SKIN INJURY (BRUISES, CUTS AND SCRAPES)

Injury Definition

• Cuts, lacerations, gashes and tears
• Scrapes, abrasions, scratches and floor burns
• Bruises (bleeding into the skin) without an overlying cut or abrasion

When Sutures (stitches) are Needed

• Any cut that is split open or gaping probably needs sutures. Cuts longer than ½ inch (1 cm) usually need sutures. On the face, cuts longer than ¼ inch (6 mm) need sutures. Any open wound that may need sutures should be checked and closed within 6 hours if possible.

See More Appropriate Topic (instead of this one) If

• It's a puncture, see PUNCTURE WOUND
• There's a sliver in the skin, see SPLINTER OR SLIVER
• Injury looks infected, see WOUND INFECTION

WHEN TO CALL YOUR DOCTOR FOR SKIN INJURY

Call 911 Now (your child may need an ambulance) If

• Major bleeding that can't be stopped
• First Aid:  Apply direct pressure to the entire wound with a clean cloth.

Call Your Doctor Now (night or day) If

• You think your child has a serious injury
• Bleeding won't stop after 10 minutes of direct pressure  
• Cut is very deep (e.g. can see bone or tendons)  
• Skin is split open or gaping and may need stitches
• Age < 1 year old
• Dirt or grime in the wound is not removed after 15 minutes of scrubbing
• Bicycle-spoke or washing machine wringer injury  
• Skin loss from bad scrape goes very deep  
• Skin loss involves > 10% of body surface (Note: the hand's surface equals 1%)
• Cut or scrape looks infected (redness, red streak or pus)

Call Your Doctor Within 24 Hours (between 9am and 4pm) If

• You think your child needs to be seen
• Several bruises occur without any known injury
• Very large bruise follows a minor injury  
• No tetanus booster in > 10 years (5 years for dirty cuts at higher risk for tetanus)

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns.

Parent Care at Home If

• Mild cut, scrape or bruise and you don't think your child needs to be seen

HOME CARE ADVICE FOR MILD BRUISES, CUTS AND SCRAPES

1. Bruises:
   • Apply an ice pack for 20 minutes once to stop the bleeding.
   • After 48 hours apply a warm wash cloth for 10 minutes 3 times per day to help reabsorb the blood.
2. Cuts, Scratches and Scrapes
   • Apply direct pressure for 10 minutes to stop any bleeding.
   • Wash the wound with soap and water for 5 minutes. (Caution: never soak a wound that might need sutures, because it may become more swollen and difficult to close.)
   • For any dirt, scrub it gently with a washcloth.
   • Cut off any pieces of loose skin using a fine scissors (cleaned with rubbing alcohol).
   • Apply an antibiotic ointment, covered by a Band-Aid or dressing.  Change daily.
3. Pain Medicine: Give acetaminophen (e.g. Tylenol) or ibuprofen as needed for pain relief.
4. Call Your Doctor If:
   • Looks infected (pus, redness, increasing tenderness)
   • Doesn't heal within 10 days
   • Your child becomes worse or develops any of the "Call Your Doctor" symptoms

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Pediatric HouseCalls Online. Copyright © 2000-2004 Barton Schmitt, M.D. FAAP

Reviewed 8/2004

Revised 7/2004

See Other Topics:

• Puncture Wound
• Splinter or Sliver
• Wound Infection

View Anatomic Index of Topics