Health Library CutsFrom Healthwise

Cuts are open wounds through the skin. Normally the skin is under slight, constant tension as it covers the body. A cut is a forceful injury to the skin. Many people accidentally cut themselves with household or work items, yard tools, or when operating machinery. Children often are cut during play and sports activities, or from falls while riding wheeled toys, such as bikes, scooters, or skateboards. Most cuts are minor and home treatment is usually all that is needed.

Cuts can be caused by:

• Blunt objects that tear or crush the skin (lacerations). These cuts are more common over bony areas, such as a finger, hand, knee, or foot, but they can occur anywhere on the body. Blunt object injuries usually cause more swelling and tissue damage and leave jagged edges, so problems with healing may occur.
• Sharp-edged objects pressing into and slicing the skin tissue (incised wounds). Sharp object injuries are more likely to cut deeper and damage underlying tissue.
• Sharp-edged objects piercing the skin tissue (stab or puncture wounds).
• A combination of blunt and sharp forces from objects that tear, crush, and slice the skin tissue.

Some types of cuts are more serious and need medical evaluation and treatment. These more serious cuts include:

• Long or deep cuts.
• Cuts that open with movement of the body area, such as a cut over a joint. A cut over a joint may take a long time to heal because of the movement of the wound edges.
• Cuts that may scar and affect the appearance or function of a body area. A cut on an eyelid or lip which does not heal well may interfere with function or leave a noticeable scar.
• Cuts that remove all of the layers of the skin (avulsion injuries), such as slicing off the tip of a finger. An avulsion injury may take a long time to heal.
• Cuts from an animal or human bite. Infection is more likely with a bite injury.
• Cuts that have damage to underlying tissues. Injuries to nerves, tendons, or joints are more common with cuts on the hands or feet.
• Cuts over a possible broken bone. Bacteria can get into a cut over a broken bone and infect the bone.
• Cuts caused by a crushing injury. With this type of injury, the cut may have occurred when the skin split open from the force of the injury. The force of the injury may also damage underlying tissues and blood vessels. Crush injuries have a high risk of infection.
• Cuts with a known or suspected object, such as glass or wood, in the wound.

Cuts to the head or face may appear worse than they are and bleed a lot because of the good blood supply to this area. Controlling the bleeding will allow you to determine the seriousness of the injury. For more information, see are stitches, staples, or skin adhesives necessary?

When you have a cut:

• Stop the bleeding. For more information see how to stop bleeding.
• Determine whether other tissues, such as blood vessels, nerves, tendons, ligaments, joints, bones, or internal organs, have been injured.
• Determine whether evaluation and treatment by a doctor is needed.
• Clean the wound and remove any dirt or debris to prevent infections, both bacterial skin infections and tetanus ("lockjaw").
• Determine if you need a tetanus shot.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.

• Signs of shock occur:
  • In children.
  • In adults and older children.
• Severe bleeding from a cut does not slow during the first 15 minutes of steady direct pressure.
• Moderate to severe difficulty breathing occurs with a cut to the neck or chest:
  • In children.
  • In adults and older children.
• A cut to the eyeball or other part of the eye affects your ability to see.
• A cut amputates or partially amputates part or all of an arm or leg.

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

If you have any of the following symptoms, evaluate those symptoms first.

• Puncture wound or injury caused by the injection of a substance under high pressure into the skin: Go to the topic Puncture Wounds.
• Injury from a bite: Go to the topic Animal and Human Bites.

	Yes	Is your cut bleeding?
When to See a Doctor See significance of inability to stop the bleeding if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Note: For more information, see how to stop bleeding. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you have moderate bleeding that has slowed but not stopped after applying steady, direct pressure for 15 minutes? Call your health professional today if you answer "Yes" to the following question. Yes Do you have mild bleeding that has slowed but not stopped after applying direct pressure 3 times for 15 minutes each time (45 minutes total)? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have signs of decreased blood flow at or near a cut injury?
When to See a Doctor See significance of signs of decreased blood flow if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Is your skin pale and cold to the touch below a cut injury? Yes Do you have tingling, burning, numbness, or a "pins-and-needles" feeling below a cut injury? Yes Do you have severe pain? Yes Do you have decreased blood flow below a cut based on the pinch test? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have any loss of function at or near a cut injury?
When to See a Doctor See significance of loss of function if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Are you unable to move your arm or leg normally (not because of pain) below the cut injury? Yes Do you have tingling, numbness, or loss of feeling below the cut injury, not just at the site of the cut? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have broken skin over the site of a bone that may be broken?
When to See a Doctor See significance of broken skin if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have broken skin over a bone that may be broken? Yes Is a bone poking through the skin or visible in the wound? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Are you unable to remove an object from a cut?
When to See a Doctor See significance of inability to remove an object from a cut if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Are you unable to remove an object from a cut? Note: You may be unable to remove an object because: Of the location and depth of the cut. Of uncertainty about the depth of the cut. Removing the object will cause severe pain. Call your health professional today if you answer "Yes" to the following question. Yes Do you think an object is still in the cut and you are unable to remove it? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have a deep cut?
When to See a Doctor See significance of a deep cut if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Note: Most deep cuts need to be evaluated by a doctor and should be stitched, stapled, or closed with skin adhesives within 6 to 8 hours after the injury. Some cuts that require closure can be closed as long as 24 hours after the injury. For more information, see are stitches, staples, or skin adhesives necessary? Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have a deep cut on the face, neck, chest, or belly? Yes Are muscles, ligaments, tendons, or bones visible? Yes Do you have a deep cut over a joint? Note: This is especially important if the cut opens with movement of the joint and if fat, muscle, bone, ligament, or joint structures are visible. Call your health professional today if you answer "Yes" to the following question. Yes Do you have a deep cut on another area of the body? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Has a cut removed all the layers of skin (avulsion injury)?
When to See a Doctor See significance of avulsion injury if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Has the full tip of a finger or toe been cut off and bone is visible? Yes Have all the layers of the skin been removed (avulsion injury) in an area that is 1 in. (2.5 cm) or larger in diameter? Call your health professional today if you answer "Yes" to any of the following questions. Yes Have all the layers of skin of the tip of a finger or toe been removed in an area that is less than 1 in. (2.5 cm) in diameter? Yes Have all the layers of skin over a joint been removed? Yes Do you have a cut that opens or increases in size when you move? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have swelling or bruising at or near a cut injury?
When to See a Doctor See significance of swelling or bruising if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you have severe swelling or bruising? Call your health professional today if you answer "Yes" to any of the following questions. Yes Did a lot of swelling and bruising begin within 30 minutes of the injury and symptoms have not gone away? Yes Did swelling begin after a cut over a joint? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Has swelling from a cut (not over a joint) gotten worse after 24 hours of home treatment? Yes Have you had a moderate amount of swelling from a cut for 2 to 3 days, but it does not interfere with normal function? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you think you have an infection?
When to See a Doctor See significance of an infection if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have increased swelling, redness, or warmth around a deep cut? Yes Do you have increased swelling, redness, or warmth around a cut over a joint? Yes Do you have a cut over a joint and increased pain with movement of the joint? Yes Do you have red streaks extending from a cut? Yes Has a cut over a joint become more tender to the touch? Yes Do you have any drainage of pus from a cut over a joint? Yes Do you have a cut over a joint and you know or think you have a fever ? Yes Do you have diabetes? Yes Do you have a cut on a leg or foot and peripheral arterial disease? Yes Do you have a disease or take medicine that causes problems with your immune system? Call your health professional today if you answer "Yes" to any of the following questions. Yes Do you have increased pain, swelling, redness, or warmth around the cut? Yes Is the area around your cut increasingly tender to the touch? Yes Do you have pus in or around the cut? Yes Do you know or think you have a fever? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Have you had mild pain and swelling with redness less than 1 in. (2.5 cm) around a cut for 48 hours or longer? Yes Have you had swollen lymph nodes near a cut for 2 weeks or longer? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you think a cut may have been caused by abuse?
When to See a Doctor See significance of a cut caused by abuse if you need information to help you answer the question below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you have a cut because someone hurt you on purpose? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Were you unable to adequately clean a cut using home treatment?
When to See a Doctor See significance of cuts that can't be cleaned adequately if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Note: For more information, see how to clean a skin wound. Call your health professional today if you answer "Yes" to any of the following questions. Yes Are you unable to adequately clean a cut at home because it is large or deep? Yes Are you unable to adequately clean a cut at home because cleaning causes too much pain? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have a cut that may need to have stitches, staples, or skin adhesives?
When to See a Doctor See significance of cuts that may need stitches, staples, or skin adhesives if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Note: Most wounds that require treatment should be stitched, stapled, or closed with skin adhesives within 6 to 8 hours after the injury. Some wounds that require treatment can be closed as long as 24 hours after the injury. For more information, see are stitches, staples, or skin adhesives necessary? Call your health professional today if you answer "Yes" to any of the following questions. Yes Do you have a cut more than 0.25 in. (0.6 cm) deep and 0.75 in. (2.0 cm) long with jagged edges or the cut gapes open? Yes Do you have a cut on the face, eyelids, lips, or another area that you are worried may scar? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you know or think you need a tetanus shot?
When to See a Doctor See significance of getting a tetanus shot if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Note: If you need a tetanus shot, call your doctor to arrange for the shot as soon as possible. Your need for a tetanus shot depends on the seriousness of your wound and your tetanus shot history. Your doctor may be able to tell you over the telephone if you need a tetanus shot. Call your health professional today if you answer "Yes" to any of the following questions. Yes Were you cut by something clean and your last tetanus shot was longer than 10 years ago? Note: Something is clean if it does not have dirt, soil, spit, or feces on it. Examples include a broken water glass, a kitchen knife, or sewing scissors. Yes Were you cut by something dirty and your last tetanus shot was longer than 5 years ago? Note: Something is dirty if it has dirt, soil, spit, or feces on it. Examples include a garden tool, a dirty nail, or a piece of glass that has been buried in the dirt. Yes Are you not sure if you were cut by something clean or dirty and your last tetanus shot was longer than 5 years ago? Yes Are you not sure when you had your last tetanus shot? Yes Did you not get the first series of tetanus shots? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

Minor cuts usually can be treated at home. If you do not have an increased chance of getting an infection, you do not have other injuries, and you do not need evaluation by a doctor or a tetanus shot, you can clean and bandage a cut at home. Home treatment can help prevent infection and promote healing.

Treat bleeding

Stop the bleeding with direct pressure to the wound. For more information, see how to stop bleeding.

• Mild bleeding can almost always be stopped within 15 minutes by applying direct pressure to the wound.
• Moderate bleeding can usually be slowed or stopped by applying steady, direct pressure to the wound for 15 minutes.
• Severe bleeding cannot be slowed or stopped by applying steady, direct pressure to the wound for 15 minutes.

Nonprescription products are available to be applied to the skin to help stop mild bleeding of minor cuts, lacerations, or abrasions. Before you buy or use one, be sure to read the label carefully and follow the label's instructions when you apply the product.

After you have stopped the bleeding, use the Check Your Symptoms section to determine if and when you need to see your doctor.

Clean the wound

Clean the wound as soon as possible to reduce the chance of infection, scarring, and tattooing of the skin from dirt left in the wound.

• Wash the wound for 5 minutes with large amounts of cool water and soap (mild dishwashing soap, such as Ivory, works well). For more information, see how to clean a wound. Some nonprescription products are available for wound cleaning that numb the area so that cleaning does not hurt as much. Be sure to read the product label for correct use.
• Do not use rubbing alcohol, hydrogen peroxide, iodine, or mercurochrome, which can harm the tissue and slow healing.

Stitches, staples, or skin adhesives (also called liquid stitches)

Determine whether your wound needs to be closed by a doctor. For more information, see are stitches, staples, or skin adhesives necessary?

Your doctor will tell you how to take care of your stitches or staples and when to return to have them removed. Skin adhesives usually do not need to be removed, but your doctor may wish to see you to check on the wound. Be sure to carefully follow your doctor's instructions. If you are unsure of how to care for your wound or have questions, call your doctor for instructions.

Consider applying a bandage

Most cuts heal well and may not need a bandage. You may need to protect the cut from dirt and irritation. It is important to clean the cut thoroughly before bandaging it to reduce the risk of infection occurring under the bandage.

• Select the bandage carefully. There are many products available. Liquid skin bandages and moisture enhancing bandages are available with other first aid products. Before you buy or use one, be sure to read the label carefully, and follow the label's instructions when you apply the bandage.
• If you use a cloth-like bandage, apply a clean bandage when it gets wet or soiled to further help prevent infection. If a bandage is stuck to a scab, soak it in warm water to soften the scab and make the bandage easier to remove. If available, use a nonstick dressing. There are many bandage products available. Be sure to read the product label for correct use.
• Watch for signs of infection. If you have an infection under a bandage, a visit to your doctor may be needed.
• An antibiotic ointment, such as polymyxin B sulfate (for example, Polysporin) or bacitracin, will keep the bandage from sticking to the wound. Apply the ointment lightly to the wound. Antibiotic ointments have not been shown to improve healing. Be sure to read the product label about skin sensitivity. If you have a skin rash or itching under the bandage, stop using the ointment. The rash may be caused by an allergic reaction to the ointment.
• Use an adhesive strip to hold the edges of a wound together. Always put an adhesive strip across a wound to hold the edges together, not lengthwise. You can make a butterfly bandage at home or purchase one to help hold the skin edges together.

Tetanus

• Determine if you need a tetanus shot.
• You may have a localized reaction to a tetanus shot. Symptoms include warmth, swelling, and redness at the injection site. A fever of up to 100 °F (37.8 °C) may occur. Home treatment can help reduce the discomfort.

Pain relief

An ice or cold pack may help reduce swelling and bruising. Never apply ice directly to a wound or the skin. This could cause tissue damage.

Elevate the injured area on pillows while applying ice and anytime you are sitting or lying down. Try to keep the area at or above the level of your heart to reduce swelling.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment:

• Signs of infection.
• Signs of loss of function.
• Signs of decreased blood flow.
• Pain gets worse.
• The wound does not heal.
• Symptoms become more severe or more frequent.

To prevent cuts, it is important to practice safety when using blunt or sharp objects:

• Pay close attention to what you are doing.
• If you become distracted, set the project aside until you can pay attention to it.
• Know how to use the object properly.
• Have good lighting so you can see what you are doing.
• Wear gloves whenever possible to protect your hands.
• Wear other safety gear, such as glasses or boots, as appropriate.
• Hold a sharp object away from your body while using it.
• Carry the object with the dangerous end away from you.
• Shut the power off and use safety locks on your power tools when you are not using them.
• Store dangerous objects in secure places away from children.
• Teach children about safety, and be a good role model.
• Do not use alcohol or drugs when you are handling sharp objects.

Be sure to have a tetanus shot every 10 years. For more information, see Immunizations.

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

• What are your main symptoms? How long have you had your symptoms?
• How and when did the injury occur? Have you had any injuries in the past to the same area? Do you have any continuing problems because of the previous injury?
• What object caused the injury? Was there or is there an object in the cut?
• What home treatment measures have you tried? Did they help?
• What nonprescription medicines have you tried? Did they help?
• What prescription and nonprescription medicine do you take?
• Was your injury caused by abuse?
• Were drugs or alcohol involved in your injury?
• When was your last tetanus shot?
• Do you have any health risks?

• Animal and Human Bites
• Puncture Wounds
• Scrapes
• Shock
• Snake and Lizard Bites

Author:	Jan Nissl, RN, BS	Last Updated: June 10, 2008
Medical Review:	William M. Green, MD - Emergency Medicine H. Michael O'Connor, MD - Emergency Medicine
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