I find that many patients who come into the clinic with a wound have questions about how to take care of it. The wound might be a post-surgical incision or even a minor cut. Hopefully this will help with some of those questions.
Do I need stitches?: The best way to know for sure is to be examined by a medical provider, but some basic things we look at:
1) Depth of the skin wound – if it does not go all the way through the skin, it usually doesn’t need stiches
2) The size of the wound, whether it’s wide, or jagged. If it’s large, wide or jagged – there is a higher likelihood of needing stiches
3) Where on the body the wound is – in areas of the body with lots of stress on the wound, the stitches help hold the skin together better than tape, or a butterfly bandage.
4) How long ago the injury occurred: If you got cut 5 days ago, there is less chance sutures would be appropriate because wound healing has already begun.
5) If it was an animal bite or dirty wound: We will sometimes put stitches in a wound that was created by an animal bite, but these are generally dirty wounds and we are very careful not to bring the skin together too tight so that the wound can drain.
What to do at home – basic guidelines:
1) Clean the cut or scrape with soap and water. If there is a piece of glass, or foreign object in the wound that will not come out, you will need to see a medical provider
2) Stop the bleeding with direct pressure on the wound. Press a clean cloth or bandage on the wound for 20 minutes minimum without releasing. If the bleeding is not stopping, contact a medical provider.
3) Put a thin layer of antibiotic ointment on the wound edges – not in the wound. I recommend bacitracin (mupirocin) and not Neosporin.
4) Cover the wound with bandage/gauze to keep the wound clean and dry. Change the bandage 1-2 times every day until the wound heals
5) Examine the wound for signs of infection – see below. Healing time for most wounds is 7-10 days but this can vary.
When to see a medical provider:
1) The wound is deep and/or you can see fatty tissue, muscle, bone or dirty/debris within the wound
2) You are having severe pain
3) There are signs of infection (usually begin on about 2-4 days after the wound injury) such as: Fever, redness, swelling, increased warmth around the wound, pus draining from the wound or red streaks on the skin around the wound.
4) The wound is from a bite
5) The wound is a puncture wound caused when a sharp object goes through the skin into the tissue underneath. There is a higher chance of infection with these kinds of wounds.
Do I need a tetanus shot?: You may need a tetanus booster depending on when your last one was. If you have deep wound, it is best to contact a medical provider if you’re unsure of whether you need a tetanus vaccine.
Abscess: An abscess is an infection under the skin where bacteria (pus) collect. A surgical procedure called an I&D (incision and drainage) can be done to drain the pus and heal the infection.
If you’ve had an incision and drainage done at your doctor’s office: After having a surgical procedure done at your doctors office, the wound is often packed with sterile gauze to allow the wound to heal from the bottom upwards. This way, the wound doesn’t close up at the top and leave a space underneath the top of the skin where bacteria can start growing and cause an infection. This type of wound needs special attention and observation each day.
Basics of wound care after an I&D (incision and drainage):
1) Keep the bandage/wound clean and dry.
2) Only remove the bandage to clean around the wound and follow the advice of your medical provider on how to do this.
3) The packing gauze should be removed little by little until the wound heals completely. The decision on how much to remove (if any) should be made by a medical provider but this can be explained to the patient on an individual basis (ie. Wounds heal differently depending on the situation).
4) You may need to wear a splint to decrease movement to the area and allow wound healing.
5) Antibiotics and pain medication may be prescribed.
This document is for informational purposes only, and should not be considered medical advice for any individual patient. If you have questions please contact your medical provider.
I hope that you have found this information useful. Wishing you the best of health,
Scott Rennie, DO