Let’s discuss the management of cuts and scrapes. As an Emergency Department and Urgent Care physician, I manage and deal with horrible lacerations all the time. Here are some high yield facts to be aware of:
The location of the laceration is one of the most important factors when the DUC clinician decides whether it is safe to stitch or glue your wound closed. Believe it or not, closing cuts often INCREASES infection rates especially if the wound is old. The risk for infection increases as you go from the head/body toward the ends of your fingers and toes. We can usually safely close facial lacerations up to 24 hours or more after the injury while cuts to the fingers might need to be left open if more than 6-12 hours old.
Glue, stitches or nothing? This is not easily explained in a clinic newsletter. We use sutures (stitches) and glue to accelerate healing and to create the smallest scar possible. The decision to close a wound is dependent on the age and location of the wound (as discussed above), size and depth. Glue is amazing. It is infused with antibiotics and flakes off on its own. What it does not have is good tensile strength. If a wound is over a joint or gaping such that the clinician feels the glue will not hold things together then we often recommend stitches or sometimes a butterfly-type bandaid (steri-strips) and glue together to keep that wound closed.
Whether you need steri-strips, glue or stitches, basic management of the wound is key to avoid an infection and minimize scar formation. If no glue is involved, antibiotic ointment for the first few days is great. Loose bandages (bandaids, gauze) will protect the wound and allow it to breath. Bacteria love dark, moist environments. (This is why we get abscesses in our groin and armpits.) If you want to avoid a wound infection, keep those cuts dry and clean. This means patting it well after a shower and then either leaving the wound open to the air or applying a very loose bandaid. New tissue exposed to those UV rays can result in permanent discoloration. We recommend placing sunblock on sun-exposed wounds to minimize the appearance of the scar. Many other treatments to minimize scar formation are out there - Aloe Vera and the silicon wound healing strips are the two most common options. Like most over-the-counter treatments, few are supported by high quality studies. Below is a link to the Cochrane Review for Aloe Vera.
Lastly, let’s not forget about Tetanus. You will need the vaccination if it has been more than 5-10 years since your last booster.
Feel free to email us with any questions or comments. Enjoy the warm weather.