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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  • Alny

    Someone help me , I got my hands cut with a butterfly knife on my palms the left one you can see how deep it’s cut pretty bad and on the right you can see the bone am I in need of stitches ??? What can I do for it to heal faster

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

      See your doctor or go to an urgent care center today

  • Pankaj Attri

    help me please i m got a wound near knuckle (feet) ..it was first a little wound and….. i started wear socks and later i found it converted into boil and it is now swelled a lot …today it was burst and flude came out and still escaping ………
    pls tell me is it a big problem i ate pill to dry the wound and tablet name is floxips 5oo ….and also iam applying povidone -iodine on it ……..need a treatment

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

      Sounds like it’s getting serious. You need to see a doctor before it gets worse. There are several things that might need to be done. It might need to be cleaned out, opened further, and require antibiotics (either oral or IV) for a good length of time.

      • Pankaj Attri

        thanks sir…

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  • Linda

    Please define ” pack it with clean rags”.

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

      Just like you would gauze, you’d use clean rags if that’s the cleanest thing you have. Use enough so that it contacts the wound and provides a little pressure when covered with tape.

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  • AM

    I cut my shin while mountain biking last Tuesday. It was pretty deep and about 1/4″ long, so when I returned home, I cleaned it and put a butter fly strip, neosporine and another bandage on it and tried my best to keep it clean.

    By Friday morning at 5am I woke up in excruciating pain and went to an emergency treatment center. My leg was infected. The doctor prescribed cephalexin (antibiotivpc), cleaned it w/ betadine, put neosporine and a bandage on it telling me to take the medicine and clean/re-dress the wound daily (or whenever I shower). He also said to use Tylenol for pain (which worked for the most part).

    I am now 2 days out from seeing the doctor and my leg wound appears to be getting getter, but is still a little swollen and kind of whitish near/around the wound. There is no liquid discharge coming from it and I don’t need Tylenol for the pain anymore.

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

      Thanks for sharing and I’m glad you’re doing better.

  • elizabeth

    Hello I really appreciate this blog, it’s taught me so much, but on a personal level, I got stabbed a couple of days ago, I have a 3-4 inch deep knife wound in my leg (calf area) the ER said no bone was damaged. They didn’t stich anything inside only the skin and it’s been three days now my leg is still swollen. I don’t know if it’s still bleeding but I know can’t walk on it at all.
    Do you know when it will heal well enough to when I could walk? I know I must have cut lots of muscle and tissues. Do you think I hit an artery? How long , in the calve area, does it take to heal?

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

      The problem with repairing a stab wound is you can never make sure if you have it completely clean and the inside area that was injured but not repaired is a perfect area for bacteria to thrive. It’s also an area where a lot of various fluids accumulate. In general, you’d want to keep the wound at heart level, or above, as much as you can to cut down on the oozing and you’d want to follow up with a doctor within about 1-3 days post-injury to see how it’s doing. I imagine if it had hit an artery there would have been profuse bleeding and your doctor would have repaired the artery or sent you to a surgeon. As far as how much muscle was damaged, that’s a question you’d have to ask the person who sewed you up.

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

    J, I have several more posts on wounds you might want to check out. It sounds like you should see a doctor. There are several things to worry about with a stab wound to your arm. 1. Did you hit an artery, 2. Did you damage a nerve or tendon that needs to be repaired, 3. Infection. Again, I have posts on those.

  • Angie

    I’ve been dealing with recurring secondary infections/chronic full-thickness wounds from epidermoid cysts on my face since last year. I’ve previously been given vancomycin IV, rocephin IV, & undergone reconstructive surgery on the scars/existing lesions to correct the disfigurement/remove remaining cysts. My last surgery was in June last year. I’m still on Bactrim DS presently (I had an infection in December of last year, & my infectious disease specialist has been weaning me off the Bactrim since then), & am away on a trip. I’ve been dealing with an ulcerated wound (behaving like the cysts again, leaving a somewhat deep cavity after oozing awhile) for a couple weeks, now (this is not new territory for me- the lesion didn’t appear/feel inflamed/infected, though). It’s located on my cheek, between the lower mandible & cheekbone, if that makes sense. I’ve kept the area clean.

    However, earlier today, I tried to remove gauze that had dried inside the wound (stupid me, I should have run it under water first, but I was in a hurry).. and I tore the exposed deeper tissue. As I cleaned the area again, I saw there was still gauze trapped in the center of the lesion, so I got a set of tweezers to remove it more carefully.

    Either my wound was deeper than usual, or in a more vascular place than usual, or the tweezers were too sharp (or all of the above)- but as I removed the dried bit of gauze, blood shot out of the lesion in a spray, at least a 3-inch radius. It was a firm, pinprick sized, very constant spray, so I’m concerned I nicked or tore a small artery when extracting the gauze. I immediately applied pressure with sterile gauze, as the steady spray was alarming, & waited approximately 1 minute before removing it. The bleeding trickled more like venous bleeding then, so I held it another minute. The bleeding stopped altogether. I ran the wound directly under the bath faucet for several minutes, gently scrubbed with Hibiclens antimicrobial solution for about 3 minutes/rinsed/repeated. Applied alcohol to the site, surrounding area, & mupirocin (Bactroban) ointment to the lesion before applying sterile gauze (adhering w/Hypafix tape).

    I’m aware I should see a doctor, & I’m sure you’re quite weary of these questions, but I’m due to fly home in another week or so, & would rather see my own doctor who is familiar with my case. I also don’t believe my insurance covers E.R. visits out of state.

    My main question is, should I be concerned about infection or blood clots, based on my description of the wound/new trauma? I tried to be as specific as possible. There’s no visible new trauma to the naked eye, but the spraying of blood alarmed me. This occurred about 3 hours prior to this posting, & there’s still no bleeding. If I see any remote sign of infection, I will go to the hospital, but as I said, I am quite hesitant to go due to financial constraints.

    Any feedback would be most appreciated. Thank you, if you read all of this.

    Take care.

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

      The spraying of blood sounds like you damaged a small artery. I have posts on how to stop the bleeding and posts on arteries. But, you did what I would have done–apply direct pressure. The damage to the small artery would not increase your risk for infection or blood clots any more than if you hadn’t damaged it. Sorry for the delay in responding. I’ve been out of the office a couple of days.

      • Angie

        Thank you so much for taking the time to read my post, as well as respond. You’ve given me a great deal of relief. The wound looks better already. I’ve been carefully cleaning with sterile saline solution/keeping it covered (with gauze that DOESN’T fray apart/stick in pieces to the wound, now.. won’t ever make that mistake again). No signs of infection, so hopefully once I get back home I’ll have this mess resolved for good.

        Thanks again, take care.

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

          Angie, you’re welcome.