The average small wound—a scrape, nick, cut finger or skinned knee—can safely and easily be cared for at home. But you need less in your first-aid kit than you might have imagined. Here are the basics.
First, stop the bleeding. Apply pressure with clean cloth, gauze or tissue. The only exception to this is a deep puncture wound as from a nail, needle or tool in the kitchen or garden, which should be encouraged to bleed a little as part of the cleansing process.
Second, cleanse the wound. If possible, hold it under cool running water. According to Larry Weiss, M.D., professor of emergency medicine at the University of Maryland School of Medicine in Baltimore, “the only thing proven to prevent infection is irrigation.” Use soap on the surrounding skin, but not on the wound itself. If you see dirt particles, remove them with tweezers.
Third, apply an adhesive bandage. This will help keep the wound moist and clean. It’s a good idea to apply an ointment to keep moisture in. Petrolatum (petroleum jelly) is fine, or you may want Aquaphor or one of its generics (“hydrating ointment” is the usual term), in which the active ingredient is petrolatum. Years ago, standard advice was to keep a wound dry and expose it to air to promote healing. But now we know that moisture is better and helps prevent scarring. For a minor wound, any standard bandage will do—either a store-bought one, or one you make yourself with gauze and tape.
Covering up a wound
There are scores of adhesive bandages in drugstores—in every shape and size, with many different properties. Some are waterproof, have gel and padding for blisters, are super-flexible, are made for sensitive skin, have long-lasting adhesives, are “stickless” and easily removable, are coated with antiseptics and so on. Some are almost invisible, others decorative. Children may take comfort from having their favorite cartoon character on a bandage, and there’s a huge selection. Bandages in different shapes and sizes may be convenient for hard-to-bandage wounds—on toes, finger tips, elbows. But plain, unmedicated, generic bandages are usually all you need.
Experts disagree about antibiotic creams. Some people (especially parents) would not be without bacitracin, neomycin or a similar ointment. These cause skin irritation, however, and are unnecessary if you cleanse the wound and keep it clean. Harsh antiseptics such as rubbing alcohol, iodine, hexylresorcinal and hydrogen peroxide are not only unnecessary but can actually damage skin and retard healing. Mercurochrome has been taken off the U.S. market because it contains mercury. Betadine (povidone iodine) is okay at concentrations of no more than one percent. It is less harmful than iodine.
Does honey disinfect?
Treating wounds with honey is an ancient idea that has been revived in recent years. But not just any honey will do. Manuka honey, made from certain flowers that grow only in Australia and New Zealand, appears to be an effective treatment for serious burns and wounds. It has antiseptic properties but does not damage skin, and it promotes healing.
In 2005, when we last reported on manuka (also called Leptospermum) honey, it was too early to recommend it as a wound treatment. But now the Food and Drug Administration (FDA) has approved dressings containing manuka for wound healing; the brand name is Medihoney. They are used in some hospitals. These bandages are expensive—$5 to $10 each—and should probably be reserved for larger wounds or burns. The average cut or scrape will heal quickly without honey anyway.
One relatively new product is KytoStat, by HemCon, which soldiers on active duty now carry in their kits. Impregnated with chitosan (made from crustacean shells, and also used as a diet aid), it seals a wound and stops bleeding. A bandage costs about $6. If you do wilderness hiking, biking or cross-country skiing—or if someone in your household is a woodworker or uses power tools—you might want a few for your first-aid kit. In addition, if you take blood thinners such as warfarin, you might try KytoStat bandages for bleeding wounds.
Is it safe to use Krazy Glue?
Readers sometimes ask about using Krazy Glue to close up a wound so that a scar won’t form. Krazy Glue is a “super glue,” or more precisely a cyanoacrylate adhesive. It is related to the skin adhesives (such as Dermabond) that are sometimes used in emergency rooms to close lacerations without the use of stitches or sutures.
But it’s not a good idea to glue a wound yourself. Krazy Glue can be toxic to skin tissue if it gets into the wound. Even the company’s website says that Krazy Glue shouldn’t be used for wound care. More to the point, small wounds don’t need glue, and larger ones may need medical attention.
Lots can go wrong if you try to glue a wound. Unless the glue is precisely applied, the edges of the wound may not close up and/or the glue can migrate into the wound, which can result in inflammation and infection and may require surgical treatment. We advise against self-treating wounds with glue. In particular, glue should not be used for jagged or nonsuperficial lacerations or cuts, or by people who have diabetes or are immunocompromised.
When to seek emergency care
Call your doctor or go to the emergency room for a wound if:
- Bleeding comes in spurts or you cannot stop the bleeding. The former indicates that an artery may have been cut. Apply pressure using compresses (sterile gauze or a clean, folded washcloth or towel) on your way to get help. Don’t attempt to apply a tourniquet.
- The wound is deep, jagged or gaping—especially a puncture wound or facial cut. You’ll need a tetanus shot if you haven’t had one in the past five years.
- You have a serious animal bite or a human bite that breaks the skin. An animal bite, especially from a wild animal, such as a raccoon, may pose a rabies risk.
- A scrape is very large and has a lot of dirt in it.
- You develop redness and swelling and/or a fever—and/or you experience numbness and loss of mobility in the wounded body part.