CUT/GRAZES/WOUNDS

See also

Sports injury

Types

• Skin only:Pressure and elevation may be required to control haemorrhage. Clean wound thoroughly. Apply clean sterile dressing, if wound edges aren't easily brought together. Attend A & E.
• Deep injury: Complicated by injury to tendons and nerves or other structures. If suspected. Attend A & E.
• Dirty injury: Require cleansing. Tetanus may also be required. Oils may particularly interfere with healing. Cats and dog bites/scratches often become infected - due to the nature of the commensals carried on these animals.Contact GP.

Danger signs

• Deformity/loss of function: May indicate damage to deeper structures. Attend A and E.
• Lacerations: Where bleeding cannot be controlled - pressure and elevation and apply compressing dressing. If blood soaks through place another on top - Attend A and E.
• Special areas: Other than minor injuries, seek advice if injury to eyes, face or fingers (especially of dominant hand). Special lacerations on nose, ears, elbows, palms and soles of feet may need special attention.

Notes for children

• Foreign bodies: Have a high index of suspicion that splinters/glass may be retained within wounds. If in doubt attend A and E.
• Tetanus immunity: Is provided as part of the normal regime of childhood immunization. If child is fully immunised they are protected.

Notes for the elderly

• Skin injuries: Beware of injuries to front of skin - healing may be very poor. If signs of necrosis, attend GP.
• Skin thinning: Elderly often have thin skin which is slower to heal.

General advice

• Pressure and elevation to control haemorrhage.
• Adequate cleaning and anti-sepsis.
• Tetanus prophylaxis if needed.
• Analgesia.

Therapy

• Antiseptics.
• Analgesia.
• Appropriate dressings.
• Emollients where scaling/ dryness of scarred areas

Dictionary

Emollient: fats and oils, such as lanolin and liquid paraffin, that soothe and soften the skin.
Necrosis: pathological death of one or more cells, or of a portion of tissue or organ, resulting from irreversible damage
Prophylaxis: the prevention of disease.

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