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This survival-medicine website provides general information, not individual advice. Most scenarios assume the victim cannot get expert medical help. Please see the disclaimer.

Skin Lacerations: How to Treat a Cut, Scrape, Gash, Stab Wound

IN AN EMERGENCY: Treating a wound with no access to medical care right now? This is the post to read.

You can sometimes use duct tape to close a wound. (See step four.)

by James Hubbard, M.D., M.P.H.

You’re cleaning up after the big storm. You’re wearing gloves but grab a pile of rubble that contains some sheet metal. Next thing you know, your glove is red with blood. You cannot get medical help. What do you do?

Basics for Treating All Cuts, Scrapes, Gashes and Stab Wounds:

1. Stop the bleeding.

Apply direct pressure. If it’s a cut finger, squeeze the wound with your other hand. With a larger area, push down with the base of your palm. Use a clean rag if available. Even if it’s a small artery, you can temporarily stop the bleeding by squeezing proximal (closest to the heart) to the wound. A tourniquet is a last resort. Direct pressure is always better if it works.

For Visual Learners

Here’s my video series on how to treat cuts:

  1. Part 1: Stop the Bleeding
  2. Part 2: Assess and Clean the Cut
  3. Part 3: Repair the Cut With Duct Tape

Be careful if you suspect a broken bone underneath. You don’t want to push too hard and move the bone out of place.

As a rule, sharp cuts bleed more than dull, at least at first. (Dull cuts pull more on the blood vessels, causing them to spasm and close more). This has nothing to do with the severity of the cut. Cuts on the face and fingers tend to bleed more (more dense blood supply). If you have a mouth or tongue cut, click here for special instructions.

2. Assess the damage.

Assessing the Wound

For more details on how to assess a wound, click here.

If the blood is squirting out, you’ve cut an artery. Oozing usually means it’s a vein. Arteries are harder to stop bleeding and are more likely to supply blood the tissue cannot do without. Small arteries on the fingers usually quit bleeding after squeezing for 10 or 15 minutes. Veins take less time. If you’ve cut an artery, follow the instructions in this article. Then come back here and continue with these instructions.

To treat small cuts and nicks click here.

To treat stab wounds click here.

Even More Wound Tips—All in One Place!

"The Survival Doctor's Guide to Wounds"Learn as you go!

Take all The Survival Doctor’s wound-treatment tips with you in The Survival Doctor’s Guide to Wounds. You’ll learn about different types of wounds, plus get an interactive guide for quick reference in an emergency.

If the wound is deep and large and won’t stop bleeding without pressure, click here.

To treat other large cuts, gashes or stab wounds, go to step three below.

3. Clean the wound.

The cleaner a laceration is the less the chance for infection. Run it under tap water or use the cleanest water you have. If your tap’s not running, punch a small hole in the bottom of a full plastic jug for extra pressure. If water is scarce, use peroxide. Alcohol is okay, including liquor, but be aware it’s going to hurt worse.

If the wound is more of a scrape, pick out the debris, and wash it. If the dirt is ground in, you may have to scrub a bit.

4. If the cut gapes open, close it.

Head-Wound Tip

Here’s how to close a head wound with hair instead of stitches.

Cuts that gape open can sometimes be closed with tape. Duct tape works well. (If the gash can’t be closed, clean it and pack it with clean rags.) To close the cut, follow these steps:

      1. Dry the wound. If you have some glue apply it to the skin edges (not the actual wound).
      2. Apply a strip of tape to one edge, close the skin gap using your hand, and apply the other side of the tape tightly.
      3. Cover the wound with clean cloth, duct tape, or whatever you have to keep dirt out of it.
No Antibiotic Ointment?

If you don’t have antibiotic ointment, you can use honey (just not on a baby).

The bandage has to be loosened if the area distal (furthest from the heart) to the cut starts turning blue or dark. This discoloration may mean this area is not getting sufficient blood flow and could be permanently damaged. See an expert as soon as possible to try to save the tissue.

5. Keep it clean and dry.

Add some antibiotic ointment if you have it. Cover it with Band-Aids, or cloth and tape, or wrap a cloth around it.

 

Questions and comments are appreciated.

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Special Instructions Linked to From Above

How to Treat Small Lacerations:

Small nicks or lacerations similar to paper cuts should be washed and bandaged. You can seal them with a little super glue if available. Keep clean and dry.


How to Treat Stab Wounds:

Stab wounds, or puncture wounds, are deeper than they are wide. They’re usually caused by a knife or a stick or something similar. You can’t see the whole damage.

If the chest or abdomen is stabbed, try to approximate the depth by the length of the stick or knife. If you think it may have punctured the chest or abdominal cavity, it becomes more important to seek expert care as soon a possible due to the risk of severe infection.

If the area begins to swell immediately, you may have hit an artery. Apply pressure.

If not severely bleeding, wash as best you can, apply ointment and cover. Keep it clean and dry.


If the wound is deep and large:

It may never stop bleeding without pressure. Pick out any noticeable debris, pack it with clean rags and cover with tape.

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  • Tricia

    3 weeks ago I dislocated my knee… Long story short, the other night while cleaning up the house a bit I picked up a kitchen knife and was on my way to the dish washer with it when my knee gave out on me and I fell . The serrated knife caught me pretty good right where your neck meets your shoulder, or I guess my collar bone. I finally got the bleeding to stop and have been cleaning it but its nasty. By that I mean its jagged and relatively deep. Is there any way to close this, and what are the risks if I can’t get it closed. I’m prepared to have a nice little scar but I would like to know how best to clean it and with what . I have been using peroxide ,clean dressings, and triple antibiotic ointment. Any advice you could give would be much appreciated.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Tricia, you’re very lucky you didn’t cut a vein or artery in that area. The risk of not getting it checked out is deep cuts tend to get infected even if they are closed up. They’re hard to get completely clean and tend to heal first at the surface leaving a deep, closed space where bacteria love to grow. You say it’s nasty, and it’s clearly in a bad place with important arteries, veins, and nerves that could be damaged with infection. You’re taking a big risk on not getting it seen. If I were you, I’d go to your doctor, or an urgent care center tomorrow.

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  • K

    My brother had a laceration stitched up that became infected and is on two medications for that. Should the wound remained covered until the stitches come out or not? It is still oozing a bit but the PA said he should keep it uncovered. Every time he goes to the urgent care they tell him something else about covering it. He’s been there 3 times because they have him coming back every 2 days for a wound check.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      K, he needs to ask the doctor for the specific recommendations regarding his specific wound. In general, I’d keep it covered and, if it’s oozing, change the bandage frequently so that the surrounding healthy skin doesn’t stay continuously moist. Covering will help keep the area clean, and not contaminate other people with his fluids. But, at home, just sitting around, I don’t think it matters a lot if he keeps it feels better uncovered.

      • K

        He called them back and they told him to keep it uncovered. This is one of those occasions though where I realized we should have a GP we should see instead of the convenience of going to urgent care. The same person would have seen the injury all the way through and you’d have consistent advice. Also you’d probably get to see a doctor rather than a P.A.

        Thank you for the quick response.

  • vinny

    SOMEONE HELP! I had a cut I’m my ring finger knuckle from scraping it , and it was a flap of skin handing off.. most of it looked like just dead skin right away but where it met my hand it was like meat , I tried to cut it off and that’s when I realised it still had feeling in half of it, the skin was a lil smaller then a dime.. I kept it bandged down till it healed but once it did it wasn’t pulled tight enough so that flap of skin turn out to be a lil bump, and me being the skab picked I am I sliced it with a razar to flaten it out, not the smartest idea but now that that’s healed closed its still had a lil dead skin where the cut was, well yesturday after like 3 months I pulled the lil piece of skin off and there’s like a hole that u can see almost to the cartilage so pretty deep its not wide, maybe the size of pin head but deep , now that its exposed its been leaking water when I make a fist for the past 2 days, and it really starting to hurt , and the back of my hand is swollen. Could it be infected? Why would there be a hole?

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Vinny, to state the obvious, the hole is there because the wound didn’t heal properly. I’d say it’s time to have a doctor look at it. Until you can, clean it well with water, put antibiotic ointment on it, cover it with a bandage, splint it with something so that finger joint doesn’t move, keep it clean and dry other than the washing it, and get to a doctor. If it is more than a little infected, the infection could spread along that tendon sheath and cause a serious infection of your whole hand.

  • Deborah

    My son is away in another state so I can’t see the real damage but he has cut his hand on a glass (broke while washing)… My understanding is that the skin was removed from on top of his index finger and it won’t stop bleeding. I know it has been an hour. How do you stop the bleeding when there is missing skin? They have no antibiotics and no tape left. only gauze and bandaids. He thinks it is pretty bad but has a tough time looking at it without getting nauseated.

    Thank you so much for your assistance.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Deborah, to stop the bleeding on a finger, just wrap the gauze around it and squeeze directly over the wound with your other hand. Also, keep the injured hand above heart level. And it sounds like he needs to get it checked by a doc today.