Skin Conditions and Diagnoses

Soft Tissue Injuries: Cuts and Scrapes

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The skin is the largest organ of the body. The skin is made up of two main layers - an outer and inner layer. A layer of fat and connective tissues lies beneath the skin. The skin is connected to the layer of fat and connective tissues, which are connected to the tissues and organs.

Function of the Soft Tissue

The skin covers the body and protects the tissues from bacteria, from drying out, and from harmful light rays. The skin helps control body temperature, gets rid of water and salts, and makes and stores several important compounds, including vitamin D.

Injuries

Soft tissue injuries involve the skin and the underlying fat and connective tissue and muscles. A closed wound is an injury to the soft tissue but without a break in the skin.

Closed wounds include:

Contusions (bruises) - bleeding beneath the skin into the soft tissue. The bleeding can be a lot or a little. A lot of bleeding can cause pain and swelling, and can lead to problems with vital structures.
Hematomas - well-defined pocket of blood and fluid beneath the skin. An open wound is an injury to soft tissue with a break in the skin. Usually, they are more serious than closed injuries because they can cause blood loss and infection.

Open wounds include:

Abrasions - superficial loss of skin from rubbing or scraping the skin over a rough or uneven surface.
Lacerations - tears in the skin. The cut can have smooth or jagged edges.
Punctures - skin is penetrated by a pointed object. Can be penetrating (entrance wound only) or perforating (entrance and exit wound). Usually, puncture wounds do not cause a lot of bleeding on the outside, but there may be a lot of bleeding on the insides and damage to organs.
Avulsions - involve a tearing off or loss of a flap of skin.
Amputations - traumatic cutting or tearing off of a finger, toe, arm, or leg.

Diagnosis

The doctor will need to know when and how the injury happened. He / she will look at your child's wound to decide what type it is. The wound will be checked for bleeding, and to see if there is any dirt or foreign matter in it. Your child will be asked if he/she can feel and move the injured part to decide if there is any injury to nerves and tendons. If the doctor thinks there may be something in the wound that shouldn't be there or if there are any broken bones, an x-ray may be done. You will be asked about your child's last tetanus immunization and if your child is allergic to medications.

Treatment

Cuts and scrapes are treated by cleaning the wound. Sterilized strips, stitches, or staples may be placed to close the skin and an antibiotic ointment may be applied. This is usually done after your child is given something for pain.

The wound may be covered with dressing. If your child has a deep wound you may need to pack the wound with some gauze at home. Your nurse will tell you how to do this if that is what your child needs. Your child may need a tetanus injection, and an antibiotic may be prescribed.

If the wound is really deep or there is a lot of bleeding sometimes the child is taken to the operating room to fix the wound. Your child will be sedated so he / she will have less pain and the doctor will be better able to look at the wound and fix it.

Some children can go home after the wound is cared for, but if your child has other injuries or if they have a bad injury, they may need to stay in the hospital to be watched for bleeding, pain, or infection.

When to Call the Doctor

Your child should be watched for any problems at home. You should call your doctor if your child has a lot of pain that does not get better after you give him/her pain medication. You should be looking at the wound for signs and symptoms of infection (redness, swelling, pus from the wound or fever). Get medical help if your child has bleeding that will not stop after placing firm pressure with your fingers over the wound for 15 minutes.

Medications/Pain

Speak to your health care provider about medications your child has previously taken. Your child may have some pain or soreness at home. If this is the case, you may give him / her acetaminophen (also known as Tylenol"). Your child's doctor may even give you a prescription for pain medication. Give your child the prescription if the pain does not go away one hour after giving acetaminophen. Follow the directions on the bottle. However, do not give your child ibuprofen (also known as Motrin", Advil", Aleve", etc.) until the doctor says that it is okay.

Wound and Skin Care

Your child may shower or take a bath, but may need help for several days after going home. Check with your doctor about taking baths if your child has had surgery.

If your child has cuts or scrapes on the skin from other injuries, wash the areas with warm, soapy water and pat them dry. If your child has stitches, follow the specific instructions on caring for them.

Prevention Education

It is very important to teach your child about all types of safety. Your child watches you, so you should also always use proper safety precautions. Your child should learn to wear a helmet when riding a bike, rollerblading or skate boarding. You should also teach your child to always wear a seatbelt when riding in a car. Remember that children 12 years old and younger should always use correct safety restraints in the back seat when the car has a passenger side airbag.

Follow-up Care

Stitches on the face are taken out in 3-5 days and stitches on the rest of the body are taken out in 7-10 days. Stitches may be taken out by your doctor or at Trauma Clinic. Your nurse will make an appointment to have the stitches taken out before you leave the hospital or they will give you a number to call to make an appointment.

Nutrition

Your child may not feel like eating regular foods right away, but it is important that your child eats nutritious foods and drinks as much fluid as he or she did before they were hurt.

Activity

Activity limitations following a soft tissue injury depend on where your child was injured and how bad the injury is. Your nurse/doctor will talk to you about what type of activity your child should stay away from after he/she leaves the hospital.

The area that is injured will heal faster if kept at rest. Your child can usually go back to day care or school right after your child is injured. Your nurse/doctor will help you decide when it is time to send your child back to school. If surgery was needed or your child has other injuries, he/she may be out of school longer. The trauma team will help you with your child returning to school. At school, your child should not be taking gym class until the doctor says it's okay.

Contact us

For additional information on this or any Health Topic, please call the Family Resource Center, 513-636-7606, or your pediatrician.

Patient Education Program 12/02
Rev. 9/04, 5/05, 5/07

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