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Is Your Child Sick?TM

Skin Injury

Is this your child's symptom?

  • Injuries to the skin anywhere on the body surface
  • Includes cuts, scratches, scrapes, bruises and swelling

Types of Skin Injury

  • Cuts, lacerations, gashes and tears. These are wounds that go through the skin to the fat tissue. Caused by a sharp object.
  • Scrapes, abrasions, scratches and floor burns. These are surface wounds that don't go all the way through the skin. Scrapes are common on the knees, elbows and palms.
  • Bruises. These are bleeding into the skin from damaged blood vessels. Caused by a blunt object. They can occur without a cut or scrape.

When Sutures (Stitches) are Needed for Cuts

  • Any cut that is split open or gaping needs sutures.
  • Cuts longer than ½ inch (12 mm) usually need sutures.
  • On the face, cuts longer than ¼ inch (6 mm) usually need to be seen. They usually need closure with sutures or skin glue.
  • Any open wound that may need sutures should be seen as soon as possible. Ideally, they should be checked and closed within 6 hours. Reason: To prevent wound infections. There is no cutoff, however, for treating open wounds.

Cuts Versus Scratches: Helping You Decide

  • The skin is about 1/8 inch (3 mm) thick.
  • A cut (laceration) goes through it.
  • A scratch or scrape (wide scratch) doesn't go through the skin.
  • Cuts that gape open at rest or with movement need stitches to prevent scarring.
  • Scrapes and scratches never need stitches, no matter how long they are.
  • So this distinction is important.

When to Call for Skin Injury

When to Call for Skin Injury

Call 911 Now

  • Major bleeding that can't be stopped
  • Deep cut to chest, stomach, head or neck (such as with a knife)

Call Doctor or Seek Care Now

  • Skin is split open or gaping and may need stitches
  • Severe pain and not better 2 hours after taking pain medicine
  • Age less than 1 year old
  • Dirt in the wound is not gone after 15 minutes of scrubbing
  • Skin loss from bad scrape goes very deep
  • Bad scrape covers large area
  • Cut or scrape looks infected (redness, red streak or pus)
  • Cut or scrape and no past tetanus shots
  • You think your child has a serious injury
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Very large bruise after a minor injury
  • Some bruises appear without any known injury
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Dirty cut and no tetanus shot in more than 5 years
  • Clean cut and no tetanus shot in more than 10 years
  • Doesn't heal by 10 days
  • You have other questions or concerns

Self Care at Home

  • Minor cut, scrape or bruise

Call 911 Now

  • Major bleeding that can't be stopped
  • Deep cut to chest, stomach, head or neck (such as with a knife)

Call Doctor or Seek Care Now

  • Skin is split open or gaping and may need stitches
  • Severe pain and not better 2 hours after taking pain medicine
  • Age less than 1 year old
  • Dirt in the wound is not gone after 15 minutes of scrubbing
  • Skin loss from bad scrape goes very deep
  • Bad scrape covers large area
  • Cut or scrape looks infected (redness, red streak or pus)
  • Cut or scrape and no past tetanus shots
  • You think your child has a serious injury
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Very large bruise after a minor injury
  • Some bruises appear without any known injury
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Dirty cut and no tetanus shot in more than 5 years
  • Clean cut and no tetanus shot in more than 10 years
  • Doesn't heal by 10 days
  • You have other questions or concerns

Self Care at Home

  • Minor cut, scrape or bruise

Care Advice for Minor Cuts, Scrapes or Bruises

  1. Cuts, Scratches and Scrapes - Treatment:
    • Use direct pressure to stop any bleeding. Do this for 10 minutes or until the bleeding stops.
    • Wash the wound with soap and water for 5 minutes. Try to rinse the cut under running water.
    • Caution: Never soak a wound that might need sutures. Reason: It may become more swollen and harder to close.
    • Gently scrub out any dirt with a washcloth.
    • Use an antibiotic ointment (such as Polysporin). No prescription is needed. Then, cover it with a bandage (such as Band-Aid). Change daily.
  2. Liquid Skin Bandage for Minor Cuts and Scrapes:
    • Liquid skin bandage seals wounds with a plastic coating. It lasts up to 1 week.
    • Liquid skin bandage has several benefits compared to other bandages (such as Band-Aid). Liquid bandage only needs to be put on once. It seals the wound and may promote faster healing and lower infection rates. Also, it's water-proof.
    • Wash and dry the wound first. Then, put on the liquid. It comes with a brush or swab. It dries in less than a minute.
    • You can get this product at a drugstore near you. There are many brands of liquid bandage. No prescription is needed.
  3. Bruises - Treatment:
    • Use a cold pack or ice bag wrapped in a wet cloth. Put it on the bruise once for 20 minutes. This will help to stop the bleeding.
    • After 48 hours, use a warm wet wash cloth. Do this for 10 minutes 3 times per day. This helps to reabsorb the blood.
  4. Pain Medicine:
    • To help with the pain, give an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil).
    • Use as needed.
  5. Tetanus Shot:
    • A tetanus shot update may be needed for cuts and other open wounds.
    • Check your vaccine records to see when your child got the last one.
    • For Dirty Cuts and Scrapes. If last tetanus shot was given over 5 years ago, need a booster.
    • For Clean Cuts. If last tetanus shot was given over 10 years ago, need a booster.
    • See your child's doctor for a booster during regular office hours. It's safe to give it within 3 days or less.
  6. What to Expect:
    • Small cuts and scrapes heal up in less than a week.
  7. Call Your Doctor If:
    • Bleeding does not stop after using direct pressure to the cut
    • Starts to look infected (pus, redness)
    • Doesn't heal by 10 days
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2000-2018. Schmitt Pediatric Guidelines LLC.

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