Cleaning and Bandaging a Wound

Topic Overview

Skin wounds need to be thoroughly cleaned as soon as possible to reduce the risk of infection and scarring and to promote healing.

If the wound is large, deep, too painful to clean, or has dirt, debris, or a foreign object in it that you cannot remove, see a health professional.

Stop the bleeding

Before you clean the wound, try to the stop the bleeding.

• Put on medical gloves, if available, before applying direct pressure to the wound. If gloves are not available, use many layers of clean cloth, plastic bags, or the cleanest material available between your hands and the wound.
• Hold direct pressure on the wound, if possible, and elevate the injured area.
• Use your bare hands to apply direct pressure only as a last resort.
• Remove or cut clothing from around the wound. Remove any jewelry from the general area of the wound so if the area swells, the jewelry will not affect blood flow.
• Apply steady direct pressure for a full 15 minutes. Use a clock—15 minutes can seem like a long time. Resist the urge to peek after a few minutes to see whether bleeding has stopped. If blood soaks through the cloth, apply another one without lifting the first. If there is an object in the wound, apply pressure around the object, not directly over it.

Clean the wound

If you are not going to see your health professional immediately, rinse the wound for at least 5 to 10 minutes.

Minor wounds

• Wash your hands well with soap and water, if available.
• Put on medical gloves before cleaning the wound, if available.
• Remove large pieces of dirt or other debris from the wound with cleaned tweezers. Do not push the tweezers deeply into the wound.
• Wash the wound under running tap water (the more the better) to remove all the dirt, debris, and bacteria from the wound. Lukewarm water and mild soap, such as Ivory dishwashing soap, are the best. (Note: If you are cleaning a wound near the eye, do not get soap in the eye.)
  • Scrub gently with a washcloth. (Moderate scrubbing may be needed if the wound is very dirty.) Hard scrubbing may actually cause more damage to the tissue and increase the chance of infection. Scrubbing the wound will probably hurt and may increase bleeding, but it is necessary to clean the wound thoroughly.
  • If you have a water sprayer in your kitchen sink, try using the sprayer to wash the wound. This usually removes most of the dirt and other objects from the wound. Avoid getting any spray from the wound into your eyes.
  • Large minor dirty wounds may be easier to clean in the shower.
  • If some dirt or other debris remains in the wound, repeat the cleaning.

Large, deep, or dirty wounds

You may need to see a health professional for a large, deep, or very dirty wound to determine whether you need stitches or antibiotics. Most wounds that need stitches should be treated within 6 to 8 hours after the injury to reduce the risk of infection. Very dirty wounds may not be stitched to avoid the risk of infection.

If you are going to see a health professional immediately, the wound can be cleaned and treated at the medical facility.

Bandage the wound

• Thoroughly clean the wound before bandaging.
• Use of an antibiotic ointment has not been shown to affect healing. If you choose to use an antibiotic ointment, such as polymyxin B sulfate (for example, Polysporin) or bacitracin, apply the ointment lightly. The ointment will keep the bandage from sticking to the wound. Be sure to read the product label about skin sensitivity. If a skin rash or itching develops under the bandage, stop using the ointment.
• Apply a clean bandage when it gets wet or soiled to further help prevent infection. If a bandage is stuck to a scab, soak it in warm water to soften the scab and make the bandage easier to remove. If available, use a nonstick dressing.
• If needed, use an adhesive strip called a butterfly bandage to hold the edges of the wound together. You can make one at home or buy them already made. Always put the butterfly bandage across a cut, not lengthwise, to hold the edges together.
• Take the dressing off and leave it off whenever you are sure the wound will not become irritated or dirty.

When to get stitches

A quick test to determine whether you need stitches is to wash the wound well and stop the bleeding, then pinch the sides of the wound together. If the edges of the wound come together and it looks better, you may want to consider getting stitches. If stitches may be needed, avoid using an antiseptic or antibiotic ointment until after a health professional has examined the wound.

• Wounds that are at high risk of infection, such as dirty cuts or crush injuries, are usually closed within 6 hours after the injury. Occasionally a wound that is at high risk of infection will not be stitched until after 24 hours, or may not be stitched at all, so that adequate cleaning and antibiotic treatment can be done initially to prevent infection.
• A cut with a clean object, such as clean kitchen knife, may be stitched from 12 to 24 hours after the injury depending on the location of the cut.
• A clean facial wound in a healthy person is at low risk of infection and can be stitched up to 24 hours after the injury. Stitching may be done for cosmetic appearance to reduce scarring.

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Author:	Sydney Youngerman-Cole, RN, BSN, RNC	Last Updated June 20, 2006
Medical Review:	William M. Green, MD - Emergency Medicine W. David Colby, MSc, MD, FRCPC - Infectious Disease
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