Essential Care Tips for Treating Cuts and Scrapes at Home

Wound care for lacerations?

Hello Dr.
Chen, today I stepped on a nearly broken plastic chair, which broke, and my left calf was cut by the chair fragments, resulting in abrasions and bleeding.
I immediately washed the area with saline solution, applied Betadine, and covered it with a Band-Aid.
There are about three cuts, with the largest measuring approximately 0.3 to 0.5 cm, while the other two are less than 0.1 cm.
I also used waterproof bandages while showering.
After showering, I changed the dressing and would like to ask a few questions:
1.
Does this wound require a visit to the hospital? I am concerned about tetanus, as the chair seemed quite dirty.
It has been over 10 years since my last tetanus shot, but the wound appears to be a superficial abrasion.
I am unsure what to do.
2.
During the second dressing change, the larger wound still had slight oozing of blood.
It stops with some pressure.
Is this normal?
3.
Is there any cleanly torn skin on the larger wound that needs to be removed? When I gently pull on it with a cotton swab, it seems to bleed, but if I don’t tug at it, it doesn’t bleed.
4.
Currently, my dressing change procedure is to wash with saline, dry the area, apply Betadine, wait for 30 seconds for it to dry, and then cover it with a Band-Aid.
Is this dressing change process correct, or does it need any modifications?
Thank you, doctor.

Shun Kang, 30~39 year old female. Ask Date: 2023/06/12

Dr. Chen Bingze reply Surgery

1.
If you're concerned, it's advisable to get a tetanus shot at a medical facility, even though the risk of infection is really low.

2.
This is normal.

3.
You can avoid touching that area for now, and later use clean scissors to carefully trim it away.

4.
You should first apply the ointment, and once it dries, wipe it off with saline solution.
However, current evidence-based medicine suggests that simply rinsing with saline is sufficient.
For wounds that truly require debridement, applying ointment is ineffective.

Reply Date: 2023/06/12

More Info

When treating cuts and scrapes at home, it's essential to follow a systematic approach to ensure proper healing and minimize the risk of infection. Based on your situation, here are some essential care tips and answers to your specific questions:
1. Do You Need to Visit a Hospital?
Given that your last tetanus shot was over ten years ago and the injury was caused by a potentially dirty object, it is advisable to consult a healthcare professional. Tetanus is a serious bacterial infection that can occur when bacteria enter the body through wounds, especially if they are contaminated. The CDC recommends getting a tetanus booster every ten years, so if your last shot was more than a decade ago, you should consider getting one. A healthcare provider can assess the wound for any signs of infection and determine if a booster is necessary.

2. Is It Normal for the Wound to Bleed Slightly During Dressing Changes?
Yes, it is normal for a wound to ooze a small amount of blood, especially if it is still healing. If the bleeding is minor and stops with gentle pressure, it is usually not a cause for concern. However, if the bleeding is excessive or does not stop, you should seek medical attention. Applying gentle pressure with a clean cloth or bandage can help control minor bleeding.

3. Should You Remove Any Skin Flaps?
If there are any skin flaps that are still attached and not completely severed, it is generally best to leave them in place. These flaps can help protect the underlying tissue and promote healing. If pulling on the flap causes bleeding, do not force it; instead, let it be. If you are concerned about the appearance or healing of the flap, consult a healthcare professional for advice.

4. Is Your Wound Care Routine Correct?
Your current wound care routine seems appropriate, but here are some refinements:
- Cleaning: Using saline solution is a good choice for cleaning the wound. Ensure that you gently clean around the wound without causing further irritation.

- Antiseptic Application: After cleaning, applying an antiseptic like iodine is acceptable. However, some people may have sensitivities to iodine, so if you notice any irritation, consider switching to a different antiseptic, such as hydrogen peroxide or an antibiotic ointment (like Neosporin).

- Dressing: After the antiseptic has dried, covering the wound with a sterile bandage (like an "OK band" or similar) is a good practice. Make sure the bandage is not too tight, as this can restrict blood flow.

- Changing the Dressing: Change the dressing at least once a day or whenever it becomes wet or dirty. Each time you change the dressing, repeat the cleaning and antiseptic application process.

Additional Tips for Wound Care:
- Watch for Signs of Infection: Keep an eye on the wound for any signs of infection, such as increased redness, swelling, warmth, or pus. If you notice any of these symptoms, seek medical attention.

- Keep the Wound Dry: While it’s important to keep the wound clean, it’s also crucial to keep it dry. If you’re showering, using a waterproof bandage is a good idea, but ensure that it is sealed properly to prevent water from getting in.

- Nutrition: Eating a balanced diet rich in vitamins (especially Vitamin C and Zinc) can help promote healing. Foods like fruits, vegetables, lean proteins, and whole grains are beneficial.

- Avoid Picking at the Wound: It can be tempting to touch or pick at the wound, but this can introduce bacteria and delay healing.
In summary, while your initial care seems appropriate, it is crucial to monitor the wound closely and consult a healthcare professional regarding your tetanus vaccination and any concerns about the wound's healing process. Proper wound care can significantly reduce the risk of complications and promote faster healing.

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