Is this your child's symptom?
- Injuries to the skin anywhere on the body surface
- Includes cuts, scratches, scrapes, bruises and swelling
Types of Skin Injury
- Cuts, lacerations, gashes and tears. These are wounds that go through the skin to the fat tissue. Caused by a sharp object.
- Scrapes, abrasions, scratches and floor burns. These are surface wounds that don't go all the way through the skin. Scrapes are common on the knees, elbows and palms.
- Bruises. These are bleeding into the skin from damaged blood vessels. Caused by a blunt object. They can occur without a cut or scrape.
When Sutures (Stitches) are Needed for Cuts
- Any cut that is split open or gaping needs sutures.
- Cuts longer than ½ inch (12 mm) usually need sutures.
- On the face, cuts longer than ¼ inch (6 mm) usually need to be seen. They usually need closure with sutures or skin glue.
- Any open wound that may need sutures should be seen as soon as possible. Ideally, they should be checked and closed within 6 hours. Reason: to prevent wound infections. There is no cutoff, however, for treating open wounds.
Cuts Versus Scratches: Helping You Decide
- The skin is about 1/8 inch (3 mm) thick.
- A cut (laceration) goes through it.
- A scratch or scrape (wide scratch) doesn't go through the skin.
- Cuts that gape open at rest or with movement need stitches to prevent scarring.
- Scrapes and scratches never need stitches, no matter how long they are.
- So this distinction is important.
When to Call for Scrape
Call 911 Now
- Major bleeding that can't be stopped
- Deep cut to chest, stomach, head or neck (such as with a knife)
Call Doctor or Seek Care Now
- Skin is split open or gaping and may need stitches
- Severe pain and not better 2 hours after taking pain medicine
- Age less than 1 year old
- Dirt in the wound is not gone after 15 minutes of scrubbing
- Skin loss from bad scrape goes very deep
- Bad scrape covers large area
- Cut or scrape looks infected (redness, red streak or pus)
- Cut or scrape and no past tetanus shots. Note: tetanus is the "T" in DTaP, TdaP, or Td vaccines.
- You think your child has a serious injury
- You think your child needs to be seen, and the problem is urgent
Contact Doctor Within 24 Hours
- Very large bruise after a minor injury (2 inches or wider, 5 cm or wider)
- Some bruises appear without any known injury
- Dirty cut or hard to clean and no tetanus shot in more than 5 years
- Clean cut and no tetanus shot in more than 10 years
- You think your child needs to be seen, but the problem is not urgent
Contact Doctor During Office Hours
- Doesn't heal by 10 days
- You have other questions or concerns
Self Care at Home
- Minor cut, scrape or bruise (minor bleeding that stops)
Care Advice for Minor Cuts, Scrapes or Bruises
- Cuts, Scratches and Scrapes - Treatment:
- Use direct pressure to stop any bleeding. Do this for 10 minutes or until the bleeding stops.
- Wash the wound with soap and water for 5 minutes. Try to rinse the cut under running water.
- Caution: Never soak a wound that might need sutures. Reason: It may become more swollen and harder to close.
- Gently scrub out any dirt with a washcloth.
- Use an antibiotic ointment (such as Polysporin). No prescription is needed. Then, cover it with a bandage (such as Band-Aid). Change daily.
- Liquid Skin Bandage for Minor Cuts:
- Liquid skin bandage seals wounds with a plastic coating. It lasts up to 1 week.
- Liquid skin bandage has several benefits compared to other bandages (such as Band-Aid). Liquid bandage only needs to be put on once. It seals the wound and may promote faster healing and lower infection rates. Also, it's water-proof.
- Use for any small break in the skin. Examples are paper cuts, hangnails and cracks on the fingers or toes.
- Wash and dry the wound first. Then, put on the liquid. It comes with a brush or swab. It dries in less than a minute.
- You can get this product at a drugstore near you. There are many brands of liquid bandage. No prescription is needed.
- Bruises - Treatment:
- Use a cold pack or ice bag wrapped in a wet cloth. Put it on the bruise once for 20 minutes. This will help to stop the bleeding.
- After 48 hours, use a warm wet wash cloth. Do this for 10 minutes 3 times per day. This helps to reabsorb the blood.
- Pain Medicine:
- To help with the pain, give an acetaminophen product (such as Tylenol).
- Another choice is an ibuprofen product (such as Advil).
- Use as needed.
- Tetanus Shot:
- A tetanus shot update may be needed for cuts and other open wounds.
- Check your vaccine records to see when your child got the last one.
- For Dirty Cuts and Scrapes. If last tetanus shot was given over 5 years ago, need a booster.
- For Clean Cuts. If last tetanus shot was given over 10 years ago, need a booster.
- See your child's doctor for a booster during regular office hours. It's safe to give it within 3 days or less.
- What to Expect:
- Small cuts and scrapes heal up in less than a week.
- Call Your Doctor If:
- Bleeding does not stop after using direct pressure to the cut
- Starts to look infected (pus, redness)
- Doesn't heal by 10 days
- You think your child needs to be seen
- Your child becomes worse
And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Last Reviewed: 05/17/2022
Last Revised: 03/17/2022
Copyright 2000-2022. Schmitt Pediatric Guidelines LLC.