Cuts and puncture wounds

Definition

A cut is an injury that results in a break or opening in the skin. A laceration is a jagged, irregular cut. A puncture is a wound made by a pointed object (like a nail, knife, or sharp tooth).

Symptoms

• Bleeding
• Loss of feeling or function below the wound site
• Pain

First Aid

If the wound is bleeding severely, call 911.

Minor cuts and puncture wounds can be treated at home. Take the following steps.

FOR MINOR CUTS

1. Wash your hands with soap to avoid infection.
2. Wash the cut thoroughly with mild soap and water.
3. Use direct pressure to stop the bleeding.
4. Apply an antibacterial ointment.
5. If the cut is likely to get dirty or be re-opened by friction, cover it (once the bleeding has stopped) with a bandage that will not stick to the injury.

FOR MINOR PUNCTURES

1. Wash your hands.
2. Use a stream of water for at least five minutes to rinse the puncture wound. Wash with soap.
3. Look (but DO NOT probe) for objects inside the wound. If found, DO NOT remove -- go to the emergency room. If you cannot see anything inside the wound, but a piece of the object that caused the injury is missing, also seek medical attention.
4. Apply antibacterial ointment and a clean bandage.

Do Not

• DO NOT assume that a minor wound is clean because you can't see dirt or debris inside. Wash it.
• DO NOT breathe on an open wound.
• DO NOT try to clean a major wound, especially after the bleeding is under control.
• DO NOT remove a long or deeply embedded object. Seek medical attention.
• DO NOT probe or pick debris from a wound. Seek medical attention.

• DO NOT push exposed body parts back in. Cover them with clean material until medical help arrives.

Call immediately for emergency medical assistance if

Call 911 if:

• The bleeding is severe, spurting, or cannot be stopped (for example, after 15 minutes of pressure).
• The person is seriously injured.

Call your doctor immediately if:

• The wound is large or deep, even if the bleeding is not severe.
• You think the wound might benefit from stitches (the cut is more than a quarter inch deep, on the face, or reaches bone).
• The person has been bitten by a human or animal.
• A cut or puncture is caused by a fishhook or rusty object.
• An object or debris is embedded -- DO NOT remove yourself.
• The wound shows signs of infection (warmth and redness in the area, a painful or throbbing sensation, fever, swelling, or pus-like drainage).
• You have not had a tetanus shot within the last 10 years.

The following types of wounds are more likely to become infected: bites, punctures, crushing injuries, dirty wounds, wounds on the feet, and wounds that are not promptly treated.

If you receive a serious wound, your doctor may order laboratory tests, such as a blood test and skin culture to check for bacteria.

Prevention

• Keep knives, scissors, firearms, and breakables out of the reach of children. When children are old enough, teach them to how to use knives and scissors safely.
• Keep up-to-date on vaccinations. A tetanus vaccine is generally recommended every 10 years.

References

Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002.

Illustrations

First aid kit

Laceration versus puncture wound

Stitches

Snake bite

Minor cut - first aid

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