SKIN INJURY (CUTS, SCRAPES, BRUISES)

Symptoms | When to call | Homecare Advice

Bruise on Thigh

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 Shoulder

Fell and struck shoulder on sidewalk.
The picture shows a shallow abrasion with minor bleeding.

Shallow Abrasion on Elbow

Bruise on Shoulder

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.

Small Minor Bruise on Forearrm

Scalp Laceration

This scalp laceration (cut) is gaping open. It required closure with medical staples.

Puncture Wound with Foreign Body

There is a small metal splinter (foreign body) embedded in the palm of the hand. This patient went to the emergency department and had the splinter removed.

Puncture Wound from BB in Left Upper Arm

X-Ray Showing BB in Left Upper Arm

Shallow Scratches on the Wrist from a Cat's Claws

Injury Definition

Cuts and Scratches: Superficial cuts (scratches) only extend partially through the skin and rarely become infected. Deep cuts (lacerations) go through the skin (dermis).
Abrasions or Scrapes: An area of superficial skin that has been scraped off. Commonly occurs on the knees, elbows and palms.
Bruises: 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.

When are Stitches Needed?

Any cut that is split open or gaping probably needs sutures (stitches). Cuts longer than 1/2 inch (1/4 inch on face) usually need sutures.
A physician should evaluate any open wound that may need sutures regardless of the time that has passed since the initial injury.

Tetanus Booster

Tetanus is a rare infection caused by bacteria that are found in many places, especially in dirt and soil. The tetanus bacteria enter through a break in the skin and then spread through the body.
Tetanus is commonly called "lock jaw" because the first symptom is a tightening of the muscles of the face. However, the final stage of the infection is much more serious. All of the muscles of the body go into severe spasm, including the muscles that control breathing. Eventually a person with a tetanus infection loses the ability to breath, and may die in spite of intensive treatment in the hospital.
A tetanus booster protects you from getting a tetanus infection. It does not prevent other kinds of wound infection.
Clean Cuts and Scrapes - Booster Needed Every 10 Years: Patients with clean MINOR wounds AND who have previously had 3 or more tetanus shots (full series), need a booster every 10 years. Examples of minor wounds include a superficial abrasion or a cut sustained while washing dishes. Obtain booster within 72 hours.
Dirty Cuts and Scrapes - Booster Needed Every 5 Years: Patients with dirty wounds need a booster every 5 years. Examples of dirty wounds include those contaminated with soil, feces, saliva and more serious wounds from deep punctures, crushing, and burns. Obtain booster within 24. When in doubt? assume that it is a dirty wound.

See More Appropriate Topic (instead of this one) If

Animal caused it, see ANIMAL BITE
It looks infected, see WOUND INFECTION
Skin is punctured (not cut or scraped), see PUNCTURE WOUND
BURNS
SPLINTER OR SLIVER is present in the skin

WHEN TO CALL YOUR DOCTOR FOR SKIN INJURY

Call 911 Now (you may need an ambulance) If

Major bleeding (actively bleeding or spurting) that can't be stopped
Cut on the neck, chest, back, or abdomen that may go deep (e.g. stab wound)
First Aid: Apply direct pressure to the entire wound with a clean cloth.

Call Your Doctor Now (night or day) If

You think you have a serious injury
Severe pain
Bleeding that hasn't stopped after 10 minutes of direct pressure
Cut is very deep (e.g. can see bone or tendons)
Skin is split open or gaping and may need stitches
Dirt or grime in the wound is not removed after 15 minutes of scrubbing
Skin loss from bad scrape goes very deep
Skin loss involves greater than 10% of body surface (Note: the hand's surface equals 1%)
High pressure injection injury (e.g. from paint gun, usually work-related)
Cut or scrape looks infected (redness, red streak or pus)

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

You think you need to be seen
Several bruises occur without any known injury
Very large bruise follows a minor injury (wider than 2 inches)
No tetanus booster in more than 10 years (5 years for dirty cuts and scrapes)
Diabetic with any cut or scrape on foot

Call Your Doctor During Weekday Office Hours If

You have other questions or concerns

Self Care at Home If

Minor cut, scrape or bruise and you don't think you need to be seen

HOME CARE ADVICE FOR MINOR CUT, SCRAPE, OR BRUISE

Treatment of Minor Cuts, Scratches and Scrapes (abrasions):
- Apply direct pressure for 10 minutes to stop any bleeding.
- Wash the wound with soap and water for 5 minutes.
- For any dirt, scrub it gently with a washcloth.
- Cut off any pieces of dead loose skin using a fine scissors (cleaned with rubbing alcohol before and after use).
- Apply an antibiotic ointment, covered by a Band-Aid or dressing. Change daily.
Treatment of Minor Bruise:
- Apply a cold pack or an ice bag wrapped in a towel for 20 minutes each hour for 4 consecutive hours. (20 minutes of cold followed by 40 minutes of rest for 4 hours in a row).
- 48 hours after the injury, use local heat for 10 minutes 3 times each day to help reabsorb the blood.
- Rest the injured part as much as possible for 48 hours.
Pain Medication: For pain relief, take acetaminophen every 4-6 hours (e.g. Tylenol; adult dosage 650 mg) OR ibuprofen every 6-8 hours (e.g. Advil, Motrin; adult dosage 400 mg).
- Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
- Do not take acetaminophen if you have liver disease.
- Read the package instructions thoroughly on all medications that you take.
Expected Course: Pain and swelling usually begin to improve 2 or 3 days after an injury. Swelling is usually gone in 7 days. Pain may take 2 weeks to completely resolve.
Call Your Doctor If:
- Looks infected (pus, redness, increasing tenderness)
- Doesn't heal within 10 days
- You become worse or develop any of the "Call Your Doctor" symptoms.

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.

Reviewed 8/2004

Revised 8/2004

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