Emergency Physicians Want Americans to Know When to Seek Medical Care For Serious Cuts

As Americans Head Outdoors for Summer, Doctors Urge Fast Aid First

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American College of Emergency Physicians

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WASHINGTON, D.C., July 1, 1999 -- A slip with a kitchen knife, a fall from a bicycle, or an accident on the playground may all cause serious lacerations that require an emergency physician's care. In fact, each year nearly 37 million people visit the emergency department due to an injury, including 11.5 million people who come to be treated for a serious laceration, according to the National Center for Health Statistics. Summer months bring on the year's peak of these injuries as people become more involved in outdoor activities. Yet physicians say that some people who sustain this type of injury wait too long to seek care, making it more difficult for doctors to close the wound, increasing the risk of infection and serious scarring. That is why the American College of Emergency Physicians (ACEP) is urging Americans to practice Fast Aid First, and learn the basics of emergency wound care.

"I see many patients come into our emergency department with serious open wounds who have waited hours before coming to see us," says Dr. John Moorhead, president of ACEP. "Whether they delayed due to reluctance to appear foolish or simply not understanding how seriously they were injured, blood loss, increased risk of infection and serious scarring may be the result."

Many lacerations, after only a few hours of delay, will contain enough bacteria that serious infections can occur if the wound is closed. Early treatment improves the chances of successful treatment in all lacerations.

How should you evaluate a wound to determine whether you need to seek immediate medical care? The following guidelines highlight the types of wounds that should prompt immediate treatment:

Wound Warning Signs

Wounds still bleeding after 5 minutes of steady, firm pressure

Wounds that appear particularly deep or "gaping" open

Deep puncture wounds, such as those caused by stepping on a nail

Wounds that have foreign materials, such as dirt, glass or metal, embedded in them

Any cut from animal bites and all human bites

Any wound that shows signs of infection (e.g., fever, swelling, bad smell, fluid draining from area or increasing pain)

Problems with movement or sensation after a laceration

According to the Centers for Disease Control and Prevention, injuries that require emergency care generally result from: falls, such as from playground equipment; accidental collisions with objects or people such as an in-line skating collision; accidents with a knife or other cutting or piercing instruments; and bicycle and pedestrian accidents. People may be more at risk for these types of injuries in the summer months.

Treatments Available

Emergency physicians now have a variety of effective treatments available to close serious wounds and get patients quickly on the road to recovery.

Topical skin adhesive is one of the newest innovations in skin closure. The physician applies the adhesive on top of the skin while holding the edges of the wound together. For some wounds, the adhesive takes less time to apply than stitches and forms a strong, flexible bond over the top of the wound and does not require a bandage. In some cases, it also may not require an injection of local anesthetic and can be associated with less patient pain and anxiety than sutures. The topical skin adhesive sloughs off the wound as it heals, usually in five to ten days, and does not require a return visit to the physician for suture removal.

Traditional stitches (or sutures) are often used to close cuts. This involves "sewing" the skin together with a needle and surgical thread. This procedure usually requires an injection of anesthetic. A bandage is generally applied to the wound. After the wound is sufficiently healed, a physician will remove the stitches from the wound. Sometimes, the sutures are absorbed.

Staples may also be used to close cuts.

Skin strips are adhesive bands placed on top of the closed wound to hold skin edges together as it heals. This type of treatment is only used on very minor, superficial cuts.

"There are several new treatments available for treating patients with serious lacerations," says Dr. Moorhead. "People shouldn't delay seeking treatment. We can close their wounds quickly and relatively painlessly. You can never know when an emergency is going to occur. Our goal is to remind people that during the summer, when these types of injuries increase, fast action is important."

To educate consumers on the basics of emergency wound care, ACEP has developed FAST AID FIRST, an educational brochure. The brochure is available by calling 1-877-312-FAST (3278).

The American College of Emergency Physicians is a medical specialty society representing more than 20,000 physicians who specialize in emergency medicine. ACEP is dedicated to improving emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state as well as Puerto Rico, the District of Columbia, and Government Services.

FAST AID FIRST is made possible by an educational grant from ETHICON, Inc, a Johnson & Johnson company.

CONTACT: Molly Todd of Golin-Harris International, 312-729-4179, for American College of Emergency Physicians; or Laura Gore of American College of Emergency Physicians, 800-320-0610 ext. 3009

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