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The Doctors Book of Home Remedies II: Cuts and Scrapes

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Cuts and Scrapes

No offense to Mom's healing kisses, but you might need more than tender loving care to help you handle everyday scrapes and cuts. Here's some practical medicine for you--and for Kid Katastrophe, with his always-scraped knee.

Give the wound a hold. "The first thing you should do to any cut or scrape is apply pressure on it, so you stop the bleeding," says Las Vegas orthopedic surgeon Michael Rask, M.D., chairman of the American Academy of Neurological and Orthopedic Surgeons and the American Board of Ringside Medicine and Surgery. If possible, wrap a clean, absorbent cloth or towel around the wound and press your hand against it. If no such compress is available, press the wound with your fingers for at least 60 seconds--releasing the pressure as soon as bleeding has been reduced. Then elevate the wounded area above the level of the heart to slow down blood flow.

When to See the Doctor

Although self-treatment is the Rx for most cuts and scrapes, doctors advise that you should seek emergency medical treatment when:

Blood is spurting and it's bright red in color. This suggests you may have punctured an artery.
The wound is large and deep enough to see "inside." This suggests you may need stitches.
You can't wash out all the debris. If bacteria-laden dirt is inside the cut, there's a good probability of infection.
The wound is on your face, your genitals or another area where you don't want a permanent scar.
The wound develops redness, streaks or weeping pus that extends more than a finger's width beyond the cut.

Take the Boo-Hoo Out of Boo-Boos

To remove adhesive strips without stripping your skin, use nail scissors, to separate the gauze part in the center from the adhesive, says Nelson Lee Novick, M.D., associate clinical professor of dermatology at Mount Sinai School of Medicine in New York City. Lift off the gauze center, then gently pull the adhesive strips from your skin on either side.

If the scab is stuck to the bandage, however, soak the area in a mixture of warm water and salt--about a teaspoon of salt for each gallon of water. The dressing will eventually free itself.

To remove bandages from areas with hair, pull in the direction of hair growth. But first wet down your skin in the shower or use cotton balls or a swab soaked in plain tap water to moisten the adhesive before pulling.

Put on some cold. Once bleeding is controlled, apply an ice pack wrapped in a towel to constrict blood vessels and stop bleeding, adds Dr. Rask. But leave the cold pack on for only 15 minutes, or until the area begins to feel numb. Clean the wound. After 10 minutes, reapply the ice pack for another 15 minutes. You can repeat this 15-on, 10-off procedure a number of times.

Take your time to clean it. When you wash out the wound, do it thoroughly You can use soap and water, hydrogen peroxide, a drugstore-bought antibacterial agent or even contact lens saline solution. "The secret here is to wash it thoroughly, for no less than a minute or two," says Robert D. Aranosian, D.O., trauma director at Pontiac Osteopathic Hospital in Pontiac, Michigan, and past president of the American College of Osteopathic Emergency Physicians. "If you're not cleaning the wound for at least 60 seconds, you're not cleaning it well enough."

Go undercover the first day. After washing the cut or scrape, apply an over-the-counter antibacterial ointment and cover the wound with a bandage for at least 24 hours. "The bandage should be loosely tented over the wound, not applied tightly like tape," says Nelson Lee Novick, M.D., associate clinical professor of dermatology at Mount Sinai School of Medicine in New York City. "You want to protect it from dirt while minimizing external irritation."

Read ointment labels. In picking an antibacterial ointment--which helps prevent infection and shorten healing time--look for the active ingredients bacitracin or polymyxin B, contained in over-the-counter products such as Polysporin. Dr. Novick also recommends plain Aquaphor ointment, which doesn't have antibacterial qualities "but can often be just as effective."

Give it air. You want to keep the bandage on if the cut will be exposed to anything that might infect it. And you also need a bandage if the wound would rub against other areas. "But if it's a minor wound and it won't be exposed to anything that will infect it, remove the bandage and let the wound heal in the open air," says Dr. Aranosian.

Keep cleaning. Whether you bandage or not, you must continue to clean the wound daily. But after the initial cleaning, forget the soap and water. "Soap is notoriously drying on your skin, and water is also a drying agent," according to Dr. Novick. "You want to keep the wound as moist as possible, so the wound heals with less crusting." (With less crusting, you aren't as likely to get a "dented mark" or scar where the wound is.) Instead of using soap and water, Dr. Novick recommends that you clean the area with plain tap water and apply an antibiotic ointment every day.

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