Cuts and Scrapes

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Cuts and Scrapes

13 Ways to Soothe a Sore

You're trotting up the stairs, proud of yourself for avoiding the escalator. Your feet tap a rhythm against the concrete and steel. Then suddenly, your foot misses a beat and you begin to fall.

Your hands swing to the front to block, your knees bend to catch. Just as suddenly, it's over. You survey the damage as you peel each appendage from the rock-hard floor.

The palms of your hands look like beavers have chewed on them, they're scraped with a dozen tiny scratches now welling with blood.

Your knees did a great job of breaking the fall. But one knee is cut and beginning to ooze dark red rivulets. And for a second—before the stinging edges into your consciousness—it reminds you of the scabby knees you wore when you were 10.

Bandage Busters Got a boo-boo? Bandage made it all better? Until you have to pull the adhesive strip off, that is. Here are a couple of tricks to help you remove adhesive bandages painlessly. The first two tips are courtesy of a New England high school nurse, and the last comes from Ed Watson, corporate spokesman for Johnson & Johnson. Use a tiny pair of scissors to separate the bandage part from the adhesive sections. Pull it gently away from your scrape. Then remove the adhesive strips. If your scab is stuck to the bandage, soak the area in a mixture of warm water and salt—about a teaspoon of salt to a gallon of water. Have patience. The dressing will eventually let go. If the bandage is stuck on your forearm, leg, or chest hair, pull in the direction of hair growth, says Watson. Use a cotton swab saturated in baby oil or rubbing alcohol to moisten the adhesive fully before pulling away from the skin.

Life is full of unpleasant little surprises like this fall. You slice a finger instead of a cucumber when making a salad; your dog gets too affectionate and accidentally scratches your arm; your hand slips while you're doing a home repair, and the wrench wrenches you instead of a bolt.

But you can do your own home repairs on these little cuts and scrapes of life with items you probably have stored in your kitchen or medicine cabinet. Here's the first-aid information you need to do the work.

Stop the bleeding. The fastest way to stop bleeding is to apply direct pressure. Place a clean, absorbent cloth—a bandage or a towel—over the cut, then press your hand against it firmly. If you don't have a cloth, use your fingers. This will usually stop the bleeding within a minute or two. If blood soaks through your first bandage, add a second one and press steadily. Add new bandages over old ones because removing a cloth may tear off coagulating blood cells.

Choosing an Over-the-Counter Ointment Look under "First Aid" on any pharmacy shelf. It can be a consumer's nightmare. What to choose? An antibacterial ointment? Perhaps something labeled "first-aid cream." Or should you choose the spray the advertisements claim doesn't sting? In one study, James J. Leyden, M.D., compared the effectiveness of nine over-the-counter products on wound healing. He found that some products are faster than others when it comes to the time it takes to mend minor cuts, scrapes, and burns. Here's what the research showed. Polysporin (active ingredients: polymyxin B, bacitracin ointment): 8.2 days Neosporin (active ingredients: neomycin, polymyxin B, bacitracin ointment): 9.2 days Johnson & Johnson First Aid Cream (wound protectant with no antibiotic agent): 9.8 days Mercurochrome (active ingredient: merbromin): 13.1 days No treatment: 13.3 days Bactine spray (active ingredient: benzalkonium chloride): 14.2 days Merthiolate (active ingredient: thimerosol): 14.2 days Hydrogen peroxide 3%: 14.3 days Campho-Phenique (active ingredients: camphor, phenol): 15.4 days Tincture of iodine: 15.7 days

If applying pressure doesn't stop the bleeding, elevate the limb about the level of the heart to reduce the pressure of blood on the cut. Continue applying pressure all the while. This should stem the bleeding.

Clean the wound. This is important to prevent infection and to decrease the chance of permanent discoloration, or tattooing. Wash the area with soap and water or just water, says Hugh Macaulay, M.D., emergency room physician at Aspen Valley Hospital in Aspen, Colorado. The object is to dilute the bacteria in the wound and remove debris. Also, if you don't remove stones or sand from the cut, they can leave pigment under the skin, which acts like a tattoo. Gently clean your cut twice a day.

Strap it up. When the bleeding stops or slows, tie the wound firmly with a cloth or wrap with an elastic bandage so there is pressure against the cut, but do not cut circulation off, says John Gillies, an emergency medical technician and program director for health services at Colorado Outward Bound School in Denver. If the cut is on an arm or leg, you can check circulation to that area by squeezing a fingernail or toenail. The nail should turn white, then when you release it, pink again. If necessary, loosen the bandage a little.

MEDICAL ALERT Doctor Your Wound with Professional Advice First aid isn't always enough. See a doctor when: Bleeding is bright red and spurting. You may have punctured an artery. You can't wash all the debris out of the wound. The cut or scrape is on your face or any other area where you want to minimize scarring. Your wound develops any red streaks, weeps pus, or redness extends more than a finger width beyond the cut. The wound is large and you "can see way down inside," says Hugh Macaulay, M.D. You may need stitches. But don't attempt home-stitchery, even if you are stranded far from medical help.

Go for extra pressure. If the cut continues to bleed, it is more serious than you thought and you probably need to see a doctor immediately. Until you get there, add a pressure point to your efforts. Press on the point nearest the cut but between the wound and the heart. The pressure points are places you might think of when taking a pulse: inside your wrists, inside your upper arm about halfway between the elbow and armpit, and in the groin where your legs attack to your torso. Press the artery against the bone. Stop pressing about a minute after the bleeding stops. If bleeding starts again, reapply pressure to the pressure point.

Don't use a tourniquet. With most everyday cuts and scrapes, first aid is plenty. Tourniquets are extreme and dangerous. "Once you apply a tourniquet, the person may end up losing that limb because you cut off all circulation," cautions Gillies.

Smear on an over-the-counter antibiotic ointment. Broad-spectrum antibacterial ointments work best, according to James J. Leyden, M.D., professor of dermatology at the University of Pennsylvania. (See "Choosing an Over-the-Counter Ointment," on page 173.)

People who use a triple antibiotic ointment and the right kind of bandage heal 30 percent faster, says Patricia Mertz, research associate professor at the University of Miami School of Medicine, who studies how wounds heal.

Still, Mertz warns, be wary of over-the-counter drugs that contain neomycin or ointments that contain a lot of preservatives. They can cause an allergic reaction. If you have an allergic reaction to the ointment, your scrape will get red and itchy and may become infected.

"In our tests," Mertz says, "we found Polysporin ointment was the best performer and Merthiolate the worst offender for irritation."

Keep it undercover. When exposed to air, cuts form scabs, which slow down new cell growth, says Mertz. She recommends a plastic bandage similar to food wrap. They come in all sizes. Most bandage manufacturers make them. Or, she says, look for gauze impregnated with petroleum jelly. Both types of bandages trap healing moisture in the wound but allow only a little air to pass through. Cells regenerate more rapidly when moist.

The Alternate Route Healing Can Be a Sweet Success Got a cut or wound? You can speed up the healing process with a little table sugar, says Richard A. Knutson, M.D., an orthopedic surgeon at Delta Medical Center in Greenville, Mississippi. He's treated more than 5,000 serious wounds over the past ten years with a mixture of tamed iodine and sugar, healing a variety of mishaps from cuts, scrapes, and burns to amputated fingertips. (Raw iodine will burn the skin.) Sugar, he says, leaves bacteria without the nutrients necessary to grow or multiply. Wounds usually heal quickly, without a scab and often with little scarring. Keloids (irregular, large scars) are kept to a minimum. Brew one of Dr. Knutson's sugary ointments by mixing household table sugar with Betadine (an iodine-based antibacterial wash available at any local pharmacy). To make a blend, mix 1/2 ounce of Betadine solution, 5 ounces of sugar, and 1 1/2 ounces of Betadine ointment. Pack a cleaned wound with the homemade ointment and cover carefully with gauze. Four times a day, rinse the area gently with tap water and hydrogen peroxide and pack on fresh ointment. Taper off as healing progresses. Caution: Make sure the wound is clean and the bleeding has stopped before applying the mixture. Sugar will make a bleeding wound bleed more. Don't use powdered sugar or brown sugar, Dr. Knutson advises. They will work, but the starch in them neutralizes the iodine. Wounds treated with those sugars will form crusts.

Top it off with a tetanus shot. Cut your thumb on a sharp knife? Nick your hand on a rusty nail? Scrape your knee on the concrete? Small or large cuts should remind you to keep your immunizations current. If you haven't had a tetanus shot in the past five years, you need a booster, says Dr. Macaulay. Local health departments usually give them for a minimal fee or for free, he adds. If you don't remember when you had your last booster, it's a good idea to have one within 24 hours of the injury.

PANEL OF ADVISERS

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John Gillies, E.M.T., is an emergency medical technician and program director for health services at the Colorado Outward Bound School in Denver.

Richard A. Knutson, M.D., is an orthopedic surgeon at Delta Medical Center in Greenville, Mississippi.

James J. Leyden, M.D., is a professor of dermatology in the Department of Dermatology at the University of Pennsylvania in Philadelphia.

Hugh Macaulay, M.D., is an emergency room physician at Aspen Valley Hospital in Aspen, Colorado.

Patricia Mertz is a research associate professor in the Department of Dermatology and Cutaneous Surgery at the University of Miami School of Medicine in Florida.