SKIN INJURY (BRUISES, CUTS AND SCRAPES) Injury Definition Cuts, lacerations, gashes and tears Scrapes, abrasions, scratches and floor burns Bruises (bleeding into the skin) without an overlying cut or abrasion When Sutures (stitches) are Needed Any cut that is split open or gaping probably needs sutures. Cuts longer than ½ inch (12 mm) usually need sutures. On the face, cuts longer than ¼ inch (6 mm) need sutures. Any open wound that may need sutures should be checked and closed within 6 hours if possible. See More Appropriate Topic (instead of this one) If It's a puncture, see PUNCTURE WOUND There's a sliver in the skin, see SPLINTER OR SLIVER Injury looks infected, see WOUND INFECTION WHEN TO CALL YOUR DOCTOR FOR SKIN INJURY Call 911 Now (your child may need an ambulance) If Major bleeding that can't be stopped First Aid: Apply direct pressure to the entire wound with a clean cloth. Call Your Doctor Now (night or day) If 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 Age < 1 year old Dirt or grime in the wound is not removed after 15 minutes of scrubbing Bicycle-spoke or washing machine wringer injury  Skin loss from bad scrape goes very deep Skin loss involves > 10% of body surface (Note: the hand's surface equals 1%) Cut or scrape looks infected (redness, red streak or pus) Call Your Doctor Within 24 Hours (between 9am and 4pm) If You think your child needs to be seen Several bruises occur without any known injury Very large bruise follows a minor injury No tetanus booster in > 10 years (5 years for dirty cuts at higher risk for tetanus) Call Your Doctor During Weekday Office Hours If You have other questions or concerns No tetanus shot in > 10 years (5 years for dirty cuts at higher risk for tetanus) Parent Care at Home If Mild cut, scrape or bruise and you don't think your child needs to be seen Back to Top HOME CARE ADVICE FOR MILD BRUISES, CUTS AND SCRAPES 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. 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.) For any dirt, scrub it gently with a washcloth. Cut off any pieces of loose skin using a fine scissors (cleaned with rubbing alcohol). Apply an antibiotic ointment, covered by a Band-Aid or dressing. Change daily. 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 (eg. 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 and usually lasts a week. It’s resistant to bathing. This new product is available at your local pharmacy. Pain Medicine: Give acetaminophen (e.g. Tylenol) or ibuprofen as needed for pain relief. Call Your Doctor If: Looks infected (pus, redness, increasing tenderness) Doesn't heal within 10 days Your child becomes worse or develops any of the "Call Your Doctor" symptoms Back to Top Disclaimer: This information is not intended 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. Pediatric HouseCalls Online. Copyright © 2000-2005 Barton Schmitt, M.D. FAAP Reviewed 8/2005 Revised 8/2005 See Other Topics: Puncture Wound Splinter or Sliver Wound Infection View Index of Topics