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Healthy Children > Tips & Tools > KidsDoc Symptom Checker > Skin Injury (Cuts, Scrapes, Bruises)
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Skin Injury (Cuts, Scrapes, Bruises)

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Definition

  • Cuts, lacerations, gashes and tears (Wounds that go through the skin (dermis) to the fat or muscle tissue)
  • Scrapes, abrasions, scratches and floor burns (Superficial wounds that don't go all the way through the skin)
  • Bruises (bleeding into the skin) without an overlying cut or scrape

When Sutures (stitches) are Needed

  • 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 closure with sutures or skin glue.
  • Any open wound that may need sutures should be checked and closed as soon as possible (ideally, within 6 hours). There is no cutoff, however, for treating open wounds to prevent wound infections.

Cuts Versus Scratches: Helping You Decide

  • The skin (dermis) is 2 mm (about 1/8 inch) thick.
  • A cut (laceration) goes through it.
  • A scratch or scrape (wide scratch) doesn’t go through it.
  • Cuts that gape open at rest or with movement need closure to prevent scarring.
  • Scrapes and scratches never need closure, no matter how long they are.
  • So this distinction is important.

See More Appropriate Topic (instead of this one) If

First Aid:

First Aid Advice For Severe Bleeding:

  • Place 2 or 3 sterile dressings (or a clean towel or washcloth) over the wound immediately.
  • Apply direct pressure to the wound, using your entire hand.
  • If bleeding continues, apply pressure more forcefully or to a slightly different spot.
  • Act quickly because ongoing blood loss can cause shock.

First Aid Advice for Shock: Lie down with the feet elevated.

First Aid Advice for Penetrating Object: If penetrating object still in place, don't remove it (Reason: removal could increase internal bleeding).

 

Disclaimer: This information is not intended to 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. For more information, click here.

Author and Senior Reviewer: Barton D. Schmitt, M.D. Clinical content review provided by Senior Reviewer and Healthpoint Medical Network.
Last Review Date: 6/1/2011
Last Revised: 8/1/2011 3:33:16 PM
Content Set: Pediatric HouseCalls Symptom Checker
Version Year: 2012
Copyright 1994-2012 Barton D. Schmitt, M.D.

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When To Call

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

  • Major bleeding that can't be stopped (see FIRST AID)

Call Your Doctor Now (night or day) If

  • For bleeding, see FIRST AID
  • You think your child has a serious injury
  • Bleeding won't stop after 10 minutes of direct pressure
  • Deep cut and can see bone or tendons
  • Skin is split open or gaping, especially on the face
  • Pain is SEVERE (and not improved after 2 hours of pain medicine)
  • Age under 1 year old
  • Dirt or grime in the wound is not removed after 15 minutes of scrubbing
  • Wringer-type injury
  • Skin loss from bad scrape goes very deep
  • Skin loss involves greater than 10% of body surface (Note: The palm of the hand equals 1%)
  • Cut or scrape looks infected (redness, red streak or pus)
  • You think your child needs to be seen urgently

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

  • You think your child needs to be seen, but not urgently
  • Several bruises occur without any known injury
  • Very large bruise follows a minor injury

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
  • No tetanus shot in over 5 years for DIRTY cuts (over 10 years for CLEAN cuts)
  • Doesn’t heal within 10 days

Parent Care at Home If

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

 

Disclaimer: This information is not intended to 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. For more information, click here.

Author and Senior Reviewer: Barton D. Schmitt, M.D. Clinical content review provided by Senior Reviewer and Healthpoint Medical Network.
Last Review Date: 6/1/2011
Last Revised: 8/1/2011 3:33:16 PM
Content Set: Pediatric HouseCalls Symptom Checker
Version Year: 2012
Copyright 1994-2012 Barton D. Schmitt, M.D.

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Care Advice

Home Care Advice for Minor Cuts, Scrapes or Bruises

  1. 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.)
    • Gently scrub out any dirt with a washcloth.
    • Cut off any pieces of loose skin using a fine scissors (cleaned with rubbing alcohol).
    • Apply an antibiotic ointment such as Polysporin (no prescription needed). Then, cover it with a Band-Aid or dressing. Change daily.
  2. Liquid Skin Bandage for Minor Cuts and Scrapes:
    • Liquid skin bandage is a new product that seals wounds with a plastic coating that lasts up to 1 week.
    • Liquid skin bandage has several benefits when compared to a regular bandage (e.g., a dressing or a Band-Aid). Liquid Bandage only needs to be applied once to minor cuts and scrapes. It helps stop minor bleeding. It seals the wound and may promote faster healing and lower infection rates. However, it is also more expensive.
    • After the wound is washed and dried, the liquid is applied by spray or with a swab. It dries in less than a minute. It's resistant to bathing.
    • This new product is available at your local pharmacy.
  3. Bruises:
    • Apply a cold pack or ice bag wrapped in a wet cloth to the bruise once for 20 minutes to stop the bleeding.
    • After 48 hours apply a warm wet wash cloth for 10 minutes 3 times per day to help reabsorb the blood.
  4. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen as needed for pain relief.
  5. Call Your Doctor If:
    • Bleeding does not stop after using direct pressure to the cut
    • Looks infected (pus, redness, increasing tenderness)
    • Doesn't heal within 10 days
    • Your child becomes worse

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

To find a pediatrician, click here.

 

Disclaimer: This information is not intended to 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. For more information, click here.  

Author and Senior Reviewer: Barton D. Schmitt, M.D. Clinical content review provided by Senior Reviewer and Healthpoint Medical Network.
Last Review Date: 6/1/2011
Last Revised: 8/1/2011 3:33:16 PM
Content Set: Pediatric HouseCalls Symptom Checker
Version Year: 2012
Copyright 1994-2012 Barton D. Schmitt, M.D.

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Photos

Abrasion on Elbow

This picture shows a shallow abrasion on the left elbow.

First Aid Care Advice for Minor Abrasion:

  • Apply direct pressure for 10 minutes to stop any bleeding.
  • Wash the abrasion with soap and water.
  • Gently scrub out any dirt with a washcloth.
  • Apply an antibiotic ointment, covered by a Band-Aid or dressing. Change daily.
  • Another option is to use a Liquid Skin Bandage that only needs to be applied once. Avoid ointments with this.

Source: LMS Inc.
Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.

 

Abrasion on Elbow (3 Days Old)

This abrasion near the elbow occurred 3 days ago. The picture shows an abrasion that is starting to crust over.

There are no signs of infection (e.g., spreading redness, pus).

Source: LMS Inc.
Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.

 

Abrasion on Shoulder

Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.

 

Bruise from Coumadin

Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.

 

Bruise on Forearm

Small minor bruise (contusion) on forearm.

Source: LMS Inc.
Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.

 

 

Bruise on Shoulder (4 days old)

Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.

 

Bruise on Thigh (1 Day Old)

This bruise is one day old.

Bruises (contusions) result from a direct blow or a crushing injury; there is bleeding into the skin from damaged blood vessels without an overlying cut or abrasion.

Source: LMS Inc.
Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.

 

 

First Aid - Bleeding Finger

Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.

 

First Aid - Cut - Gaping and Needing Sutures

  • Apply direct pressure for 10 minutes to stop any bleeding.
  • Wash the wound with soap and water
  • Cover the wound with a sterile gauze or a clean cloth until seen.

Source: LMS Inc.
Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.

 

Impetigo of Elbow

The photo shows an abrasion of elbow that has become infected with bacteria.

Source: Wikimedia Commons

Permission is granted to copy, distribute and/or modify this document under the terms of the GNU Free Documentation License.

This is a public domain image file from Wikimedia Commons. Wikimedia is a freely licensed media repository.

 

Laceration - Chin

This photo shows a gaping laceration (cut) of the chin. It will require closure with either sutures or with skin glue (i.e., Dermabond).

First Aid Care Advice:

  • Apply direct pressure for 10 minutes to stop any bleeding.
  • Wash the cut with soap and water.
  • Cover with a gauze dressing or adhesive bandage (e.g., Band-Aid).

Source: LMS Inc.
Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.

 

Laceration - Chin (After Skin Glue)

The photograph shows a chin laceration that was closed with skin glue (i.e., Dermabond).

Dermabond (2-octylcyanoacrylate, Ethicon) is a tissue adhesive or "skin glue" which received FDA approval in the United States in 1998. It is used as an alternative to suturing for the repair of simple lacerations. The cosmetic outcome of wounds closed with tissue adhesive is comparable and in some cases superior to suturing.

To apply, the wound edges are held firmly together, and several coats of the glue are painted along the wound margins. The glue dries quickly, within 45-60 seconds. The glue will come off on its own as the wound heals and the top skin layer falls off, usually in about one week.

Source: LMS Inc.
Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.

 

 

Laceration - Scalp

This scalp laceration (cut) is gaping open. It will require closure with sutures or medical staples.

First Aid Care Advice:

  • Apply direct pressure for 10 minutes to stop any bleeding.
  • Wash the cut with soap and water.

Source: LMS Inc.
Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.

 

Laceration - Scalp (After Staples)

This photo shows a scalp laceration after it has been closed with 4 metal medical staples.

Source: LMS Inc.
Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.

 

 

Puncture Wound - BB Gun

Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.

 

Puncture Wound - With a Foreign Body

There is a small metal splinter (foreign body) embedded in the palm of the hand.

This patient went to the emergency department and had the splinter removed.

Source: LMS Inc.
Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.

 

Scratches from a Cat

The photo shows 3-4 parallel scratches on the wrist caused by a cat.

First Aid Care Advice:

  • Wash the scratches with soap and water.
  • Apply an antibiotic ointment twice daily.
  • Watch closely for signs of infection, especially the first 1-3 days.

Source: LMS Inc.
Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.

 

Disclaimer: This information is not intended to 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. For more information, click here.

Author and Senior Reviewer: Barton D. Schmitt, M.D. Clinical content review provided by Senior Reviewer and Healthpoint Medical Network.
Last Review Date: 6/1/2011
Last Revised: 8/1/2011 3:33:16 PM
Content Set: Pediatric HouseCalls Symptom Checker
Version Year: 2012
Copyright 1994-2012 Barton D. Schmitt, M.D.

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