Lacerations- What to Know!
We have all had that questionable cut or laceration that we look and and wonder..."Do I need stitches?" "Can I use glue?" "Should I just try a band-aid?""How often do I need tetanus?" "Would it be bad if I went surfing with this?"
One of the most common things my friends and family ask me about are lacerations (cuts) so here are some tips about lacerations!
- Does it need stitches?
While it is always easier to tell by seeing it in person a general rule of thumb is that if it is over two centimeters in length and especially if it is over a joint (e.g. a knuckle) most lacerations (cuts) will benefit from some form of closure such as stitches, steristrips/butterfly, surgical glue and even staples. Wound closure generally decreases the chance of infection, results in faster healing, less bleeding and less scarring. We have experienced medical providers at Island Urgent Care who are experts in wound closure and we have all the options available at each clinic.
- Can it be glued?
There are several factors that determine whether it is appropriate to use tissue glue. Factor #1: Is it bleeding? Glue does not work on wounds that are still bleeding. Sometimes there are things we can do in the clinic to stop the bleeding and glue can be used - otherwise if is still bleeding, stitches would be better. Factor #2: Is there tension over the wound? This means it is located on a part of the body where the skin is stretched which pulls the wound open. A common place where this occurs is over joints (a knuckle, for example). The glue is not strong enough to hold when the finger bends and straightens repeatedly and will break down too fast.
- What is the best thing to clean a wound with?
This answer may be a bit surprising,... tap water. Yes, turning on the faucet and letting water flow over the wound for 5 minutes cleans it better than betadine, alcohol, or hydrogen peroxide. The movement of water over the wound removes dirt and bacteria. Those other substances, while effective in killing bacteria, do not do as good a job at cleaning the wound and they also they can be harsh and actually a bit harmful to your own tissue. You may also use a gentle soap and a bit of scrubbing to loosen dirt and bacteria.
- How soon do I need to get stitches? (e.g. Can it wait till morning/after work/clinic is open?)
The sooner the better. Ideally the wound would be closed within the first 6 hours, but we can often can still close up to 7- 12 hours from the time of injury. Beyond this the risk of infection increases. One exception is cuts on the face and scalp which have a lower risk of infection. These you can often close up to 24 hours from time of injury without increased risk of infection.
- What is a skin tear and what do we do for them?
A skin tear is a condition we commonly see in our older patients whose skin has gotten fragile and the top layer is pulled off as a result of a fall or other injury. These lacerations though not deep, often cover a large area of someone’s arm or leg and benefit from wound cleaning and closure with glue or steri strips to speed healing and decrease risk of infection.
- Do I need a tetanus shot update?
Tetanus vaccinations are generally effective for 10 years. While most wounds are relatively low risk for tetanus it is always good to have your tetanus vaccination current. If it is a higher risk wound (e.g. larger, contaminated wound) we may recommend vaccination if has been longer than 5 years since your last tetanus immunization.
- Do I need antibiotics?
Most wounds do not need oral antibiotics to prevent infection. Cleansing and closing the wound is usually all you need. Topical antibiotic ointment can be use after wounds repaired with stitches as further protection. One exception to this rule though is animal bites, including human bites. These have a much higher risk of infection, particularly puncture wound from cats and oral antibiotics are recommended for these wounds.
If you have any questions about your cuts or laceration come see us at Island Urgent Care today.