Cuts, grazes and lacerations

  • Wounds such as cuts, grazes (e.g. scrapes or abrasions) and lacerations (e.g. a deep cut or tear of the skin) are a split of the skin caused by an impact of some sort. It is common for children to sustain these types of injuries through play, sport, accident or during ordinary day-to-day activities.

    Cuts, grazes, lacerations and other wounds (e.g. punctures) can happen on almost any area of the body. Depending on the area affected and the severity of the wound, there may be a great deal of bleeding.

    First-aid treatment for all wounds

    The most important thing to do is to try and stop the bleeding. If available, put on clean rubber gloves or clean your hands first with hand sanitiser, but do not delay treating the wound if these are not close by.

    • Use a clean, dry cloth to apply pressure directly to the wound.  A tea-towel is ideal if at home, or if out and about use a scarf or item of clothing instead.
    • If the wound is on an arm or leg, elevate the limb above the level of the heart while applying pressure; this will help to slow the flow of blood.
    • Apply pressure for five minutes.

    Thoroughly cleaning the wound will reduce the risk of infection. However, there is no need to use anything other than water as other substances may irritate the injured skin, or cause a delay in the wound healing. Antiseptic creams are not recommended and do not help the wound to heal.

    Minor wounds

    Minor wounds do not usually require any medical attention, but can be managed with standard first-aid procedures.

    After removing pressure, the bleeding should have slowed to a trickle or have stopped altogether.

    • If bleeding continues, reapply pressure and take your child to a GP or hospital emergency department.
    • If bleeding has stopped or slowed, rinse the wound and surrounding area with water. If you can see any dirt or debris in the wound, use tweezers (cleaned first with hot water, alcohol swabs or sanitiser lotion) to remove any particles. If there is dirt or debris you can’t remove, you should take your child to your local GP. Very small amounts of dirt are OK in grazes.

    Cover the wound with a dressing (e.g. Band-Aid) or a small bandage. This will help to keep the wound clean and will protect the area from further knocks as it heals. Keeping the wound covered also keeps the wound moist, which aids healing.

    More serious wounds

    As with minor wounds, try to stop the bleeding by applying pressure to the area. Take your child to the GP or local hospital emergency department in the following situations:

    • there is a large amount of bleeding that does not quickly stop
    • the wound is very deep or is a deep puncture wound
    • the cut or laceration is deep and is over a joint (e.g. a knee, wrist or knuckle)
    • a human or animal bite caused the wound
    • you cannot get the wound clean
    • your child has not had a tetanus vaccination within the last five years
    • the wound is gaping apart, despite controlling the bleeding. It may need closing with glue or stitches. Clean with water, cover the wound and see your GP within 24 hours.

    In the following situations, call an ambulance or take them to the nearest hospital emergency department immediately:

    • If blood is spurting from the wound. This may be a sign of a damaged artery. Continue applying pressure to the wound.
    • If the wound has something sticking out of it, such as a piece or glass or a stick. Do not try to remove the object. Continue to apply pressure to the wound around the object.

    If you are alone with your child, it is better to call an ambulance rather than try to drive to hospital yourself while maintaining pressure to a wound.

    Follow-up

    • For minor wounds, change the dressing or bandage whenever it becomes wet or dirty. Remove the bandage or dressing after a couple of days - this will promote healing.
    • Watch for signs of infection as the wound heals. Take your child to your local GP if the wound isn’t healing or your notice any redness, increasing pain, oozing, warmth or swelling of the wound or the immediate area. If the wound is infected, it may also smell and your child may develop a fever and feel generally unwell.

    Key points to remember

    • Stop the bleeding by applying pressure.
    • Clean the wound.
    • Cover the wound with a dressing or bandage.
    • Seek urgent medical attention if you can’t stop any bleeding, if something is sticking out of the wound, if blood is spurting, or is from a human or animal bite.
    • Watch for signs of infection.

    For more information

    Common questions our doctors are asked

    How can I prevent my child’s wound from leaving a scar?

    Taking good care of the wound and ensuring your child eats a healthy diet helps all wounds to heal. Keeping the healed wound protected from the sun for at least a year will prevent the scar from becoming darker. Applying moisturiser in a massaging motion once the wound has come together may also help with scar healing. Some people find that vitamin E cream is good for reducing scarring, but this has not been proven by research.

    My child has cut his lip and there is a lot of blood. Do I need to take him to the doctor?

    Certain parts of the body have a higher blood supply than others. Parts of the face, including the tongue and lips, will often bleed very heavily when cut. Follow this fact sheet’s first aid instructions, and have your child seen by your GP or local hospital emergency department. Parts of the body with a good blood supply tend to bleed more initially, but also heal quicker than other parts of the body.

    Why are antiseptic lotions and creams not recommended for use on wounds?

    Strong antiseptic solutions (e.g. hydrogen peroxide or iodine) should not be used to wash open wounds, because they can cause tissue damage. While antiseptic creams will clean the surrounding skin, they can also be irritating to wounds, painful on application and delay healing. For these reasons they are not recommended, unless you are specifically advised to use them by your child's nurse or doctor, due to the cleanliness of the wound or the risk of an infection.


    Developed by The Royal Children's Hospital. We acknowledge the input of RCH consumers and carers. 

    Reviewed September 2020.

    Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au


Disclaimer  

This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.