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.

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  • Tarah

    Yesterday I nearly cut the top of my middle finger off with a potato peeler.. It’s a long story.. After about 10 minutes I got the bleeding to stop and sealed the cut with super glue them super glued a steri strip over it. Today I woke up with an intense itch all over my hand, not a surface itch but deep in my hand itch. Why is it so itchy!?

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

      One possibility is super glue or a steri-strip could cause irritation or a local allergic reaction.

      You could test another finger with the same products and see.

      • Tarah

        Thank you for your quick response! I will try that right now. Though the finger I cut does not itch, just everywhere else. Top of my hand in two places and my palm all over. Could the finger itself not react but areas close to it do? Sorry I’m just confused by this as I have used super glue and steri strip to seal wounds before with no reaction! But I will certainly try putting them both on my other hand to test.

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

          There’s no way I could tell for sure about your problem. An example is my previous answer. I assumed it was your finger itching. Since it was the rest of your body, the only thing possibly related to the finger would be if you’re having a systemic reaction to the glue or tape. Again, I can only talk in generalities but if the itching is bad and not getting better, I would suggest seeing a doctor. If it’s not so bad and no rash, perhaps an antihistamine would help.

          • Tarah

            Oh jeez, I’m sorry I am not being very clear at all! It is the palm and back of the hand that is very itchy. The same hand with cut on my middle finger! I am having a hard time with it still. I don’t have insurance which is why I fixed it myself but it looks like I will be going into the doctor if the selling and itching isn’t any better by morning. Thank you for your time!!

  • lakshmi

    shdn’t one squeeze the finger and let the infected blood out in a case of needle stick injury ? increasing the size of the wound/ laceration is not imp here ??

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

      I don’t think purposely increasing the size of the wound would be a good idea unless a doctor did it in rare circumstances in sterile conditions. I guess gently squeezing some blood out of a wound might help but very little.

  • ur mom

    poop

    • TacocatsRAwesomeUAllSuckAss

      hahahhahhahahahhahahahhahaha

  • alswearengen

    So a small gash around the thumb knuckle that won’t stop seeping heavily without pressure, for 3 hours now, is a situation where I just keep it wrapped with gauze and pressure by wrapping tape around it? It’s ok then, only when I take it off does it just pick right back up with the heavy seep. I am usually a fast clotter but have been taking horse chestnut for the last week and can only figure that is the culprit. Sister-in-law nurse declares I should be in the ER. At what point to start worrying about the blood situation? Horse chestnut half-life is 20 hours.

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

      Every person and every injury is different. The information is for when you can’t get medical help. I’d definitely get it seen if: 1. it’s still bleeding or 2. you’re concerned or 3. if you sister-in-law has seen it and thinks you should go. Your regular family doctor (if he/she treats cuts) or an urgent care clinic might be a good option. But the ER would suffice also.

      • alswearengen

        Thank you. It stopped bleeding with pressure and completely stopped by the time I woke up. I butterflied it and it’s doing fine. It was late at night and the only professional option was the ER and I did not want to get caught up in their web of liabilities and the associated costs. I knew why I wasn’t clotting, well, assuming it’s the Horse Chestnut and high Vitamin C since before taking those I clotted just fine, but when they couldn’t get it to stop maybe they would have had to do expensive tests. The nurse didn’t see it and an ER visit for her is totally different than for others, since she works there so I know how easy it is for her to say, “Go to the ER”. Turned out fine and I appreciate the lack of hysteria on this blog since it helped to calm me down and assess the situation.

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