Laceration Repair (Cuts and grazes)
Cuts and grazes are a common type of injury and, in most cases, do not pose a threat to health.
Treating minor cuts and grazes
Most cuts and grazes are minor and can be easily treated at home.
Cleaning them thoroughly and covering them with a plaster or dressing is all that is needed.
Stopping the bleeding
If your cut or graze is bleeding heavily or is on a particularly delicate area of your body, such as the palm of your hand, you should stop the bleeding before applying any kind of dressing.
Apply pressure to the area using a bandage or a towel. If the cut is to your hand or arm, raise it above your head. If the injury is to a lower limb, lie down and raise the affected area above the level of your heart so the bleeding slows down and stops.
To dress a cut or graze at home:
- Wash and dry your hands thoroughly
- Clean the wound under running tap water but do not use antiseptic because it may damage the tissue and slow down healing
- Pat the area dry with a clean towel
- Apply a sterile, adhesive dressing, such as a plaster
Keep the dressing clean by changing it as often as necessary and keep the wound dry by using waterproof dressings, which will allow you to take showers.
The wound should heal by itself in a few days. If the wound is painful, you can take painkillers, such as paracetamol or ibuprofen.
When to see Dr. B C Shah
You only need to see Dr. B C Shah if there is a risk of a cut or graze becoming infected or you think it already has become infected.
You are more at risk of the wound becoming infected if:
- It has been contaminated with soil, pus, bodily fluids or faeces (stools)
- There was something in the wound before it was cleaned, such as a tooth or a shard of glass
- The wound has a jagged edge
- The wound is longer than 5cm (1.9 inches)
You should also contact Dr. B C Shah if your skin has been bitten (either by an animal or a person), as bites are prone to infection.
Signs that a wound has become infected include:
- Swelling of the affected area
- Pus forming in the affected area
- Redness spreading from the cut or graze
- Increasing pain in the wound
- Feeling generally unwell
- A high temperature (fever) of 38°C (100.4°F) or above
- Swollen glands
An infected wound can usually be successfully treated with a short course of antibiotics (usually around seven days).
When to seek emergency help
Some cuts and grazes can be more serious and will require an emergency treatment.
It is recommended that you visit Dr. B C Shah if:
- You are bleeding from a cut artery. Blood from an artery comes out in spurts (with each beat of the heart), is bright red and is usually hard to control.
- You cannot stop the bleeding.
- You experience loss of sensation near the wound or you are having trouble moving body parts. If this is the case you may have damaged underlying nerves.
- There is severe pain, extensive bruising and you are having trouble moving body parts. If this is the case you may have damaged one of your tendons.
- You have received a cut to the face. You may require urgent treatment to prevent scarring.
- You have received a cut to the palm of your hand and the cut looks infected. These types of infection can spread quickly.
- There is a possibility that a foreign body is still inside the wound.
- The cut is extensive, complex or has caused a lot of tissue damage.
Your cut will be examined to determine whether or not there is any risk of infection. If there was glass inside your cut, you may need an X-ray to ensure it has been removed.
What happens if there is no risk of infection
If there is no risk of infection, your cut will be cleaned using water or a sterile saline solution before it’s closed. This may be done using stitches, tissue adhesive or skin-closure strips.
- Stitches (sutures). These are usually used to close cuts that are more than 5cm long, or wounds that are particularly deep. A sterile surgical thread is used for stitches, which is flexible and allows the wound to move.
- Tissue adhesive (glue). This may be used to close less severe cuts that are less than 5cm long. The tissue adhesive is painted onto your skin, over your cut, while the edges are held together. The paste then dries, forming a flexible layer that keeps the cut closed.
- Skin-closure strips. These may be used as an alternative to tissue adhesive, for cuts that are less than 5cm long, where there is a risk of infection. The strips are sticky and can be placed over the edges of the cut to hold them together. They are easier to remove than tissue adhesive.
Once your cut is closed, it may be covered with a protective dressing to ensure that your stitches, tissue adhesive or skin-closure strips stay in place.
If you have stitches or strips, you will need to return to Dr. B C Shah to have them removed.
- Stitches or strips on the head are removed after three to five days
- Stitches over joints are removed after 10-14 days
- Stitches or strips at other sites are removed after 7-10 days
You should never try to remove stitches yourself. They should only be removed by Dr. B C Shah
Tissue adhesive comes off by itself after a week or so.
To prevent tetanus (a serious bacterial infection), you may be given a tetanus booster injection. If it’s suspected that you are at risk of developing tetanus, you may be referred for specialist treatment.
If there is risk of infection, or your cut is already infected
If there is risk of infection or your cut is already infected, Dr. B C Shah may take a sample for analysis using a swab, before cleaning it as usual.
However, they will not yet be able to close your cut because this may trap any infection inside it, making it more likely to spread. Instead, the cut will be packed with a non-sticky dressing so that it cannot close, before it is covered with a protective dressing. You may also be given antibiotics to fight the infection.
You will need to return Dr. B C Shah after three to five days to see if any infection has cleared up. If so, your cut will be closed using stitches or skin-closure strips.
If your infection has not cleared up, a change of antibiotics may be required.
If your graze is very severe and you have lost a lot of skin, you may need to have a skin graft.
Dr. B C Shah will take some skin from another part of your body and put it over the wound. After a while, it will heal and look normal.