiffness, take a hot bath or hot shower instead. Move the sore area under the warm water.
    • Rest the injured part as much as you can for 48 hours.
  4. Pain Medicine:
    • You can take one of the following drugs if you have pain: acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve).
    • They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
    • Use the lowest amount of a drug that makes your pain feel better.
    • Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old.
    • Read the instructions and warnings on the package insert for all medicines you take.
  5. What to Expect: Pain and swelling most often get better 2 to 3 days after an injury. Swelling is most often gone in 7 days. Pain may take 2 weeks to go away.
  6. Call Your Doctor If:
    • The wound has pus, redness, or is tender to touch
    • The wound does not heal within 10 days
    • You think you need to be seen
    • You get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: This information is not intended to 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.


Last Reviewed: 12/14/2017 1:32:40 AM
Last Updated: 5/7/2017 1:36:18 PM

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Bruise from Coumadin

This 74 year old female did not recall hurting her hand. She takes the blood thinner Coumadin.

The picture shows a large amount of bruising (ecchymosis) of the left hand. There is no broken bone (fracture).

Bruise on Shoulder (4 Days Old)

This bruise is four days old.

Bruises (contusions) result from a direct blow or a crushing injury; there is bleeding into the skin from damaged blood vessels without an overlying cut or abrasion.

Abrasion on Shoulder

This individual fell and scraped his shoulder on the sidewalk. The picture shows a shallow abrasion with minor bleeding.

First Aid Care Advice for Minor Abrasion:

  • Apply direct pressure for 10 minutes to stop any bleeding.
  • Wash the abrasion with soap and water.
  • Gently scrub out any dirt with a washcloth.
  • Apply an antibiotic ointment, covered by a gauze dressing. Change daily.
  • Another option is to use a Liquid Skin Bandage that only needs to be applied once. Avoid ointments with this.

Bruise on Thigh (1 Day Old)

This bruise is one day old.

Bruises (contusions) result from a direct blow or a crushing injury; there is bleeding into the skin from damaged blood vessels without an overlying cut or abrasion.

Abrasion on Elbow

This picture shows a shallow abrasion on the left elbow.

First Aid Care Advice for Minor Abrasion:

  • Apply direct pressure for 10 minutes to stop any bleeding.
  • Wash the abrasion with soap and water.
  • Gently scrub out any dirt with a washcloth.
  • Apply an antibiotic ointment, covered by a Band-Aid or dressing. Change daily.
  • Another option is to use a Liquid Skin Bandage that only needs to be applied once. Avoid ointments with this.
Laceration - Scalp

This scalp laceration (cut) is gaping open. It will require closure with sutures or medical staples.

First Aid Care Advice:

  • Apply direct pressure for 10 minutes to stop any bleeding.
  • Wash the cut with soap and water.
Puncture Wound - BB Gun

This photo shows a puncture wound from a BB gun in left upper arm. Note the small hole in the arm where the BB struck and entered the skin.

Scratches from a Cat

The photo shows 3-4 parallel scratches on the wrist caused by a cat.

First Aid Care Advice:

  • Wash the scratches with soap and water.
  • Apply an antibiotic ointment twice daily.
  • Watch closely for signs of infection, especially the first 1-3 days.
First Aid - Bleeding Finger
  • Apply direct pressure to the entire wound with a sterile gauze dressing or a clean cloth.
First Aid - Wound - How to Clean
  • Wash the wound with soap and water for 5 minutes.
  • Gently scrub out any dirt with a washcloth.
  • Cover the wound with a sterile gauze or a clean cloth.
  • Apply direct pressure for 10 minutes to stop any bleeding.
Abrasion on Elbow (3 Days Old)

This abrasion near the elbow occurred 3 days ago. The picture shows an abrasion that is starting to crust over.

There are no signs of infection (e.g., spreading redness, pus).

First Aid - Cut - Gaping and Needing Sutures
  • Apply direct pressure for 10 minutes to stop any bleeding.
  • Wash the wound with soap and water.
  • Cover the wound with a sterile gauze or a clean cloth until seen.
Laceration - Chin

This photo shows a gaping laceration (cut) of the chin. It will require closure with either sutures or with skin glue (i.e., Dermabond).

First Aid Care Advice:

  • Apply direct pressure for 10 minutes to stop any bleeding.
  • Wash the cut with soap and water.
  • Cover with a gauze dressing or adhesive bandage (e.g., Band-Aid).
Laceration - Chin (After Skin Glue)

The photograph shows a chin laceration that was closed with skin glue (i.e., Dermabond).

Dermabond (2-octylcyanoacrylate, Ethicon) is a tissue adhesive or "skin glue" which received FDA approval in the United States in 1998. It is used as an alternative to suturing for the repair of simple lacerations. The cosmetic outcome of wounds closed with tissue adhesive is comparable and in some cases superior to suturing.

To apply, the wound edges are held firmly together, and several coats of the glue are painted along the wound margins. The glue dries quickly, within 45-60 seconds. The glue will come off on its own as the wound heals and the top skin layer falls off, usually in about one week.