When to see the doctor for cuts, puncture wounds and foreign bodies. Plus, home treatment.

 

 

by James Hubbard, M.D., M.P.H.

 

Many people I see with skin trauma tell me they didn’t know whether the wound is serious enough to warrant coming in.

Here are some tips on when to see a doctor for a cut—and what you can do at home.Remember, this if for information only.Everyone is unique and specific recommendations need to come from your personal doctor.

  1. Stop the bleeding.Usually, it’s as simple as applying direct pressure on the wound.Use a clean cloth or gauze, if available, or your free hand if not. (Click here for a list of supplies to have on-hand in case of skin wounds.)If the wound is too large and blood is spurting, try applying deep pressure to the area of skin next to the side of the wound that’s closest to the heart. If an extremity is involved, elevate the cut above your heart level.
  2. Clean the wound if you’re going to have to treat it at home.  If not, just wrap it and head for the clinic. However, don’t wait more than a few hours before making the decision (12 hours max).

    • If you’re cleaning it, if there’s any chance of debris being in there, you have to get it out.  Use soap and water, or peroxide and gauze, or a cotton swab.
    • If the cut is deep, wash it out with water from the faucet.  To provide a little extra pressure, you might try filling a water jug and punching a small hole: Direct the water to the wound and squeeze the jug.
    • In order to inspect or clean a bleeding wound, you can temporarily stop the bleeding by applying the deep pressure mentioned in step one.  Oozing blood, rather than spurting, is usually from a vein instead of an artery, so try applying pressure to the area away from your heart (side closer to the feet or hand, known as distal).

Definitely seek medical help for a wound if:

  • you can’t stop it from bleeding.
  • it’s large and gaping.
  • the extremity distal to the wound (away from the heart) has areas of numbness (nerve damage).
  • you have trouble moving joints in full range distal to the wound (tendon damage).
  • you’re unable to clean it adequately.

You probably need medical help for a wound if:

  • you’re worried about scarring.
  • the wound is over a joint. (Moving the joint in daily activities will make the cut harder to heal.)
  • you have doubts.

If you decide to treat the wound at home:

  • Take off all rings if the cut involves a finger.
  • Bring the edges together and tape using Steri-Strips, butterfly bandages or strips of regular tape.Make sure the adjacent skin is dry.You can help the tape stick better by applying a little super glue to the adjacent skin (not the wound) first.

Puncture wounds:

  • In simple terms, a puncture wound it is a wound that goes deeper than is wide.Since these are hard to clean, they tend to get infected.Don’t try to close the wound since it will probably drain for a day or two.
  • If you think it has hit a nerve or blood vessel or gone into bone, the chest or abdominal cavity, seek medical help.

Foreign bodies:

  • I’m talking about small objects stuck in the soft tissue of the skin, usually metal or wood. Anything larger than, say, a toothpick, and you definitely need to see a doctor for removal.Also if you can’t see it or feel it, you might as well be trying to find a needle in a haystack.
  • If you want to try to get it out, you’ll need some sterile tweezers and maybe a needle.If the implement isn’t sterile, burn the tips until they’re red hot.Dip in alcohol for good measure.Use the needle to pick at the skin surface to remove the object or to better see it for removal with tweezers.
  • Often, the object is too deep to remove.If you think it’s really small—say, tip of pencil lead or less—try applying cloths soaked in warm water for about 20 minutes at a time, several times a day,  for a few days.It just might come closer to the surface for easy pickings.However, small pieces of metal may not cause near the inflammatory reaction as non-metals, so you may just be stuck with it, so to speak.As long as it doesn’t get infected and hasn’t damaged a blood vessel or nerve, just leave it alone until you can see a doctor.

Please add comments with additional advice, if mine is not clear or you don’t agree.

Doctors and business owners: Send customized issues of James Hubbard’s My Family Doctor to your customers or patients. E-mail publisher-at-familydoctormag.com for details.

As with all information on this site, this article cannot replace professional, personal medical advice. Read more here.

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9 Responses to “When to see the doctor for cuts, puncture wounds and foreign bodies. Plus, home treatment.”

  1. Sagan Says:

    Thanks for the tips on how to take care of wounds at home- it’s so difficult to manage to see a doctor because they’re so busy that it makes sense to treat those smaller wounds at home.

    Sagans last blog post..Life Lessons: Learning how to cook

  2. James Hubbard Says:

    Sagan, If there is any doubt at all, see the doctor.

    James Hubbards last blog post..How to Help a Loved One: depression, alcoholism, addiction …

  3. FatFighterTV Says:

    I’m one of those people who goes to the doctor even if I’m not sure I need to! I think it’s because I’ve covered health for so long that I’m a bit paranoid now. :)

    FatFighterTVs last blog post..News Nugget: 1 in 5 U.S. preschoolers obese

  4. James Hubbard Says:

    FatFighterTV,

    No argument here.

    James Hubbards last blog post..How to Help a Loved One: depression, alcoholism, addiction …

  5. Judy Rodman Says:

    I had a funny puncture wound situation that left a tatto on my leg. When I was a little girl, I had a pencil fall from my elementary school desk and I instinctively caught it between my knees. The tip of the pencil lead (I guess it was not lead but graphite? ) was not removed and left a blue point tatto that I still carry to this day. I’m still alive to tell about it, but if it happened again would leaving the point of the pencil in be a safe thing to do?

    Judy Rodmans last blog post..I"m Speaking at Indie Connect Monday night, April 6th

  6. ocbody.com doc Says:

    A pretty good list. I might add to the list under seek medical help that help should be sought if structures under the skin other than fat are exposed by the wound such as tendons or bone. Healing with exposure can allow these structures to dry out and become injured. Also if the wound is really dirty, sterile wound wash saline (in cans) is now available at the pharmacy. These sprays sterile saline into the wound to help clean it without causing damage or adding the potential for contamination. They also hurt less. Hydrogen peroxide can hurt.

    ocbody.com docs last blog post..Stevie Nicks & "The Botox Blame Game"

  7. James Hubbard Says:

    Hi Judy, I have one of those things also. The graphite is non-toxic and your skin took up the color, like a tattoo. There is nothing to do unless the actual lead tip breaks off and is embedded or the wound gets infected.

    James Hubbards last blog post..How to Help a Loved One: depression, alcoholism, addiction …

  8. James Hubbard Says:

    ocbody,

    Thanks for the excellent info.

    James Hubbards last blog post..How to Help a Loved One: depression, alcoholism, addiction …

  9. Cosmetic Surgery UK Says:

    I see the doctor always to be sure and to avoid worries.

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