Stephen J. Schueler, M.D.

Head Injury Skin Wound

Most minor cuts, abrasions and puncture wounds to the head can be safely treated at home. Initial care includes:

  • Control bleeding with direct pressure.
    • Use a gauze or clean cloth directly on the wound.
    • Maintain the pressure for at least 10 minutes.
    • Do not keep looking at the wound.
  • Clean the wound with mild soap and water. Running water can help remove dirt.
  • You may gently dab the wound with hydrogen peroxide to remove clotted blood or debris. Do not scrub or re-injure the wound.
  • Be sure there is no dirt or other foreign material left in the wound.
  • A butterfly bandage can be used to close very small, clean cuts.
  • Apply an antibiotic ointment and a dry dressing.
  • Minor scalp wounds may be left uncovered.
  • Keep the wound clean and dry.

Ongoing care for minor scalp wounds includes:
  • Abrasions may be cleaned 2-3 times a day with a mild soap such as dilute baby shampoo or dilute hydrogen peroxide - try not to cause bleeding. Do not disturb dry scabs.
  • Dry the wound gently, and completely, with a clean towel or gauze.
  • Apply an antibiotic ointment after each cleaning.

Tetanus Considerations
Tetanus shots (boosters) can be given up to three days after an injury, as long as you have had all your tetanus shots in the past. A tetanus booster seldom needs to be given right at the time of the wound. This is not an emergency and can be done in the doctor's office or clinic.

A tetanus shot is necessary right away if you have not had three tetanus shots at any time in your life.

You need a tetanus shot within three days for:
  • A dirty wound and you have not had a tetanus shot in the last five years
  • A clean, minor wound and you have not had a tetanus shot in the last ten years

Continue to Head Injury Vomiting

Last Updated: Mar 18, 2009 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Head Injury References
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  2. Grappling with traumatic brain injury. Lancet. 2007 Dec 8;370(9603):1879. [18068492]
  3. Lee AC, Ou Y, Fong D. Depressed skull fractures: a pattern of abusive head injury in three older children. Child Abuse Negl. 2003 Nov;27(11):1323-9. [14637305]
  4. McKinley J. New challenges in assessing and managing concussion in sports. Am Fam Physician. 2007 Oct 1;76(7):948-9. [17956064]
  5. Ropper AH, Gorson KC. N Engl J Med. 2007 Jan 11;356(2):166-72. Review. No abstract available. Erratum in: N Engl J Med. 2007 Apr 26;356(17):1794. [17215534]
  6. Smits M, Dippel DW, de Haan GG, Dekker HM, Vos PE, Kool DR, Nederkoorn PJ, Hofman PA, Twijnstra A, Tanghe HL, Hunink MG. External validation of the Canadian CT Head Rule and the New Orleans Criteria for CT scanning in patients with minor head injury. JAMA. 2005 Sep 28;294(12):1519-25. [16189365]
  7. Tender GC, Awasthi D. Risk stratification in mild head injury patients: the head injury predictive index. J La State Med Soc. 2003 Nov-Dec;155(6):338-42. [14750754]
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