Cuts And Scrapes

You’re hurrying along and the front of your shoe catches on a crack in the cement, sending you tumbling to the ground. When you get up, you . find that not only is your ego bruised, but you’ve managed to peel away the skin on your elbows and knees. You’ve got yourself a collection of painful scrapes.

You scramble home to prepare the appetizer tray for the guests who will be arriving any minute. You have just one more carrot to slice when, “Ouch!”¬≠your knife slips and slices not the carrot, but your finger. You’ve got a cut.

“A cut is an incision into the skin,” explains Robert Matheson, M.D., a dermatologist in private practice in ortland, Oregon. “It’s a vertical slice into the skin that affects only a limited number of nerves. In contrast, a scrape involves the traumatic removal of skin in a horizontal fashion. It scrapes away the skin’s surface and exposes a larger number of nerves, usually making it more painful than a cut.”

An amazing number of things happen when you cut or scrape yourself. When you disrupt the skin, a clear, antibody-containing fluid from the blood, called serum, leaks into the wound. The area around the cut or scrape becomes red, indicating that more blood is moving into the wound site, bringing with it nutrients and infection-fighting white blood cells. Nearby lymph nodes may swell. After a few days, pus (which contains dead white blood cells, dead bacteria, and other debris from the body’s inflammatory response to infection) may form. And finally, a scab develops to protect the injury while it heals.

Even being extra careful, you can’t always avoid the scrapes and cuts of life. But you can learn how to care for them and speed their healing.

Stop the bleeding. When you get a cut or scrape, the first thing to do (after admonishing yourself for being so clumsy) is to stop the bleeding. “Apply pressure with a clean cloth or tissue to stop the blood flow,” says Louisa Silva, M.D., a general practitioner in Salem, Oregon, who sees plenty of cuts and scrapes in her private practice.

If possible, elevate the wound above the heart t slow the blood flow. Don’t use a tourniquet.

Wash up. One of the most important things you can do in treating a cut or scrape is to make sure you cleanse it thoroughly. “Wash it thoroughly with soap and water,” says dermatologist Paul Contorer, M.D., chief of dermatology for Kaiser Permanente in Beaverton, Oregon, and clinical professor of dermatology at Oregon Health Sciences University in Portland.

Matheson says soap and water is usually sufficient, but you can also use over-the-counter cleansers like Hibiclens that don’t sting. If the wound is really dirty, he recommends using hydrogen peroxide to bubble out debris. Apply it carefully, since it can damage surrounding skin.

Bring on the antibacterial ointment. Contorer say antibacterial ointments can be very helpful. Polysporin, Neosporin, and Bactine are example of antibacterial ointments available without a prescription. Matheson says he prefers Polysporio to other ointments because it contains fewer ingredients that may cause allergic reactions.

Close the skin. Properly closing the skin is important in cuts that are an eighth to a quarter inch wide. Matheson says closing makes the cut faster and reduces the chances of scarring. Be that you have thoroughly cleansed the cut sure attempting to close it. Line up the edges of the cut, then apply butterfly strips or an adhesive bandage to keep the cut closed.

Cover it. “It’s important to keep a cut or scrape d,” says Silva, “to keep the wound clean and ted.” Instead of covering with plain gauze, which tends to stick to wounds, Silva recommends II Telfa, a coated, gauze-type bandage.

Aadhesive bandages often have Telfa on them, she I but you can also buy larger pieces of Telfa in the pharmacy and cut them to fit. Cover the would with the Telfa pad, and use adhesive tape to the pad in place.

Keep it clean. The initial washing isn’t enough to :nt infection, says Matheson. You’ll need to love the bandage and wash the wound every day with soap and water. Then re-cover it with a clean bandage.

Don’t let it dry out. One of the myths about cuts and scrapes is that a thick, crusty scab is good. Not so, says Matheson. “Don’t let your wound get I and crack,” he says. “If you keep it relatively moist, you’ll speed healing and minimize scarring.”

If a scab forms, don’t pick at it, this disrupts the. and can introduce bacteria. Instead, the skin recommends soaking off crusty scabs with a solution of one tablespoon of white vinegar one pint of water. The mildly acidic solution is othing and helps kill bacteria.

Contorer advises patients to use a water/petrolatum regimen at night before retiring. “I have them wash the wound thoroughly and then cover it with a little Vaseline to seal in the moisture,” he says.

Both doctors emphasize that a certain amount of air circulation is important to wound healing. You want the bandage or covering to be tight enough to protect, but not so tight that it seals out all air and causes the wound to become too moist.

Don’t get locked up. Silva says it’s important to have a tetanus shot within 72 hours if you haven’t had one in the last five years. Tetanus bacteria, which causes “lockjaw” -a condition that can involve stiffness in the jaw and other joints, paralysis, and even death–exists in our soil, she says. “It’s still very much a threat in this country.”

Protect it from sunlight. To avoid the skin darkening that often occurs when a cut or scrape heals, Contorer says to avoid sun exposure during the healing process and apply over-the-counter hydrocortisone to the wound.

Matheson suggests using a good sunscreen for several weeks on areas where you’ve had a wound. Look for a sunscreen with a sun protection factor (SPF) of 15 or higher. (Of course, to shield your skin from damaging ultraviolet light and protect your skin from sunburn and skin cancer, it’s wise to wear sunscreen on all exposed skin when you go outside during the day, especially if you are faIr skinned.)


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