PYAM offices will be closed from 10AM to 1PM on Wednesday November 15th for the funeral of Dr Terence Coyne.

Skin Trauma

Cuts and Scratches 

Most cuts are superficial and extend only partially through the skin.  The cuts that need sutures are deep and leave the skin edges separated.  Another rule of thumb is that cuts need sutures if they are longer than 1/2 inch (1/4 inch if on the face).

Scrapes (Abrasions) 

An abrasion is an area of superficial skin that has been scraped off during a fall, such as a floor burn or a scraped knee.

Puncture Wounds 

The skin has been completely punctured by an object that is narrow and sharp, such as a nail.  The wound is not wide enough to need sutures.  Since puncture wounds usually seal over quickly, there is a greater chance of wound infection with this type of skin injury.  Puncture wounds of the upper eyelid are especially dangerous and can lead to a brain abscess.  A deep infection of the foot can begin with swelling of the top of the foot 1 to 2 weeks after the puncture.  Tetanus is also a risk if your child is not immunized.

Bruises

Bleeding into the skin from damaged blood vessels gives a black and blue mark, or a bruise.  Since the skin is not broken, there is no risk of infection.  Bruises usually follow injury caused by blunt objects.  Unexplained bruises can indicate a bleeding tendency.  (Exception:  “Unexplained” bruises on the shins are usually not a sign of a bleeding tendency.  Children often bump this area and forget about it.)

Cuts and Scratches 

Most cuts are superficial and extend only partially through the skin.  The cuts that need sutures are deep and leave the skin edges separated.  Another rule of thumb is that cuts need sutures if they are longer than 1/2 inch (1/4 inch if on the face).

Home Care 

Treatment

  • Apply direct pressure for 10 minutes to stop any bleeding.
  • Wash the wound with soap and water for 5 minutes.
  • Cut off any pieces of loose skin using a small scissors.
  • Apply an antibiotic ointment and cover it with a Band-Aid or gauze. Wash the wound, apply the ointment, and change the Band-Aid or gauze daily.
  • Give acetaminophen or ibuprofen as needed for pain relief.

Common Mistakes in Treating Cuts and Scratches

  • Don’t use alcohol or Merthiolate on open wounds, because they sting and damage normal tissue.
  • Don’t kiss an open wound because the wound will become contaminated by the many germs in a normal person’s mouth.
  • Let the scab fall off by itself; picking it off may cause a scar.

Call our Office IMMEDIATELY if . . . 

  • Bleeding won’t stop after 10 minutes of direct pressure.
  • The skin is split open and might need sutures. Note:  Lacerations must be sutured within 12 hours of the time of injury, and the infection rate is far lower if they are closed within 4 hours.
  • There is any dirt in the wound that you can’t get out.
  • The cut looks infected (yellow pus, spreading redness or streaks).

Call our office during regular hours if . . . 

  • Your child hasn’t had a tetanus booster in10 years.
  • The wound hasn’t healed after 10 days.
  • You have other questions or concerns.

Scrapes (Abrasions) 

An abrasion is an area of superficial skin that has been scraped off during a fall, such as a floor burn or a scraped knee.

Home Care 

Cleaning the scrape.  First, wash your hands and then wash the wound vigorously for at least 5 minutes with warm water and liquid soap.  The area will probably need to be scrubbed several times with a wet piece of gauze to get out all the dirt.  You may have to remove some dirt particles with a pair of tweezers.  If there is tar in the wound, it can often be removed by rubbing it with petroleum jelly, followed by soap and water.  Pieces of loose skin should be cut off with sterile scissors, especially if the pieces of skin are dirty.  Rinse the wound well.

Antibiotic Ointments and Dressing. Apply an antibiotic ointment and cover the scrape with a Band-Aid or gauze dressing.  This is especially important for scrapes over joints where the skin is stretched constantly, like elbows and knees.  Cracking and reopening at these sites can be prevented with an antibiotic ointment, which keeps the crust soft.  Cleanse the area once a day with warm water and then reapply the ointment and dressing until the scrape is healed.  Because abrasions can hurt badly, give acetaminophen or ibuprofen for the first day.

Call our office IMMEDIATELY if . . . 

  • There is any dirt or grime in the wound that you can’t get out.
  • Skin loss involves a very large area.
  • The scrape looks infected (yellow pus, spreading readness).

Call our office during regular hours if . . . 

  • Your child hasn’t had a tetanus booster in 10 years.
  • The scrape hasn’t healed after 2 weeks.
  • You have other questions or concerns.

Puncture Wounds 

The skin has been completely punctured by an object that is narrow and sharp, such as a nail.  The wound is not wide enough to need sutures.  Since puncture wounds usually seal over quickly, there is a greater chance of wound infection with this type of skin injury.  Puncture wounds of the upper eyelid are especially dangerous and can lead to a brain abscess.  A deep infection of the foot can begin with swelling of the top of the foot 1 to 2 weeks after the puncture.  Tetanus is also a risk if your child is not immunized.

Home Care 

Cleansing and Trimming.  Soak the wound in warm water and soap for 15 minutes.  Scrub the wound with a washcloth to remove any debris.  If the wound bleeds a little more, that may help remove germs. Cut off any flaps of loose skin that cover the wound and interfere with drainage or removing debris.  Use a fine scissors after cleaning them with rubbing alcohol.

Antibiotic Ointment and Pain Relief.  Apply an antibiotic ointment and a Band-Aid to reduce the risk of infection. Resoak and reapply antibiotic ointment every 12 hours for 2 days.  Give acetaminophen or ibuprofen for any pain.

Call our office IMMEDIATELY if . . . 

  • Dirt remains in the wound after you have soaked it.
  • The tip of the object could have broken off in the wound.
  • The sharp object or place where the injury occurred was dirty.
  • The wound looks infected (yellow pus, spreading redness).

Call our office during regular hours if . . . 

Your child hasn’t had a tetanus booster in more than 5 years.

Pain, redness, or swelling increases after 48 hours.

You have other questions or concerns.

Bruises

Bleeding into the skin from damaged blood vessels gives a black and blue mark, or a bruise.  Since the skin is not broken, there is no risk of infection.  Bruises usually follow injury caused by blunt objects.  Unexplained bruises can indicate a bleeding tendency.  (Exception:  “Unexplained” bruises on the shins are usually not a sign of a bleeding tendency.  Children often bump this area and forget about it.)

Home Care 

Apply ice for 20 to 30 minutes.  No other treatment should be necessary.  Give acetaminophen or ibuprofen for pain.  Avoid aspirin because it may prolong the bleeding.  After 48 hours apply a warm washcloth for 10 minutes 3 times a day to help the skin reabsorb the blood.  Bruises clear in about 2 weeks.  If the injury is a blood blister, do not open it, or the risk of infection will be increased.  Blisters will dry up and peel off in a 1 to 2 weeks.

Call Our Office Immediately … 

  • Bruises are unexplained and several in number.