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Laceration

Definition

A cut is an injury that results in a break or opening in the skin. A laceration is a jagged, irregular cut. A puncture is a wound made by a pointed object (like a nail, knife, or sharp tooth). Other types of wound such as incisions (clean, straight cuts), abrasions (grazes), stab wounds and gunshot wounds are treated in broadly the same manner as lacerations.

Symptoms

• Bleeding
• Loss of feeling or function below the wound site
• Pain

First Aid

FOR MAJOR CUTS

The priority with major cuts is to prevent further blood loss. Treat the casualty to control the bleeding, prevent shock, and summon an ambulance (call your local emergency telephone number) as soon as possible.

1. Get the casualty to raise the wound above the level of the heart (if the wound is in a limb) and, if there is no object embedded in the wound, apply direct pressure to the area with their own hand.
2. Help the casualty to lie down (on a blanket or carpet to protect them from the cold). Raise their legs and support them, on a chair or similar. This is to stop the casualty from developing shock.
3. Put on disposable gloves, if available, to protect yourself from infection. Remove or cut the casualty's clothing to expose the wound.
4. Apply a sterile dressing (or if none is available, an improvised dressing made from a clean towel or cloth). Secure the dressing with a bandage that is tight enough to maintain pressure on the wound (but not so tight as to impair circulation beyond the wound).
5. If blood seeps through the first dressing, apply a second dressing on top of the first. If blood seeps through the second dressing, remove both dressings and apply a fresh one, ensuring that sufficient pressure is applied.
6. Support the injured part in a raised position - a leg supported on a chair, or an arm rested across the chest (so that it is above the level of the heart).
7. Summon an ambulance, if you have not sent someone to do so already, and monitor the casualty's condition until help arrives.

If there is an object (for example, broken glass) embedded in the wound, or an open fracture where a broken bone sticks through the skin, do not apply pressure over the object or attempt to remove the object yourself. Build up padding on either side of the object until it is possible to bandage over or around the wound without pressing on the object. Seek medical attention.

FOR MINOR CUTS

Minor cuts and puncture wounds are easily treated at home. The priority with minor cuts is to reduce the risk of infection.

1. Wash your hands with soap to avoid infection. Put on disposable gloves if available.
2. Wash the cut gently with water, and clean the surrounding area with mild soap and water.
3. Pat the wound dry with a clean gauze swab or similar clean, non-fluffy material.
4. If you are treating yourself or a member of your family at home, you may if you wish apply an antibacterial ointment. This is not strictly part of first aid and you should not apply any ointments or lotions to a stranger on whom you are performing first aid.
5. Cover the cut with an adhesive dressing (a sticking plaster).
6. If the bleeding does not stop, if there is a special risk of infection, or if the wound does not begin to heal within 48 hours, advise the casualty to see his or her doctor.

FOR MINOR PUNCTURES

1. Wash your hands.
2. Use a stream of water, for at least five minutes, to rinse the puncture wound and wash with soap.
3. Look (but DO NOT probe) for objects inside the wound. If found, DO NOT remove -- go to the emergency room. If you cannot see anything inside the wound, but a piece of the object that caused the injury is missing, also seek medical attention.
4. Apply antibacterial ointment, if you wish, and a clean dressing.

Do Not:

• DO NOT assume that a minor wound is clean because you can't see dirt or debris inside. Wash it.
• DO NOT breathe on an open wound.
• DO NOT try to clean a major wound, especially after the bleeding is under control.
• DO NOT remove a long or deeply embedded object. Seek medical attention.
• DO NOT probe or remove debris from a wound. Seek medical attention.
• DO NOT push exposed body parts back in. Cover them with clean material until medical help arrives.

When immediate medical assistance is required

Emergency medical assistance must be sought in the case of:

• Severe bleeding, or if the bleeding does not stop (for example, after 15 minutes of pressure).
• An embedded object in a wound.
• An exposed body part.

When a visit to a doctor is required

• The wound is large or deep, even if the bleeding is not severe.
• You think the wound might benefit from stitches (the cut is more than a quarter inch deep, on the face, or reaches bone).
• The person has been bitten by a human or animal.
• A cut or puncture is caused by a fishhook or rusty object.
• An object or debris is embedded in a minor cut -- DO NOT remove yourself.
• The wound shows signs of infection (warmth and redness in the area, a painful or throbbing sensation, fever, swelling, or pus-like drainage).
• You have not had a tetanus booster vaccination within the last 10 years.

The following types of wounds are more likely to become infected: bites, punctures, crushing injuries, dirty wounds, wounds on the feet, and wounds that are not promptly treated.

If you receive a serious wound, your doctor may order laboratory tests, such as a blood test and skin culture to check for bacteria.

Prevention

• Keep knives, scissors, firearms, and breakables out of the reach of children. When children are old enough, teach them to how to use knives and scissors safely.
• Keep up-to-date on vaccinations. A tetanus vaccine is generally recommended every 10 years.