Care for a Skin Wound
Skin wounds, including animal or human bites, need thorough cleaning to reduce the risk of infection and scarring and to promote healing.
You may be able to do this yourself for minor wounds. You'll have to stop any bleeding, clean the wound, and perhaps bandage the wound.
Stop the bleeding
Before you clean the wound, try to stop the bleeding.
- Put on medical gloves, if available, before applying direct pressure to the wound. If gloves aren't available, put something else between your hands and the wound. You can use many layers of clean cloth, plastic bags, or the cleanest material available. Use your bare hands to apply direct pressure only as a last resort.
- Hold direct pressure on the wound, if possible, and elevate the injured area.
- Remove or cut clothing from around the wound. Remove any jewelry from the general area of the wound so if the area swells, the jewelry will not affect blood flow.
- Apply steady, direct pressure for a full 15 minutes. Use a clock—15 minutes can seem like a long time. Resist the urge to peek after a few minutes to see whether bleeding has stopped. If blood soaks through the cloth, apply another one without lifting the first. If there is an object in the wound, apply pressure around the object, not directly over it.
- If moderate to severe bleeding has not slowed or stopped, continue direct pressure while getting help. Do not use a tourniquet to stop the bleeding. Do all you can to keep the wound clean and avoid further injury to the area.
- Mild bleeding usually stops on its own or slows to an ooze or trickle after 15 minutes of pressure. It may ooze or trickle for up to 45 minutes.
Clean the wound
If you are not going to see your doctor immediately, rinse the wound for at least 5 to 10 minutes. Let the injured person clean his or her own wound, if possible.
- Wash your hands well with soap and water, if available.
- Put on medical gloves before cleaning the wound, if available.
- Remove large pieces of dirt or other debris from the wound with cleaned tweezers. Do not push the tweezers deeply into the wound.
- Wash the wound under running tap water (the more the better) to remove all the dirt, debris, and bacteria from
the wound. Lukewarm water and mild soap, such as Ivory dishwashing soap, are the best. (Note: If you are
cleaning a wound near the eye, don't get soap in the eye.)
- Scrub gently with a washcloth. (Moderate scrubbing may be needed if the wound is very dirty.) Hard scrubbing may actually cause more damage to the tissue and increase the chance of infection. Scrubbing the wound will probably hurt and may increase bleeding, but it is necessary to clean the wound thoroughly.
- If you have a water sprayer in your kitchen sink, try using the sprayer to wash the wound. This usually removes most of the dirt and other objects from the wound. Avoid getting any spray from the wound into your eyes.
- Large, minor, dirty wounds may be easier to clean in the shower.
- If some dirt or other debris remains in the wound, repeat the cleaning.
Bandage the wound
Consider bandaging the wound if you need to protect it from getting dirty or irritated. Choose the bandage carefully. There are many products available. Before you buy or use one, be sure to read the label carefully and follow the label's instructions when you apply the bandage.
- Be sure you have thoroughly cleaned the wound.
- Put on the bandage.
- When your bandage gets wet or soiled, put on a new, clean bandage to help prevent infection. If a bandage is stuck to a scab, soak it in warm water to soften the scab and make the bandage easier to remove. If available, use a nonstick bandage.
- If needed, use an adhesive strip called a butterfly bandage to hold the edges of the wound together. You can make one at home or buy them already made. Always put the butterfly bandage across a cut, not lengthwise, to hold the edges together.
Watch for signs of infection. If an infection develops under a bandage, you may need to see your doctor.
- Take the bandage off and leave it off whenever you are sure the wound will not become irritated or dirty.
Use of an antibiotic ointment has not been shown to affect healing. If you choose to use an antibiotic ointment, such as polymyxin B sulfate (for example, Polysporin) or bacitracin, apply the ointment lightly. The ointment will keep the bandage from sticking to the wound. Be sure to read the product label about skin sensitivity. If a skin rash or itching develops under the bandage, stop using the ointment.
Large, deep, or very dirty wounds
You may need to see a doctor for a large, deep, or very dirty wound. You may also need to see a doctor if the wound is too painful to clean or you cannot remove dirt, debris, or a foreign object. The doctor will also know if you need antibiotics or stitches.
Most wounds that need stitches should be treated within 6 to 8 hours after the injury to reduce the risk of infection. Very dirty wounds may not be stitched to avoid the risk of infection.
If you are going to see a doctor immediately, the wound can be cleaned and treated at the medical facility.
When to get stitches
A quick test to determine whether you need stitches is to stop the bleeding, wash the wound well, and then pinch the sides of the wound together. If the edges of the wound come together and it looks better, you may want to consider getting stitches. If stitches may be needed, avoid using an antiseptic or antibiotic ointment until after a doctor has examined the wound.
- Most cuts that require treatment should be stitched, stapled, or closed with skin adhesives within 6 to 8 hours after the injury. Some cuts that require treatment can be closed as long as 24 hours after the injury. Your risk of infection increases the longer the cut remains open. Occasionally a wound that is at high risk of infection will not be stitched until after 24 hours. Or it may not be stitched at all, so that adequate cleaning and antibiotic treatment can be done first to prevent infection.
- A cut from a clean object, such as a clean kitchen knife, may be stitched from 12 to 24 hours after the injury depending on the location of the cut.
- A facial wound may be treated to reduce scarring.
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer H. Michael O'Connor, MD - Emergency Medicine
Current as ofSeptember 9, 2014
Current as of: September 9, 2014
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