A wound is a break in the skin (the outer layer of skin is called the epidermis).  Wounds are usually caused by cuts or scrapes. Different kinds of wounds may be treated differently from one another, depending upon how they happened and how serious they are.  Healing is a response to the injury that sets into motion a sequence of events. With the exception of bone, all tissues heal with some scarring. The object of proper care is to minimize the possibility of infection and scarring.

Reason for Wound Care

Scrapes and abrasions are superficial (on the surface). The deeper skin layers are intact, and bleeding is more of a slow ooze. They are usually caused by friction or rubbing against an abrasive surface.  Lacerations (cuts) go through all layers of the skin and into the fat or deeper tissues. Bleeding may be more brisk or severe. Severe blows by a blunt object, falls against a hard surface, or contact with a sharp object are the most common causes of lacerations.  Puncture wounds are generally caused by a sharp pointed object entering the skin. Most common examples are stepping on a nail, getting stuck with a needle or a tack, or being stabbed with a knife. Bleeding is usually minimal, and the wound may be barely noticeable.  Human bites and animal bites can be puncture wounds, lacerations, or a combination of both. These wounds are always contaminated by saliva and require extra care.

General Procedure

• After careful examination and evaluation, the wound will once again be cleaned.
  
  
• The area will then be numbed with a local anesthetic.  This will allow a deeper examination of the wound as well as repair without any further discomfort. You may feel pressure, but no pain.
  
  
• If the wound requires stitches, it will be cleansed with an antispetic solution, and sterile towels or drapes placed over the area.
  
  
  • The doctor will wear sterile gloves and put in the stitches to bring the wound edges together.
    
    
  • Once this has been accomplished, the area will be washed off once again and a sterile bandage applied.

Recovery

Generally the bandage is kept on for 2 days. You should keep it clean and dry, elevating it whenever possible to minimize swelling and pain.  Over the counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Motrin) are usually sufficient for any pain.  You will be told when the stitches need to be removed. Once they are removed, small tapes may be applied over the wound to lessen the stress on the healing wound and to lower the amount of scarring, especially if on the face.  Use a sunblock (not a sunscreen) on the area for 6 months to avoid discoloration from sun exposure.  Bites may not be sutured unless a large area is involved or the bite involves the face. Many of these become infected, so most doctors prefer to leave them open for daily wound care. You usually will be given antibiotics for bite wounds.  Abrasions will be washed and scrubbed, if needed. It is important that all the dirt and debris be removed because tattooing (permanent skin discoloration) may result if this debris is left in the wound.  Puncture wounds will require careful examination. If there is any dirt or debris in the wound, the doctor may remove this small area so that an infection does not occur.