Cuts and Scrapes
Cuts and Scrapes
How to Mend Broken Skin
Women are no less prone to cuts and scrapes than their kids are. It's easy to accidentally slice your thumb while cutting a bagel or gash your hand on a piece of broken glass while doing dishes. Or perhaps you've slipped on loose gravel, scraping your knee or elbow.
Your skin is designed to repair itself--provided that you take steps to prevent infection and promote healing, say women doctors.
"Researchers have microscopically videotaped cells in action, and they found that cells in the top layers of skin actually do little cartwheels over each other as they find the spots that they need to fill in to heal a wound," says Sheryl Clark, M.D., assistant clinical professor of dermatology at Cornell Medical Center and an assistant attending physician in medicine at the New York Hospital, both in New York City.
SPEED UP THE REPAIR PROCESS
If your cut doesn't warrant stitches or other medical attention, here's what women doctors say that you can and should do.
Apply pressure. Gently press a clean, damp towel against a cut or scrape for up to 20 minutes, until the bleeding stops, says Dr. Clark.
Wash the wound. It is vital that you clean dirt out of a cut or scrape so that it doesn't cause infection, says dermatologist Karen E. Burke, M.D., Ph.D., an attending physician at Cabrini Medical Center in New York City and at Greensboro Specialty Surgical Center in North Carolina. "Gently rinse a scrape under running water until it is totally clean."
"For a minor cut or scrape all you need is plain old soap and water," says Wilma Bergfeld, M.D., head of clinical research in the Department of Dermatology at the Cleveland Clinic Foundation. "Try Hibclens, a brand-name soap available in drugstores. It's a superior cleanser, not irritating to tender skin."
Don't use hydrogen peroxide--some women doctors say that it's too strong. "Along with killing bacteria in the cut or scrape, it also kills the healthy skin cells that are trying to heal the wound," says Dr. Clark.
Repeat three times a day. Sizable cuts or scrapes should be cleaned three times a day, says Dr. Bergfeld.
When To See A Doctor
If a cut is deep or large (more than a half-inch long), you definitely need stitches, says dermatologist Karen E. Burke, M.D., Ph.D., an attending physician at Cabrini Medical Center in New York City and at Greensboro Specialty Surgical Center in North Carolina. "Stitches help the cut heal faster and reduce the chance of scarring. And a cut is less apt to get infected if it is stitched closed," explains Dr. Burke. But how can you tell if you need stitches? If a cut shows white or flesh color, then it's not deep enough to require stitches. But any cut that is deep enough to reveal a rich yellow color has cut into the layer of fat underneath skin, and it must be stitched closed to heal properly. See a doctor, even if you're in doubt, say women doctors. To keep swelling down apply pressure and ice (with a bandage and ice pack), then make an appointment for some time within the next 24 hours. Other times when you may need a physician's care: * The cut area is red, tender, inflamed, oozing or discharging pus. * You also have a fever or swollen lymph nodes. * You have multiple cuts and scrapes. You may need an antibiotic, says Wilma Bergfeld, M.D., head of clinical research in the Department of Dermatology at the Cleveland Clinic Foundation. You should also see a doctor if: * Cinders, gravel or other foreign material is imbedded in the cut. "Your doctor may need to anesthetize (numb) the wound and remove the debris," says Dr. Bergfeld. * You get a cut on your face or other prominent area. * You have mitral valve prolapse, an artificial heart valve or a hip replacement and you get a deep cut. You may need to take an oral antibiotic, says Dr. Burke.
|
Top it off with ointment. For years doctors thought that cuts and scrapes heal better when they are dry. Research shows, however, that the opposite is true: "If you keep wounds moist, they heal more quickly and with a nicer cosmetic result," says Dr. Clark. "They need a moist environment so that they can maneuver around and form nice, flat, beautiful layers of skin."
So after cleansing, apply an antimicrobial ointment such as Bacitracin or Polysporin to keep the wound moist and bacteria-free and to speed healing, suggests Dr. Bergfeld.
Seal it to heal it. Women doctors recommend a new type of over-the-counter product called a colloidal dressing. "It's a porous, gelatin-like material that sticks on your skin like contact paper," says Dr. Bergfeld. It also contains an antimicrobial medication to fight bacteria.
These membranes form a "breathable" membrane over the wound, which is like a second skin. "They allow oxygen to pass back and forth across them, but they don't allow water to pass. So they keep the wound moist, and fluid stays in," says Dr. Clark. She recommends Tegasorb (by 3M) and Spenco Second Skin.
"These dressings can cut healing time in half," says Dr. Bergfeld. "They're especially good on scrapes or cuts on your legs, where healing time is prolonged."
Leave it alone. Leave the dressing on for two to five days. "It will naturally loosen and come off on its own--or it will wash off in the shower. Then you can replace it if necessary," says Dr. Bergfeld.
Tape it shut. If you don't have any colloidal dressing available, traditional bandaging will do. To keep both edges of a small cut together and help it mend, pull the cut closed and stick the edges together with a small strip of surgical tape. "Or try one of those little narrow strips that you find in a Band-Aid box," says Dr. Bergfeld.
Put on the covers. Protect the wound with a gauze bandage and tape, if necessary, or with just an adhesive bandage if the cut or scrape is small, says Dr. Clark.
Apply the bandage loosely so that the wound can air out without being constricted, says Dr. Burke.
Dress and undress. Change the dressing two or three times a day--whenever you wash the injury, says Dr. Clark.
Give it some support. If you have a large cut or scrape on your leg or a lower extremity, support the surrounding tissue and reduce swelling by putting on an elastic bandage or pulling on an elastic knee-high stocking or some support hose, says Dr. Bergfeld. "You don't want it to be tight--just supportive," she says.
