Cuts Scrapes and Scratches Remedies
CUTS, SCRAPES AND SCRATCHES Remedies for Minor Wounds
Your son has taken a spill off his skateboard and comes home looking like an extra from a Friday the 13th movie. His right leg is bloodied from a scrape that stretches from thigh to calf. He has six or seven light scratches on his face and a nasty, deep-looking cut over his eye that is bleeding heavily.
Before you reach for your first-aid kit, you should know that cuts, scrapes and scratches are not all equal and may need different treatment. Cuts and scratches slice through the skin to a varying degree, while scrapes are caused by the skin rubbing against something abrasive such as gravel, wood or cement.
Serious wounds need the prompt attention of a doctor (see ''Medical Alert'' on page 120). But most minor cuts, scrapes and scratches can be taken care of at home. Here's how.
Cuts
Apply pressure. Cuts can bleed a lot, which can be scary, but in almost every case, bleeding can be controlled with direct pressure, says Samuel Wentworth, M.D., a pediatrician in private practice in Danville, Indiana. ''Take a clean cloth or gauze pad and apply pressure directly over the wound. If you don't have a cloth around, you can even use your hand alone. In either case, you may have to use a fair amount of pressure to get the bleeding to stop,'' says Dr. Wentworth.
If you can't stop the bleeding, get emergency medical care. Do not apply a tourniquet. ''Tourniquets can cut off circulation to the limb and ultimately cause more problems than they solve,'' he says.
Cleanse and bandage. '' Wash the cut thoroughly with soap and water, cover it with antibacterial cream and, if the cut is minor, use a butterfly bandage to close the wound,'' says Fran E. Adler, M.D., a pediatrician in private practice in Upper Montclair, New Jersey. These butterfly-shaped bandages are sticky all over and keep the edges of the skin together so that the wound heals with a nice, straight scar.
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| When to See the Doctor ''If the cut seems very deep or gaping, or if there is a lot of bleeding, it should be seen by a doctor and sutured. If it is on the face or hand, you should ask for a plastic surgeon,'' says Ann DiMaio, M.D., director of the pediatric emergency room at the New York Hospital--Cornell Medical Center and assistant professor of pediatrics at Cornell University Medical College, both in New York City. ''If you think that a cut needs stitches, don't put off your doctor visit. If you wait more than eight hours, your doctor can't close the wound because bacteria may have entered, and closing the wound would invite infection. Also, if you wait and let a wound heal on its own, the scar that results will be a lot worse than one on a cut that has been sutured or stitched,'' says Dr. DiMaio. If your child has received a major cut on the arm or hand, make sure he can move his hand, wrist and fingers. If he can't, a tendon may have been cut, warns Samuel Wentworth, M.D., a pediatrician in private practice in Danville, Indiana. Call a doctor immediately. |
Leave it alone. ''Once a butterfly bandage is on, leave it in place for a couple of days. It usually takes 24 to 48 hours for the skin to knit together and heal, and you don't want to disturb the healing process by removing the bandage,'' says Dr. Wentworth.
Check your child's tetanus status. Make sure that tetanus shots are up-to-date. If the shots aren't up-to-date, see your doctor for a booster, says Dr. Adler.
Scrapes
Wash it. ''The most important thing to do with a scrape is to wash it well with soap and water to remove all the little particles of dirt and grit. If these are not removed, they can result in permanent scars,'' says Ann DiMaio, M.D., director of the pediatric emergency room at the New York Hospital-Cornell Medical Center and assistant professor of pediatrics at Cornell University Medical College, both in New York City.
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| When to See the Doctor If a scrape is weeping clear fluid, it's okay, but if it contains blood or pus or there is redness that is traveling away from the wound, the scrape has become infected and needs to be treated with a course of oral antibiotics, says Samuel Wentworth, M.D., a pediatrician in private practice in Danville, Indiana. See a doctor if you see any sign of infection. Cuts and scratches can get infected too. Again, watch for swelling, pus or a traveling area of redness. And if you suspect infection, see your doctor. |
Soak it. If your child is really upset about having his scrape washed, run a bath and let him soak in the tub for a while. ( Warn him, though, that he may feel some mild stinging initially.) ''Most kids don't mind taking a nice soapy bath, and once your child has soaked, he'll be used to the feeling of the water on the wound. At that point, it won't be so bad when you take a washcloth and soap and really wash the area,'' says Dr. Adler.
Brush it. ''Dirt can become very embedded in the scrape, and you may need to use a soft nailbrush to clean out the wound,'' says Dr. Wentworth. He admits that your child probably won't be happy about the procedure and that if the scrape is extensive, you may want to take your child to an emergency room, where a doctor can give a local anesthetic before cleaning the wound.
Pat it, dab it, cover it. Pat the area dry and apply a dab of antibiotic cream. ''The scrape will heal best if you leave it uncovered, but kids love Band-Aids, and it won't hurt to use one if it makes them feel better,'' says Dr. Adler. She suggests that you remove the Band-Aid at night, though, after bath time. ''The Band-Aid will peel off easily after a soak in the tub, and then the scrape should be left uncovered for the night,'' she says.
Protect it. ''Although leaving a scrape uncovered promotes faster healing, if your child is going to play in the dirt, cover any open wound with a loose-fitting bandage. When your child gets home, remove the dressing and wash the wound,'' says Dr. DiMaio.
Watch for weeping. ''If the scrape is weeping (oozing clear fluid), apply an over-the-counter antibiotic cream according to the directions on the label. Some antibiotic creams need to be applied twice a day, while others need three or four applications,'' says Dr. Wentworth. He recommends washing the area before each application and covering it afterward with a nonstick bandage, such as Telfa, which prevents the scab from binding the bandage to the wound.
Scratches
Clean it out. Wash the scratch well with soap and water, advises Dr. Adler, and leave it uncovered. ''A scratch may bleed and hurt, but it won't be deep enough to need stitches or a butterfly bandage. We don't worry about scratches unless they are deep, dirty or numerous.''
Consider the source. If your child has been scratched by an animal or by a dirty implement such as a nail, it is a good idea to check on your child's tetanus status. It's unusual to develop tetanus from a scratch. But it can't hurt to be cautious, says Dr. Wentworth.
