Lacerations, wounds, or bleeding

Lacerations, cuts, and wounds

Cuts are open wounds through the skin.  Normally the skin is under slight, constant tension as it covers the body. A cut is a forceful injury to the skin. Many people accidentally cut themselves with household or work items, yard tools, or when operating machinery. Children often are cut during play and sports activities, or from falls while riding wheeled toys, such as bikes, scooters, or skateboards. Most cuts are minor and home treatment is usually all that is needed.
Cuts can be caused by:

  • Blunt objects that tear or crush the skin.  These cuts are more common over bony areas, such as a finger, hand, knee, or foot, but they can occur anywhere on the body. Blunt object injuries usually cause more swelling and tissue damage and leave jagged edges, so problems with healing may occur.

  • Sharp-edged pointed objects pressing into and slicing the skin tissue (incised wounds). Sharp object injuries are more likely to cut deeper and damage underlying tissue.

  • Sharp-edged objects piercing the skin tissue. 

  • A combination of blunt and sharp objects that tear, crush, and slice the skin tissue.

Some types of cuts are more serious and need medical evaluation and treatment. These more serious cuts include:

  • Long or deep cuts.

  • Cuts that open with movement of the body area, such as a cut over a joint. A cut over a joint may take a long time to heal because of the movement of the wound edges.

  • Cuts that may scar and affect the appearance or function of a body area. A cut on an eyelid or lip which doesn't heal well may interfere with function or leave a noticeable scar.

  • Cuts that remove all of the layers of the skin such as slicing off the tip of a finger. An avulsion injury may take a long time to heal.

  • Cuts from an animal or human bite. Infection is more likely with a bite injury.

  • Cuts that have damage to underlying tissues. Injuries to nerves, tendons, or joints are more common with cuts on the hands or feet. Slight swelling, bruising, and tenderness around a cut, bite, scrape, or puncture wound is normal. Swelling or bruising that begins within 30 minutes of the injury often means there is a large amount of bleeding or that damage to deeper tissues is present.

  • Cuts over a possible broken bone. Bacteria can get into a cut over a broken bone and infect the bone.

  • Cuts caused by a crushing injury. With this type of injury, the cut may have occurred when the skin split open from the force of the injury. The force of the injury may also damage underlying tissues and blood vessels. Crush injuries have a high risk of infection.

  • Cuts with a known or suspected object such as glass or wood, in the wound.

Injury to the skin may also break small blood vessels under the skin and cause more swelling and bruising than you would expect.
 
Before you clean the wound, try to stop the bleeding.

  • Put on medical gloves, if available, before applying direct pressure to the wound. If gloves aren't available, put something else between your hands and the wound. You can use many layers of clean cloth, plastic bags, or the cleanest material available. Use your bare hands to apply direct pressure only as a last resort.

  • Hold direct pressure on the wound, if possible, and elevate the injured area.

  • Remove or cut clothing from around the wound. Remove any jewelry from the general area of the wound so if the area swells, the jewelry will not affect blood flow.

  • Apply steady, direct pressure for a full 15 minutes. Use a clock-15 minutes can seem like a long time. Resist the urge to peek after a few minutes to see whether bleeding has stopped. If blood soaks through the cloth, apply another one without lifting the first. If there is an object in the wound, apply pressure around the object, not directly over it.

  • If moderate to severe bleeding has not slowed or stopped, continue direct pressure while getting help. Do not use a tourniquet to stop the bleeding. Do all you can to keep the wound clean and avoid further injury to the area.

  • Mild bleeding usually stops on its own or slows to an ooze or trickle after 15 minutes of pressure. It may ooze or trickle for up to 45 minutes.