The skin’s external location makes it susceptible to a number of wounds and injuries. These include:

• Cuts (injuries that result in a break or opening in the skin)
  
  
• Lacerations (a jagged and irregular type of cut produced by the tearing of soft body tissue)
  
  
• Scratches (minor injuries that result from sharp objects scraping along the skin)
  
  
• Abrasions (scrapes that result from the skin being rubbed away)
  
  
• Puncture wounds (wounds that occur when a pointed object pierces the skin)

Although many of these wounds are minor and heal quickly without complications, some wounds can lead to extensive blood loss or an infection or injury to deeper structures (e.g., nerves, tendons, blood vessels). Complications may also result from foreign material remaining inside a wound.

In order to prevent complications, people should take the proper first aid steps when treating cuts or other types of common wounds. Proper first aid includes controlling the bleeding, cleaning the wound, applying a topical antibiotic ointment, covering the wound, and frequently changing the bandages.

More serious wounds, such as those with jagged edges or edges that gape open, may require more extensive treatment. In order to heal properly, these types of wounds often need to be sewn shut by a physician (stitches). In some cases, a skin adhesive may be used to “glue” the edges of the wound together.

Cuts, lacerations, scratches, abrasions and puncture wounds are examples of common skin wounds.

Caused by sharp objects, such as a knife, cuts are injuries that result in a break or opening in the skin. A laceration is a jagged and irregular type of cut produced by the tearing of soft body tissue. Scratches are minor injuries that result from sharp objects, such as a fingernail or thorn, scraping along the skin. Abrasions are scrapes that result from the skin being rubbed away. “Rug burn” is a common form of abrasion. A puncture wound is another type of wound. It occurs when a pointed object, such as a nail, pierces the skin.

People often start to bleed following a cut, scratch or abrasion. This occurs because these wounds break or tear the blood vessels under the skin’s surface. Puncture wounds, however, are less likely to bleed than lacerations because a smaller total area is damaged. Over time, the bleeding will stop and a scab (hard crust) will form over the injury. Scabs protect the wound and allow a new layer of skin to form and to cover the injury. The scab falls off on its own once the wound is completely healed. This usually occurs within 1 to 2 weeks. Patients should avoid picking or scratching a scab. This can cause the new skin under the scab to rip, resulting in longer healing time and possible scarring.    

Minor skin injuries do not usually require emergency medical attention. However, patients must take proper steps to avoid infection and other possible complications. In order to properly care for simple wounds, patients should:

1. Control the bleeding. Minor skin injuries usually stop bleeding quickly on their own. Wounds on the face, head or mouth may bleed longer because these areas contain a large number of blood vessels. When a wound continues to bleed, patients should apply firm yet gentle pressure to the wound with a clean cloth, tissue or bandage. Using a finger or hand, pressure should be continuously placed on the injury for 20 to 30 minutes. Patients should avoid lifting the cloth or bandage during this time to check if the bleeding has stopped. Doing so can damage the blood clot that is forming in the wound and cause the bleeding to begin again. When blood soaks through the cloth or bandage, additional cloth or bandages should be placed over the existing material and more pressure should be applied.
   
   Raising the injury above the level of the heart can also help control bleeding. A person with a wound on the arm or leg, for example, should raise the limb.
   
   
2. Clean the wound. Cleaning a wound is important because dirt and bacteria can lead to infection. Patients should wash their hands and then use cool water and gentle soap to clean the wound. Patients can either hold the injury under running water or use a cup to pour water onto it. Hydrogen peroxide, iodine or other sterilizing substances should not be used because they can irritate the injury and impair the tissue's ability to heal. When dirt or other particles (e.g., glass, splinters) remain in the wound, tweezers that have been sterilized with isopropyl alcohol (rubbing alcohol) can be used to remove the debris. In many cases, a foreign object remaining inside a wound will cause part of the wound near the object to be painful when touched. Long or deeply embedded objects should not be removed by the patient. Instead, the patient should seek medical treatment.
   
   The area around the wound should also be cleaned to reduce the risk of tetanus, a dangerous type of bacterial infection. Soap and a soft washcloth can be used to clean the surrounding area.
   
   
3. Apply a topical antibiotic. A thin layer of antibiotic ointment or cream should be applied to the wound once the area is cleaned. Antibiotic treatments are useful because they keep the surface of the wound moist, prevent infection and enable the body to close the wound more effectively. They also discourage heavy scabs from forming and reduce the size of scars. Although the majority of cuts and scrapes heal well without the use of a topical antibiotic, applying it can speed healing time and reduce scarring. Some people may develop a mild rash when using antibiotic ointment. People should discontinue use of the product if a rash develops.
   
   
4. Cover the wound. Wounds that are located in areas that will be exposed to dirt or rubbed by clothing should be covered. Applying a bandage to the wound keeps the injury clean and prevents harmful bacteria from entering the site. Adhesive bandages are commonly used to cover minor wounds. Other alternatives include adhesive–free dressings and sterile gauze. Medical tape can be used to keep small wounds closed. Certain types of wounds, such as scrapes that cover a large section of the body, require special bandages. Known as occlusive or semiocclusive bandages, these bandages reduce scarring and speed healing by keeping the wound clean and moist.
   
   
5. Change the bandages. Bandages should be changed at least once a day. A bandage should also be changed whenever it becomes wet or dirty.

In some cases, a wound should be examined by a medical professional. Patients are advised to contact their physician if:

• The wound spurts blood, blood soaks through the bandage or bleeding continues after 10 minutes of firm and continuous pressure
  
  
• The wound is longer than 1/3 inch (0.8 centimeter) or covers a large area (more than 10 percent) of the body (e.g., chest, back, entire limb)
  
  
• Redness surrounds the wound or red streaks have formed near the wound
  
  
• A thick, creamy, grayish fluid (pus) drains from the wound
  
  
• There is warmth or numbness in the area of the wound or swelling around it
  
  
• The wound is jagged, appears deep or is located on the face, head or hand 
  
  
• The wound becomes tender or inflamed
  
  
• The edges of the cut gape open
  
  
• Dirt or debris (e.g., gravel, glass) is embedded in the wound despite attempts to clean it
  
  
• The wound was caused by a dirty or rusty object
  
  
• A long or deeply embedded object is present in the wound
  
  
• The patient cannot move comfortably or develops a temperature over 100 degrees Fahrenheit (38 degrees Celsius)
  
  
• The wound is failing to heal

Most minor wounds heal on their own within a few days. Deep cuts, such as those caused by stepping on a piece of glass, and cuts with gaping or jagged edges may not heal well on their own. Injuries with fat or muscle protruding through the wound may also require medical attention. In order to minimize bleeding, scarring and infection, these types of injuries often require stitches.

Stitches are used to join the sides of a cut together so it can heal properly. First the physician cleans the cut and makes sure that there is no foreign matter remaining in the wound. Then, in a process similar to sewing fabric together, a physician uses a small needle and suture string made of nylon, silk or vicryl to join the edges of the cut together. Once the edges are joined together, the physician ties a knot in the string. The procedure is usually not painful because an anesthetic (numbing agent) is often applied to the area beforehand.

Once the stitches are in place, the physician provides the patient with instructions on how to care for them, including when and how to wash the area. The physician may also recommend applying antibiotic ointment and elevating the wound above the level of the heart to lessen swelling, reduce pain and improve healing time.

The stitches stay in place until the wound is healed, usually between three days and two weeks, depending on the location of the cut. Injuries around the joints, for example, may take longer to heal because of the movement associated with that area.

To remove the stitches the physician will cut the knot and pull out the string. Patients may experience a pulling sensation but the removal of stitches is usually not painful. Vicryl string dissolves in the skin, so this type of stitch does not require removal.  

Skin adhesive may also be used to close a small wound. An alternative to stitches, skin adhesive is a liquid film used by physicians. When applied to a wound and allowed to dry, the glue-like film holds the edges of a wound together. The adhesive is left in place over the wound until the adhesive falls off. This usually occurs within five to 10 days.

Patients should avoid picking or scratching at the skin adhesive. Patients with bandages over the adhesive should keep the bandage from getting wet. Physicians may also instruct the patient to change the bandage daily. In addition, patients should not place antibiotic ointment or other types of ointment on the adhesive because it can cause the skin adhesive to loosen and fall off prematurely. The adhesive should stay out of direct sunlight. 

Whether a wound is minor and treated at home or more serious and requires stitches, it is recommended that patients monitor the injury for signs of infection during the first several days after treatment. Although cuts and other minor wounds can be painful at first, the severity of the pain typically lessens after the first day. The first sign of infection is often pain that worsens a day or more after the injury. Other signs include redness or warmth in the area of the wound. In addition, pus may ooze from the wound and the patient may develop a fever. Patients should contact their physicians within several hours after signs of infection appear.

Patients should also contact their physician when signs of nerve or tendon injury are present. Numbness in the area of the wound can indicate this type of injury. Inability to fully move a body part may be a sign of serious injury.

Some wounds result in tetanus, a type of serious infection. The disease is caused by the toxin of the bacterium Clostridium tetani. Spores of the bacteria live in the soil. When they are introduced to the body through a wound, the toxins affect the central nervous system (the brain and spinal cord). Tetanus is also known as “lockjaw” because stiffness of the jaw is the condition’s most common symptom. It may also result in stiffness and spasms of various other muscle groups (e.g., neck, chest, abdomen, back), seizures and, in some cases, death.

Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions regarding cuts and other common wounds:

1. What first aid steps should I take to treat cuts and other wounds?
   
   
2. When should I seek medical treatment for a cut, laceration, scratch, abrasion or puncture wound?
   
   
3. How long will it take for my wound to heal?
   
   
4. Will my wound leave a scar?
   
   
5. Does my wound put me at risk for any complications?
   
   
6. Do I need a tetanus shot?
   
   
7. How will I know if my wound becomes infected?
   
   
8. What should I do if I think my wound is infected?
   
   
9. Will I require stitches?
   
   
10. Is it possible that I have damaged nerves or tendons? What symptoms may indicate this?