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.
- 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.
- 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.
- 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.
- 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.
Tags: first aid