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

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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.

  • Jazzy

    My three year old son smashed his pinky finger from the opposite side of the nail and now it has a cut with like the inside trying to burst out..it is bruised and swollen.what should I do?

    • Jazzy

      It looks as if the inner tissue is protruding and its swollen and bruised..I don’t know what to do..the bleeding stopped with pressure

      • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

        Jazzy, how is your son? Sorry but I’ve been out.

  • Michelle Neardymonkey Stout

    I need help I got stab in the palm of my hand at with a inkpen at 10:30 am. it’s now 11:05pm its swelling up n my entire hand is still super pain it hurts to move my middle finger and ring finger it hurts super bad everything num in that hand feels like the hand is not heavy then my arm what do I do I have work I can’t take day of fhelp

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      If it’s not a lot better this morning you should see a doctor.

  • cassadea

    Hi, I cut my finger this morning with a knife and it took a chuck out of it the skin is still there but it is still bleeding what can I do it really hurt still it has been about 12hours

  • Gregg

    I cut a good sized piece of skin off my finger while washing a beer glass. The glass cut passed the dermis, leaving about 1/2″ long and a little over a 1/4″ wide wound. There is still a flap of skin that’s been, for the most part, covering it for about 6 days. A piece of the flap is lifted up where i can see the red flesh underneath, especially if i bend my finger. I’ve been flushing it with hydrogen peroxide and spraying with saline solution for 4-5 days. I keep in wrapped up for the most part, but let it breath a few hours a day, before bed. This is definitely too wide to have stitched up. So my questions are: do i just keep doing what i’m doing? Do i get something like liquid stitches, or do i not want that seeping into the wound? And will it heal normally in doing so? I don’t have health insurance, so i’m trying to avoid going to the doctor.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      In general, the skin will fill in quite nicely if you clip off some fingertip skin depending on how deep it is. Usually you just have to keep it clean and bandaged. You might ask a healthcare professional to take a quick look since I can’t give specific information about your specific case without an exam.

      • Gregg

        Thanks, James. This is actually on the side of my pointer finger, almost spanning the entire area from the first to second finger joints. I could clip off the flap of skin, but i feel like that’s what’s mainly protecting it right now. Do you think clipping it is still a good idea given the area?

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  • D

    Hi,
    I accidently cut my arm on the front approx between my wrist and elbow in the middle. It is about 2cm long and 1/2 cm deep. Its clean and doesn’t seem infected. I have washed it put anti bacterial cream on and bandaged it. My question is I can still see tissue and will it heal on its own? I did it nearly 72 hours ago? Will the tissue heal and skin e
    ventually come back together?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      I couldn’t tell you in your specific case. In general though, a cut that big would heal unless it gets infected, albeit with a scar.

  • Kara

    Hi, I accidentally kicked a knife that fell from the counter. My foot met the point of the knife on the right side of my left foot. It wasn’t bleeding much so I just cleaned it and put a band-aid on it. It’s healed now…its been about a month and a half… It still hurts when any pressure is applied to it though. I can wear shoes and heels just fine without it hurting, but if I actually touch it .. it hurts. Is this normal? Do I need to go get it checked?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      if there swelling or a knot or if it looks infected then definitely. Otherwise it depends on how much it’s bothering you. Ultimately it’s up to you.

  • A2016

    I cut a strip of skin off the top of my middle finger at work, between the first and second joint. It’s about 1/4″ x 1/8″ and looks like the epidermis is gone, just the spongy looking dermis underneath. It bled quite a bit at first, so I put a bandaid on it and it stopped bleeding about 5-10 min later. Anyway, it’s been 5 days and there’s no apparent sign of heeling, it leaks a small amount of water, but no blood, and no scab formed.
    Will it close up or fill in??

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      It should fill in with scar tissue with time but if it’s no better at all, have a health care person check it out.

  • Sarah

    I just got a stick and punctured my skin, the wound isn’t deep but it still hurts, What do I do?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      It would depend on how deep and if you’re able to clean it completely. How’s it doing now?

  • CLMAZ

    My great-grandmother, working in her garden, cut the tip off her index finger. In those days, hospitals weren’t just down the street. She wiped off the finger and the fingertip, joined them back together, tied them with a piece of fabric from her dress. After leaving that in place for about a week, she untied it, and the finger had grown back together….. but the tip had slipped, and her fingernail was pointed to the side for the rest of her life.

    A few years ago, I stabbed a small, very sharp knife point into my palm while peeling a potato. A little tap water and soap, and it stopped bleeding. The hole was so tiny, it was barely visible. The next day, Wed., I was in agony. Went to the dr. Got antibiotics. By Fri, my hand was so sore, I couldn’t bend my fingers. The pain was worse than childbirth, migraines and toothaches, combined. Back to the dr. He called local hospitals to find one with a hand surgeon on call for the weekend. Off to UofA Medical Center. The surgeon thought he’d have to do emergency surgery, cutting a zigzag the length of my index finger, and keeping me in the hospital for about 4 days. That tiny little knife prick stabbed the sheath over the vein in my index finger, and it got infected…. not visible to the naked eye, but internally. I cried (it was 5 days before Christmas, and I didn’t want surgery.) They opted for overnight stay, and some really mega-strong antibiotics and morphine thru IV, and said they would wait until morning to decide about surgery. Ten hours later, I was fit as a fiddle and itching to get out of there. All better.

    Point is, injuries that look like they could be fatal, may not be. Ones that look harmless, could have deadly infections inside. You just can’t tell. ALWAYS follow the best available medical info you have (good 1st aid books, or phone calls to ER, etc.) And if there is any unusual pain, swelling, etc., do whatever you can to get to a professional. Everyone believes they could “doctor” themselves, and live off the grid, and brave the worst, but if you aren’t in the absolute worst situation, don’t be adventurous with your health. In all cases, cross your fingers and pray that it’s the lesser of many evil wounds.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Thanks for sharing.