Dr. Roger Hicks
Everyone gets a cut or scrape now and then, whether it’s you slicing your finger instead of that onion or your child scraping her knee while learning to ride her bike. Most minor wounds can be taken care of at home, but some require professional attention. How do you know which is which?
If the bleeding stops with a few minutes of pressure and the edges stay together during normal movement, you probably don’t need stitches. But, if the wound is all the way through the skin and you can see the fatty layer when the edges are spread, if it is still bleeding after 10-15 minutes of pressure, if bone or tissue is exposed, or if scarring is a concern – for instance, a cut to the face – a trip to your doctor or local urgent care center is in order. Wounds that open when a joint is bent need stitches and an expert eye to see if there is damage to tendons, ligaments, or nerves. And you should see a professional if there is dirt or anything else in in the wound, like gravel or a splinter.
Closing a wound with stitches can reduce scarring and decrease both the time it takes for the wound to heal and the chance that it will get infected. Just like stiches in cloth, medical stiches in your body, or sutures, are threads that hold things together. Sutures are made of many different materials, including nylon, polypropylene, silk and steel. Some are made from synthetic material designed to dissolve when placed under the skin or in the mouth. And certain lacerations that need professional attention are best closed with surgical staples or medical superglue.
Skin wounds should be washed as soon as possible after the injury with warm water and mild soap. Avoid hydrogen peroxide, betadine, and alcohol as they kill not only germs, but also normal cells – and they sting like crazy.
People with diabetes have a lower threshold for seeing a medical professional for a skin injury because they have an increased risk of infection. Anyone with a wound showing signs of infection, which include redness, pus, swelling or worsening pain, should consider seeing a doctor.
Dog, cat and other animal bites frequently become infected, especially those on the hand or foot. Animal bites should be evaluated by a medical professional, especially if there is any question about the animal’s rabies vaccination status.
If your wound does need professional care, time is of the essence. Wound edges start to seal off quickly, making it difficult for them to bond to each other, and if the wound is dirty,
Infection can start within a few hours. How long after an injury a wound can be stitched, stapled or glued depends on the situation. A cut from a clean sharp edge, like a kitchen knife, that has been thoroughly washed and bandaged at home may be sutured from 12 to 24 hours after the injury depending on the location of the cut. But a dirty wound, or one that needs to be numbed with local anesthesia to be cleaned properly, should be treated right away.
Whether or not you have had stitches, keep your wound covered with a clean, dry dressing. Leaving a fresh scrape or cut open to the air to heal is not a good idea because unlike normal skin, an open wound cannot protect itself against dirt, germs or drying out. So, change the dressing twice a day or right away if it gets wet or dirty. It’s OK to get the wound wet when you shower or bathe, but don’t leave a wet dressing on it. If the wound is on your hand, wash your hands whenever needed and put a fresh, dry dressing on after. You can put a small amount of antibacterial ointment or cream on each time you change the bandage, but not too much – it’s easy to overdo this.
No matter how careful we are, scrapes and cuts are bound to happen. Fortunately, when thoroughly cleaned and (sometimes) sewn back together, our bodies heal quickly and are ready for the next adventure.
A director of the Urgent Care Association of America from 2011 to 2017, Dr. Roger Hicks served as the Association’s treasurer and then secretary. He is a founder and current board member of the Urgent Care Assurance Company, a malpractice company specializing in urgent care. He is the founding President of the California Urgent Care Association.
He is also the founding president of the South Yuba River Citizens League and served on SYRCL’s Board of Directors for 30 year.