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.
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