Whether you cut your hand while preparing dinner or step on something sharp in your driveway, there are a few ways to determine if your injury warrants a trip to the emergency department or not.
“We see quite a bit of cuts and scrapes in the emergency department,” says Sean Sue, M.D., a Piedmont emergency medicine physician.
When to see a doctor for a cut
When deciding whether to seek medical attention, consider:
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The location of the cut. A cut on your hand or foot may be more likely to get infected, and one over a joint may continue to split open without stitches.
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Any medical problems you already have, such as diabetes.
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The amount of bleeding. If the wound is deep and/or the bleeding is not controlled by consistent pressure, you need to seek medical attention.
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If the wound is from an animal or human bite, you should contact a healthcare provider.
“In terms of the risk of infection, it really depends on the mechanism of the cut,” Dr. Sue explains. “A cut by a dirty, rusty nail on the hand is more likely to get infected than a cut by a clean knife on your upper thigh.”
First aid for cuts and lacerations
1. Stop the bleeding. If you cut yourself, the first thing you should do is apply pressure with a clean bandage or cloth, and keep that part of your body elevated above the heart, if possible. Once pressure is applied, do not repeatedly remove the dressing to check on the cut – doing so can disrupt the clotting process.
“The body has a normal mechanism to clot, so when you apply the pressure then remove that dressing, you’ve dislodged a clot, and you tend to bleed more,” Dr. Sue says. If the bleeding is heavy or does not stop after you apply consistent pressure, you need to seek medical attention.
2. Clean the wound. Every cut has the potential to become infected, so once you have controlled the bleeding, you should rinse the area with tap water.
“They’ve actually done studies showing that cleaning with tap water was as effective as using sterile saline,” Dr. Sue says. “I’m not a big fan of peroxide or Betadine because many people tend to use too much and that can be toxic to the tissues.”
3. Use an antibiotic ointment. “Most people use Neosporin,” he says. “It doesn’t clean the wound or affect healing, but it will diminish the chance of infection.”
4. Cover the wound. Once you’ve cleaned the wound and applied antibiotic ointment, dress it with a sterile bandage.
5. Change the dressing. “It’s important to change the dressing frequently if the wound is draining quite a bit,” he says. “If it’s a relatively dry wound, changing the dressing once a day is appropriate.”
6. Get stitches for deep wounds. You likely need sutures if the wound is large and/or exposes fat or muscle tissue, pressure and elevation isn’t controlling the bleeding, and the wound is over a joint.
When appropriate, tissue adhesive may be used as an alternative to traditional stitches.
“It’s basically superglue that we can use in different wounds,” he says. It works best for small wounds that are not cosmetic or over a joint, as regular stitches can help reduce scarring. “We tend to use it a lot more in kids because there is no pain involved,” Dr. Sue says.
7. Watch for signs of infection. Keep an eye on the wound and watch for changes, as every cut carries a risk for infection. Signs of infection include:
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Redness
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Swelling
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Pus or drainage
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Excessive pain
If you are in a high-risk population (e.g., you have diabetes or an autoimmune disorder) or the injury is on your hands or feet, you should pay special attention to any signs of infection. Seek medical advice if you notice anything suspicious or the cut is not healing properly.
8. Get a tetanus shot. “Most wounds we see are not tetanus-prone wounds; it’s not very common in this country,” Dr. Sue says. “However, if you get stuck by a dirty nail or something exposed to dirt, those are more likely to be tetanus-prone wounds.”
As a general rule, get a tetanus booster shot every 10 years. If you get a cut, make sure you had a tetanus shot within the last five years to reduce your risk of infection. If you are unsure about your tetanus risk, consult a healthcare provider.
How to treat a cut at home
“Most cuts can be managed at home; however, I always tell people, if you are concerned about the cut, seek medical attention,” Dr. Sue says. “At that point, we can decide if it is a benign cut that requires simple first aid or a cut that requires antibiotics, sutures or tissue adhesives.”
Here's how to know if you should go to the emergency department or urgent care.
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