What's the best way to treat a cut?
A cut, or laceration, is a wound that breaks through the skin and into the tissues beneath. Because the injury is deeper than a scrape, there are more likely to be problems, such as bleeding, and there is the possibility of damage to nerves and tendons.
The following simple guidelines will help you prevent serious bleeding and other problems such as scarring when your child gets a cut.
- Apply pressure. Almost all active bleeding can be stopped by applying direct pressure with clean gauze or cloth over the site for five or ten minutes. The most common mistake is interrupting the pressure too early in order to peek at the wound. Doing this may result in more bleeding or in the buildup of a clot that can make it harder to control the problem with further pressure. If bleeding starts again after five minutes of continuous pressure, reapply pressure and call your doctor for help. Do not use a tourniquet or tie-off on an arm or leg unless you are trained in its use, since this can cause severe damage if left on too long.
- Stay calm. The sight of blood frightens most people, but this is an important time to stay in control. You’ll make better decisions if you are calm, and your child will be less likely to get upset by the situation. Remember, by using direct pressure you will be able to control bleeding from even the most severe lacerations until help can arrive. Relatively minor cuts to the head and face will bleed more than cuts to other parts of the body because of the greater number of small, superficial blood vessels.
- Seek medical advice for serious cuts. No matter how much (or how little) bleeding occurs, call your doctor if the laceration is deep (through the skin) or more than 1⁄2 inch (1.27 cm) long. Deep cuts can severely damage underlying muscles, nerves, and tendons, even if on the surface the wound does not appear serious. Long lacerations and those on the face, chest, and back are more likely to leave disfiguring scars. In these situations, if the wound is properly sutured (stitched), the scar probably will be much less apparent. If in doubt about whether sutures are needed, call your doctor for advice. To reduce unsightly scarring, sutures should be placed within eight hours after injury occurs.
You should be able to treat short, minor cuts yourself, as long as the edges come together by themselves, or with the aid of a "butterfly" bandage, and if there is no numbness beyond the wound and no reduction in sensation or movement. (A butterfly bandage is a strip of adhesive with ends that flare. It's used to keep the edges of a cut together during the healing process.) However, have your doctor examine your child if there is any possibility that foreign matter, such as dirt or glass, is trapped in the cut. Any injury that cannot be managed by you should be seen by your pediatrician or emergency medical services as soon as possible to maximize healing. Your child may not like to let you examine a laceration thoroughly because of the pain involved. The pediatrician, however, can use a local anesthetic, if necessary, to ensure a thorough exam. - Cleanse and dress the wound. If you feel comfortable handling the problem, wash the wound with plain water and examine it carefully to be sure it is clean. Apply an antibiotic ointment, then cover it with a sterile dressing. It’s easy to underestimate the extent or severity of a laceration, so even if you choose to treat it yourself, don’t hesitate to call your pediatrician for advice.
If any redness, swelling, or pus appears around the wound, or if bleeding recurs, consult your physician as soon as possible. Antiseptics such as iodine and alcohol are not necessary and increase the discomfort for your child, so do not use them on cuts. If your child’s immunizations are current, tetanus shots are not necessary after most abrasions and lacerations. If your child has not had a tetanus booster within five years, however, your pediatrician may recommend that one be given.
Prevention
It is almost impossible for a curious and active child to avoid some scrapes and minor cuts, but there are things you can do to decrease the number your child will have and to minimize their severity. Keep potentially dangerous objects like sharp knives, easily breakable glass objects, and firearms out of his reach. When he gets old enough to use knives and scissors himself, teach him how to handle them properly and insist that they be used safely. At regular intervals make a safety check of your house, garage, and yard. If you find objects that are potentially dangerous because your child is older and can get into them, store them securely out of his reach.
- Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)
