How To Dress a Wound

Properly dressing a wound is one of the most basic first aid techniques there is. The process remains unchanged regardless of the size or severity of the injury. Whether it's a child's skinned knee or a gunshot wound, the tenets of wound dressing are the same. 

Minor cuts and scratches can be treated at home or on the road. Larger lacerations may also need to be dressed until medical help can be obtained.

Cleanliness is key.

Steps

1. Stay Safe. If you are not the patient, practice universal precautions and wear personal protective equipment if available.
2. A little bleeding is OK; it helps flush dirt and other contaminants out of the wound. To stop bleeding, follow the steps to control bleeding. Call 911 if:
   • there is bright red or squirting blood
   • it's a deep (more than an inch) puncture wound on the head, neck, chest, abdomen, pelvis, or back
   • it's a deep puncture wound on an arm above the elbow or a leg above the knee
3. Clean the wound with running water. Wash the skin around the injury with soap. Don't worry if soap gets into the wound, though it is likely to sting and irritate the raw tissue. Rinse the wound thoroughly to rid it of any dirt and soap. Tweezers can be used to remove particles. Use of hydrogen peroxide is neither necessary nor encouraged (see tips below).
4. Only cover the wound if it is likely to come in contact with clothing or dirt. Cuts less than 2 centimeters long can be held closed with butterfly bandages. If the edges of a laceration are not easily pulled together, then the wound may need stitches. Adhesive bandages are the easiest way to cover most minor lacerations and abrasions.

1. Deep lacerations are those that extend into the tissues below the skin. If you can see layers of tissue along the sides of the laceration, it's pretty deep. Puncture wounds are harder to evaluate, and should be based on how long the offending object is. Seek medical attention for a deep wound if:
   • it has been more than five years since the victim had a tetanus shot
   • it's a laceration with jagged edges or won't close
   • the wound is tender or numb
   • the wound is inflamed (swelling and redness)
   • the wound is draining pus (yellowish, thick liquid)

Tips

1. Hydrogen peroxide is not necessary to adequately clean a wound. The bubbling action of hydrogen peroxide creates oxygen gas—more than blood can handle. Surgeons using hydrogen peroxide to clean deep surgical wounds have accidentally triggered gas bubbles in the bloodstream (known as a gas embolism), a potentially deadly condition. Very little evidence exists to show the effectiveness of hydrogen peroxide on minor lacerations, and plenty of evidence is published on the merits of plain old water—so just use water.
2. Antibiotic ointment is not necessary for a wound to heal nicely. Ointment will help raw injuries—such as abrasions—be less painful.

Source:

National Guideline Clearinghouse (NGC). Guideline summary: SOLUTIONS® wound care algorithm. In: National Guideline Clearinghouse (NGC) [Web site]. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); 2013 Sep 01.