Encyclopaedia


Cuts and grazes

Introduction

Cuts and grazes are some of the most common of all injuries. 

Minor cuts and grazes (where only the surface layer of skin is cut or scraped off) may bleed and feel slightly painful, but the affected area will normally scab over and heal quickly.

However, if the cut is in an area that is constantly moving, such as your knee joint, it may take longer to heal.

Depending on how deep the cut is and where it is on your body, a scar may remain once the cut has healed.

Deeper cuts may damage important structures below the skin, such as nerves, blood vessels or tendons (see Complications). Grazes that remove the deeper layers of skin are rare.

Most cuts and grazes can be easily treated at home. More severe cases may need medical attention, such as stitches to close the wound (see Treatment for more information).

When to seek medical help

Seek medical help if any of the below apply:

  • You think you have damaged deeper tissues: signs include numbness (indicating injury to a nerve), blood spurting from the wound or bleeding that does not stop after five minutes of continuous firm pressure.
  • The wound is at risk of becoming infected: for example, a cut has been contaminated with soil, faeces or a dirty blade, or fragments of material (such as grit or glass) can be seen in the wound.
  • The wound has become infected: signs include swelling of the affected area, pus coming from the wound, redness spreading from the wound and increasing pain from the wound.
  • The wound cannot be closed with a plaster, or it starts to open up when you move.
  • The wound will create an unwelcome scar: for example, if it occurs on a prominent part of your face.

 

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Treatment

Most cuts and grazes are minor and can be easily treated at home. However, if your injury is more severe, you may need to receive treatment in hospital.

Treating minor cuts and grazes

For most cuts and grazes, cleaning them thoroughly and covering them with a plaster or dressing is all that is needed.

Stopping the bleeding

If your cut or graze is bleeding heavily, or is on a particularly delicate area of your body, such as the palm of your hand, you should stop the bleeding before applying any kind of dressing.

Apply pressure to the area using a bandage or a towel. If the cut is to your hand or arm, raise it above your head. If the injury is to a lower limb, lie down and raise the affected area above the level of your heart so the bleeding slows down and stops.

Dressing

To dress a cut or graze at home:

  • wash and dry your hands thoroughly
  • clean the wound under running tap water, but do not use antiseptic because it may damage the tissue and slow down healing
  • pat the area dry with a clean towel
  • apply a sterile, adhesive dressing, such as a plaster

Keep the dressing clean by changing it as often as necessary and keep the wound dry by using waterproof dressings, which allow light wetting (showering).

Painkillers

The wound should heal by itself in a few days. If the wound is painful, you can take painkillers, such as paracetamol or ibuprofen. However, you should not take ibuprofen if you have certain conditions, such as a stomach ulcer or asthma, and children under the age of 16 should not take aspirin. When taking medication, always check the packaging for recommendations regarding use and dose.

If you are unsure how serious your injury is, or if it has not healed after a few days, see your GP. Always seek medical advice if:

  • your injury does not stop bleeding or is on a joint crease (go straight to an accident and emergency department if this is the case)
  • your injury is very large or very deep
  • your injury was caused by a bite
  • there is something in your cut or graze, such as grit

Treating severe cuts and grazes

If you have a cut that is too severe to treat at home, go to your local NHS walk-in centre or accident and emergency (A&E) department. Go straight to A&E if the cut is to an artery, or if the bleeding will not stop.

At the hospital, a healthcare professional will examine your cut to determine whether or not there is any risk of infection. Factors that make an injury more prone to infection include jagged wound edges and any material inside the cut. If there was glass inside your cut, you may need an X-ray to ensure it has been removed.

If there is no risk of infection

If there is no risk of infection, the healthcare professional will clean your cut using water or a sterile saline solution before closing it. This may be done using stitches, tissue adhesive or skin-closure strips.

  • Stitches (sutures). These are usually used to close cuts that are more than 5cm long, or wounds that are particularly deep. Stitches are made from a sterile surgical thread, which is flexible and allows the wound to move. If your cut needs stitches, you will have a local anaesthetic, which means you will be awake but will lose feeling in the area of your cut.
  • Tissue adhesive (glue). This may be used to close less severe cuts that are less than 5cm long. The tissue adhesive is painted onto your skin, over your cut, while the edges are held together. The paste then dries, forming a flexible layer that keeps the cut closed.
  • Skin-closure strips. These may be used as an alternative to tissue adhesive, for cuts that are less than 5cm long, where there is a risk of infection. The strips are sticky and placed over the edges of the cut to hold them together. They are easier to remove than tissue adhesive.

Once your cut is closed, a healthcare professional may cover it with a protective dressing to ensure that your stitches, tissue adhesive or skin-closure strips stay in place.

If you have had stitches or strips, you will need to return to the hospital after a few days to have them removed.

  • stitches or strips on the head are removed after 3-5 days
  • stitches over joints are removed after 10-14 days
  • stitches or strips at other sites are removed after 7-10 days

You should never try to remove stitches yourself. They should only be removed by a healthcare professional.

Tissue adhesive comes off by itself naturally after a week or so.

To prevent tetanus (a serious bacterial infection), you may be given a tetanus booster. If the healthcare professional treating you thinks you are at risk of developing tetanus, you may be referred for specialist treatment.

If there is risk of infection, or your cut is already infected

If there is risk of infection or your cut is already infected, a healthcare professional may take a sample for analysis using a swab, before cleaning it as usual.

However, they will not yet be able to close your cut because this may trap any infection inside it, making it more likely to spread. Instead, they will pack your cut with a non-sticky dressing so that it cannot close, before covering it with a protective dressing. You may also be given antibiotics to fight the infection.

You will need to return to hospital after three to five days so your cut can be assessed to see if any infection has cleared up. If so, your cut will be closed using stitches or skin-closure strips. Tissue adhesive will not be used as it is difficult to remove if infection occurs. If your infection has not cleared up, a change of antibiotics may be required.

Skin grafts

If your graze is very severe and you have lost a lot of skin, you may need to have a skin graft. Your surgeon will take some skin from another part of your body and put it over the wound. After a while, it will heal and look normal.

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Complications

Infection

Infection is the most common complication of cuts and grazes. The following signs can mean that your cut or graze is infected:

  • loss of sensation (if a nerve has been cut)
  • pulsatile bleeding, where blood spurts from the wound (if an artery has been cut)
  • swelling of the affected area
  • pus forming in the affected area
  • redness spreading from the cut or graze
  • increasing pain in the wound
  • feeling generally unwell
  • fever
  • swollen glands

If you have a cut or graze and notice any of these symptoms, see your GP as soon as possible.

People who are most at risk include diabetics, those with weakened immune systems (such as those undergoing chemotherapy, or those with HIV or AIDS) and the elderly. Infections can be treated using antibiotics.

Tetanus

If your wound becomes contaminated by soil, faeces or saliva, you are at risk of getting tetanus (a severe bacterial infection).

The bacteria enter your body through the wound and release a toxin (poison) that affects your nerves, causing your muscles to spasm (twitch). Tetanus can also cause a spasm in the muscles you use to chew, which can make it very difficult to move and open your mouth. This is known as lockjaw.

If you notice any of these symptoms after a cut or a graze, seek medical attention immediately. Tetanus can be treated with antibiotics but, if left untreated, the infection can be fatal.

Damage to your internal system

Cuts and grazes that are particularly deep can cause damage to important structures such as your nerves, blood vessels, muscles, tendons and bones. If your nerves and tendons have been injured, you may have long-term problems with movement and feeling in the affected area.

Scarring

Scars can form if your cut or graze is very deep, or if you pick at a scab. They are more likely to form on areas such as the knees and elbows.

If you feel self-conscious about a scar, there are treatments available without a prescription from pharmacies, such as creams and gel sheets, which may help to minimise the appearance of a scar. In some cases, your GP may refer you to a skin specialist for treatment, or you may be able to have surgery to make the scar less noticeable.

 

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Prevention

It may not always be possible to avoid a cut or a graze, so it is a good idea to have a first aid kit at home, work and at school in case of accidents.

There are, however, several precautions you can take to minimise the risk of cuts and grazes:

  • When using sharp tools, always wear any protective clothing provided. 
  • Chop food away from yourself and pass scissors with the sharp ends pointing away from the person you are giving them to.
  • When doing manual work, including DIY and gardening wear protective clothing and strong gloves.
  • Consider wearing long sleeves, a helmet and other protective equipment (such as knee and elbow pads) when doing outdoor activities, such as cycling or skateboarding.

 

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Selected links

NHS Direct Wales Encyclopaedia links

Tetanus

Scars 

External Links

British Red Cross

St John Ambulance

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The information on this page has been adapted by NHS Wales from original content supplied by NHS Choices.

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