I get asked this very frequently: When should you have a wound evaluated?
Everyday minor cuts and scrapes should be cleansed with soap and water. For small wounds and cuts you can usually stop bleeding with direct pressure. Try to use a clean cloth or tissues and apply firm pressure directly to the wound. Hold the pressure until bleeding stops; sometimes this can take a few minutes of pressure. It’s important to leave your dressing alone for a while. If you peel it right off or keep checking, you’re likely to get it bleeding all over again. If you can’t get bleeding to stop over ten minutes or so, you should make your way to the ER. If there is a lot of bleeding or you’re not able to drive, dial 911.
Some wounds need to be evaluated by your medical provider or local emergency department. These injuries include:
- those injuries where the bleeding doesn’t stop quickly and easily.
- penetrating injuries.
- animal bites.
- crushing injuries.
- dirty wounds where there might be debris deep in the wound.
- lacerations over one centimeter.
- gaping or jagged wounds.
- any amputation.
Your medical provider needs to see and evaluate a wound to know if deep structures such as arteries, nerves or tendons are involved. Some wounds require antibiotics, especially in the case of animal bites. Left unattended, some seemingly minor injuries can cause permanent disabilities or disfiguring scarring if not treated properly.
We want to evaluate and treat wounds in need of treatment as soon as possible after the injury. In this way we reduce your risk for infection. The soft rule is less than 8 hours, but even if you come in later, we can reduce your risk of infection or long term problems with proper wound care and suturing when needed. Even late, we can evaluate for injuries that are likely to cause long term issues.
In infection prone wounds like animal bites or very dirty wounds we sometimes preform delayed closure. That is, we might wash out a wound well, make sure there aren’t foreign bodies, start you on prophylactic antibiotics and then wait two or more days before actually closing a wound with sutures. In this way we can evaluate for serious injury and significantly reduce your risk for infection and scarring.
In wounds that should have been sutured but instead we’re left to heal on their own, there can be significant scarring. Some of these wounds can be revised by a plastic surgeon long after the initial injury.
Most wounds will heal just fine on their own. You can reduce your risk for infection with good wound care at home. Keep the area clean by washing daily with soap and water. If you notice any new redness, swelling, pus, red streaking up your arm or leg or you run a fever you should be immediately evaluated by your medical provider. We’re always happy to see you in the ER.