An open wound is an injury involving an external or internal break in body tissue, usually involving the skin. Nearly everyone will experience an open wound at some point in their life. Most open wounds are minor and can be treated at home.
Falls, accidents with sharp objects or tools, and car accidents are the most common causes of open wounds. In the case of a serious accident, call 911 or seek immediate medical attention, particularly if there’s a lot of bleeding or if bleeding lasts for more than 20 minutes.
There are four types of open wounds, which are classified depending on their cause.
An abrasion occurs when the skin rubs or scrapes against a rough or hard surface. Road rash is an example of an abrasion. There’s usually not a lot of bleeding, but the wound needs to be scrubbed and cleaned to avoid infection.
A laceration is a deep cut or tearing of the skin. Accidents with knives, tools, and machinery are frequent causes of lacerations. In the case of deep lacerations, the bleeding can be rapid and extensive.
A puncture is a small hole caused by a long, pointy object, such as a nail, needle, or ice pick. Sometimes, a bullet can cause a puncture wound. Punctures may not bleed much, but these wounds can be deep enough to damage internal organs. If you have a puncture wound (even just a small one), visit your doctor to get a tetanus booster shot and prevent infection.
An avulsion is a partial or complete tearing away of skin and the tissue beneath. Avulsions usually occur during violent accidents, such as body-crushing accidents, explosions, and gunshots. They bleed heavily and rapidly.
Home care for minor wounds
Minor wounds can be treated at home. First, wash and disinfect the wound to remove all dirt and debris. Use direct pressure and elevation to control bleeding and swelling. When wrapping the wound, always use a sterile dressing or bandage. (Very minor wounds may heal fine without a bandage.) You’ll need to keep the wound clean and dry for five days. You should also make sure you get plenty of rest.
Pain typically accompanies a wound. You can take acetaminophen (Tylenol) as directed on the package. Avoid aspirin products, since they can cause or prolong bleeding. Apply ice if you have bruising or swelling, and avoid picking at scabs. If you’re spending time outdoors in the sun, use sun protection factor (SPF) 30 sunscreen over the area until it’s completely healed.
When to see a doctor
Although you can treat some wounds at home, you should see a doctor if:
- an open wound is deeper than 1/2 inch
- the bleeding does not stop with direct pressure
- the bleeding lasts longer than 20 minutes
- the bleeding is the result of a serious accident
Your doctor may use different techniques to treat your open wound. After cleaning and possibly numbing the area with anesthetic, your doctor may close the wound using skin glue, sutures, or stitches. You may receive a tetanus booster shot if you have a puncture wound. Depending upon where your wound is located and the potential for infection, your doctor may elect to not close the wound and let it heal naturally. This is known as “healing by secondary intention,” meaning from the base of the wound to the superficial epidermis. This process may require you to pack your wound with gauze. Although the healing may not be cosmetically appealing, it prevents infection of the wound and the formation of abscesses.
Other treatments for an open wound include pain medication and penicillin. Your doctor may also prescribe penicillin or another antibiotic if there’s an infection or high risk for developing an infection. In some cases, surgery might be needed. If a body part is severed, it should be brought to the hospital for possible reattachment. Wrap the body part in moist gauze and pack it in ice.
When you leave the doctor’s office, you might have bandages and dressings. It’s important to always wash your hands and work on a clean surface when changing bandages and dressings. Disinfect and dry the wound thoroughly before dressing it again. Dispose of old dressings and bandages in plastic bags.
The main complication of an open wound is the risk of infection. Call your doctor immediately if you’ve had a puncture, deep laceration, or serious accident and you’re showing signs of significant bleeding (hemorrhage) or infection. Signs of hemorrhage include continuous bleeding that does not respond to holding direct pressure. You may have an infection if the wound shows:
- an increase in drainage
- thick green, yellow, or brown pus
- pus with a foul odor
Other signs of infection include having:
- a fever of over 100.4°F for more than four hours
- a tender lump in your groin or armpit
- a wound that isn’t healing
Your doctor will drain or debride the wound and often prescribe an antibiotic if infection from bacteria develops. In serious cases, surgery may be required to remove infected tissue and sometimes the surrounding tissue as well.
Conditions that can develop from an open wound include the following.
- Lockjaw is caused by an infection from the bacteria that cause tetanus. Lockjaw can cause muscle contractions in the jaw and neck.
- A necrotizing soft tissue infection (gas gangrene) can develop. This is a severe infection caused by a variety of bacteria including Clostridium and Streptococcus that can lead to tissue loss and sepsis (a systemic infection).
- Cellulitis, an infection of the skin that is not in immediate contact with the wound.
Whether you have a minor or a more serious open wound, it’s important to take quick action. Some open wounds can be treated at home, but this isn’t always the case. You need medical attention if you have a deep cut or if you’re bleeding a lot. This ensures you receive the most appropriate treatment and reduces your risk of complications and infection.