Most of are accustomed to dealing with small cuts and scrapes at home, treating them with some over-the-counter topical disinfectant and a band-aid. But more serious wounds may require a visit to the doctor. Any injury that breaks the skin can technically be considered a wound. It opens the skin up and makes it vulnerable to dirt, germs and bacteria. If a wound is particularly deep, wide or unclean, you should visit a doctor or trauma care specialist for treatment.
Evaluating the Wound
The doctor's first order of business will be to assess your risk of infection. A tetanus shot may be necessary if you stepped on a rusty nail or sustained a wound that is particularly dirty or in a vulnerable area.
Clean wounds are the easiest kind to care for. These are wounds that aren't contaminated with bacteria, and have a low risk of infection. An example would be a surgical wound, because operations are performed in mostly sterile environments. Another example might be if you take a clean knife out of a drawer and accidentally cut yourself (before using the knife on a food surface).
Sometimes wounds are clean, but they require extra care because of their depth or location. For example, because the bottom of your foot can come into contact with a lot of dirt and bacteria, a wound there may require more care and professional treatment. Some internal parts of the body are more exposed to bacteria as well, such as the gastrointestinal system or urinary tract. A clean wound in these areas can carry an increased risk of bacterial infection.
Dirty wounds are more troublesome. An abscess, a gunshot wound or a wound that introduces a foreign object or material into the body carries an increased risk of infection. These wounds may require ongoing care and specialized treatment to facilitate healing.
Closing the Wound
If a wound is clean, your doctor might close it with stitches on the first visit. The area around the wound can be numbed with a local or topical anesthetic. The doctor may use stitches that will eventually dissolve. These can be used to connect the tissue beneath the skin, and tape or staples may be used on the surface skin. Any non-dissolving stitches will remain in place for a week to 10 days, and the doctor will remove them on a follow-up visit.
Leaving the Wound Open
Sometimes a doctor will opt against closing a wound with stitches. If the wound has been contaminated, it may be left open until the entire wound can be properly flushed and disinfected. Closing a contaminated wound is the quickest way to for an infection to occur, so the doctor may wait to ensure all of the contaminants have been removed. Once the wound is clear of contaminants, the doctor will use stitches to close it up.
There are instances where a wound is so severe that the doctor will choose not to close it off. For example, when a serious injury results in a lot of tissue loss, it is sometimes better to leave the wound open to allow scar tissue to form and heal the wound.
Caring for a Wound
Your doctor will give you specific instructions on caring for the wound at home. You should receive instructions on how to change any dressings that cover the wound, and how and when to bathe. Depending on the severity of the wound, you'll receive nutritional advice on how to help your body speed up the healing process. You may receive a recommendation for over-the-counter pain medication or a prescription for something stronger. It is important to follow your doctor's instructions closely in this regard. If you notice any signs of infection, such as reddening and itchy tissue around the wound, swelling or fever, contact your doctor immediately. You may need additional wound care or antibiotics to help reduce infection during treatment.