Washing a cut or scrape with soap
and water and keeping it clean and dry is all that is required to care
for most wounds. Putting alcohol, hydrogen peroxide, and iodine into a
wound can delay healing and should be avoided. Seek medical care early
if you think that you might need stitches. Any delay can increase the
rate of wound infection. Any puncture wound through tennis shoes has a
high risk of infection and should be seen by your healthcare professional.
Any redness, swelling, increased pain, or pus draining from the wound
may indicate an infection that requires professional care.
What is the best way to
care for a cut or scrape?
The most important first step is
to thoroughly clean the wound with soap and water being careful to remove
any foreign material, such as dirt or bits of grass, that might be in
the wound and which can lead to infection. The area should then be kept
clean and dry.
Covering the area with a bandage
(such as gauze or a band-aid) helps prevent infection and dirt from getting
in the wound. A first aid ointment, such as BACITRACIN, can be applied
to help prevent infection. Generally, however, these products are best
avoided on the hands and feet beyond the first day because they can delay
healing in these areas.
Continued care to the wound is also
important. Washing the area gently with soap and water daily without scrubbing
is best as the wound heals.
Avoid putting products such as hydrogen
peroxide, alcohol, or iodine solutions in the wound. These only delay
wound healing and do not do anything to prevent infection.
Who should seek medical
care for a cut?
People who have diabetes, other
long-term illnesses such as cancer, or are taking drugs that suppress
the immune system such as steroids (cortisone medications like prednisone
and prednisolone) or chemotherapy, are more likely to develop a wound
infection and should be seen by a health care professional.
Any cut that goes beyond the top
layer of skin that might need stitches (sutures) should be seen by a health
care professional. Generally, the sooner sutures are put in, the lower
the risk of infection. Therefore, any cut that might need suturing should
be seen as soon as possible.
What are the signs of a
If the wound begins to drain greenish
fluid (pus) or if the skin around the wound becomes red, warm, swollen,
or increasingly painful, a wound infection may be present and medical
care should be sought.
Any red streaking of the skin around
the wound may indicate an infection in the system that drains fluid from
the tissues, called the lymph system. This infection (lymphangitis) can
be serious, especially if it is accompanied by a fever. Prompt medical
care should be sought if streaking redness from a wound is noticed.
How are puncture wounds
There are two risks with puncture
wounds. First, a wound infection can occur because of dirt pushed deep
into the skin by the object (typically a nail) puncturing the tissue. As
you can imagine, these wounds are very difficult to clean out. The second
problem that can occur is an infection of the bone. If a nail penetrates
deep into the foot, it can hit a bone and introduce bacteria into the
bone. This risk is especially great if the nail has gone through a pair
of tennis shoes. The foam in tennis shoes can harbor a bacteria (Pseudomonas)
that can lead to serious infection in the tissues.
First aid for puncture wounds includes
cleaning the area well and keeping the foot elevated for several days
(depending on the severity of the puncture wound). Especially if the puncture
wound occurred through tennis shoes, an evaluation by a healthcare professional
should be sought. Additionally, diabetics, the elderly, those persons
taking drugs that can suppress the immune system (such as cortisone-related
medications), or any particularly deep puncture wound should be seen by
a healthcare professional. This is particularly true if it was difficult
to remove the nail, indicating that it may have penetrated the bone. Most
puncture wounds do not become infected, but if redness and swelling persist,
see your health care professional.
Puncture wounds commonly occur when
someone steps on a nail. It is a good idea to wear shoes to minimize the
risk of a puncture wound, especially if you have diabetes or loss of sensation
in the feet for any reason.
Will I need a tetanus shot?
Most people in the United States
have been immunized against tetanus (lockjaw). If you have been immunized,
you will need a booster shot if you have not had one in over five years.
If you have never had a tetanus shot, or if your series is incomplete
(fewer than 3 shots), you might need tetanus immunoglobulin, a medication
that can prevent lockjaw.