How should I take care of a scraped knee?

Care at home or hospital?

How to care for a road rash scraped knee at home

How do I clean my scraped knee?

Normal Saline Recipe

How do I dry my wound?

Should I put iodine on my wound or mercurochrome or hibiclens?

What do I cover my wound with now that it's clean and dry? Best two choices: Telfa or Tegaderm

Should I apply Bacitracin or antibacterial ointment to the wound?

Care at home or hospital?

First to decide is whether you need home care or a hospital / urgent care center. If only the skin is scraped, I can tell you how to take care of it at home below. If you see bone, muscle, tendons, nerves or fat, please visit a health care provider.

If you have not had a tetanus vaccine in 5 years, visit a health provider to get updated.

See suggestions below. The decision about how to take care of your wound is up to you. We are not providing health care advice. Scroll down to learn how to take care of minor wounds like the first two images. Use your discretion as to what needs professional care. This is not intended to replace the advice of your health professional.

How to care for a road rash or scraped knee at home

Please get professional help if for a serious injury (broken bone, visible bone, nerve, tendon, fat, infection...).

If you have a wound that you think can be cared for at home, first, shave the hair off of surrounding skin so that the bandage can stick to smooth skin. Hair also collects bacteria, which can cause infection. It's best to get rid of it to keep your wound clean. You can either wet or dry shave, but the wound needs cleaning first, so wet might be easier. You don't need shaving cream, it doesn't have to be a perfect shave. Keep hair out of the wound, or flush it out if some should get in there. Also, when the tape comes off for dressing changes, you don't want to be ripping hair out. That hurts and you feel badly enough. Please shave the healthy skin around the wound. Do not shave the wound.
 

How do I clean my scraped knee or skinned elbow?

Wash your hands.

In many countries, the water is probably clean enough to use straight out of the tap if the wound is not too deep. Many times I am at my kids' soccer games, and they or their teammates get a scraped knee and I do not clean it at all, I just put the dressing over the wound because it is not practical to clean wounds at a soccer match. But if the wound is deep, it would be best to clean it with sterile water with a little salt also known as "normal saline." If you live in a country where tap water is not drinkable, it is important to use normal saline.
 

Normal Saline Recipe

Never apply hot water to skin--wait for the water to cool to body temperature first. This might take 30-90 minutes, depending on how warm the air temperature is and how big of a container the water is in. If you are taking care of children, always test the temperature of the water on the inside of your wrist first to make sure it is a comfortable temperature before using the saline on children.

To wash the wound, you could use a bulb syringe, only if it is extremely clean, or pour water over the wound with a cup. Or you could wet gauze below and dab (lightly touch and very slightly brush) at the wound until the dirt is out. If you don't see any dirt, you can just rinse it by pouring from the clean pot--as long as the water has cooled off.

How do I dry my wound?

Let the wound air dry unless you have clean sterile gauze to use to pat it dry. Do not use those cotton makeup removers as they will leave cotton fuzz in the wound that will make healing more difficult.

Should I put iodine on my wound or mercurochrome or hibiclens?

I don't. First, that stuff hurts. Second, it can kill the cells the body sends to the wound to fight infection. The most important part of cleaning a wound and keeping it from getting infected is to flush out all of the dirt, leaving none in there. This can take a long time to do it right, and it can hurt, but it hurts way less if you do it first rather than waiting until it becomes infected. Just do it now. (see above on how to clean a wound). If it hurts too much, seek out a health care provider. They can numb you up so you can get it cleaned properly.

What do I cover my wound with now that it's clean and dry?

It depends. If it is fairly large and pretty bloody, use non-stick pads, sometimes called Telfa pads. If it is not too deep and not bleeding, it is easier to use Tegaderm transparent dressings. (We do not get any funding for saying this!) I always carry about 30 of them in my purse in case I find someone in need, and I do, about once per week. The most affordable ones I can find are online here. We do not get any money for mentioning that either, we just want to share where we find them most affordable. In the drug store they can often cost 10 times as much as they do in packs of 100 online.

For most scrapes, you can use the small size (2-3/8" X 2-3/4"), but some will need more than one, or you can get the larger sizes (4" x 4 3/4").

How do I apply non-stick pads or Telfa?

1) Wash your hands.

2) Put an antibiotic ointment in the center of the non-stick pad--enough so that a thin layer of the ointment will spread across the surface of the wound. Lightly dab the little blob of ointment all around the wound to make sure it gets spread out. Then lay that dressing on top of the wound. Try to get dressings large enough so that one pad can cover the entire wound.

Put tape across the four edges of the wound and stick it to shaved skin.

Or if it is a big wound, try the elastic nets to keep the dressing in place without tape. If you are using tape, I like the clear tape best for this, or paper tape. Adhesive tape is just a little too sticky and tough on the skin. If that is all you have, ok, but if it is going to take a while to heal, you might consider investing in clear or paper tape.

Change the dressing every day or perhaps sooner if it becomes soaked with blood.

If it starts getting red, swollen, more painful or draining pus, please see a health care professional about the wound.

Try to leave the ointment and non-stick pads on until it is healed, or until it is better enough to apply Tegaderm, please see below. Moist wound healing is so much faster and more comfortable than letting it form a scab. Please keep it moist.

Tegaderm: How do I apply it?

1) Wash your hands.

2) Remove the paper on the back of the dressing.

3) Apply the dressing to the wound so you can see the wound through the window.

4) Remove the window frame from the top that surrounds the film.

See an online video explaining more details here.
 

How can I get the the Tegaderm to stick really well?

Tegaderm dressings can be a little pricey, so in order not to use too many, try to keep them stuck to the skin for as long as possible. This means applying something to help it stick better. You can use Skin Tac wipes, tincture of benzoin, or Skin-Prep. Apply one of these to the surrounding healthy skin, NOT to the wound.

I like Skin Tac the best, but if you would like benzoin, I like Sunmark because it is clear, doesn't smell too strong and doesn't discolor the skin, unlike some other brands. (We do not get any funding for promoting these brands, this is just what I prefer).

The purpose of the sticky products is to make dressings stick to skin better so the dressings stay on for days instead of hours. With Skin Tac or Skin Prep, just open the packet and wipe it on the healthy skin where the dressing is supposed to stick. With benzoin, use a cotton swab or piece of gauze, get it wet with benzoin and rub it on the healthy, undamaged skin that surrounds the wound. Let the sticky solution dry for about a minute, until the skin is sticky. (Do not put your fingers in the wound, only touch the healthy skin to test if it is dry.)

This system is so much better than gauze or Bandaids, which stick to the wound and reinjure the wound when the bandage is changed. Tegaderm is the most comfortable dressing (perfect for kids who do not like to remove Bandaids) and provides moist healing which makes healing fast and reduces scarring.
 

How long do I leave the Tegaderm on for?

Try to leave the Tegaderm on until it falls off. This might be hours or it might be a week. Sometimes the wound gets a little goupy and this is the body getting rid of tiny bits of dirt and junk (hopefully you have washed out the larger pieces already). So when the dressing builds up some fluid, just remove the outer edges of the entire dressing first, then remove the center of the dressing that covers the wound. It almost never hurts. Dispose of safely. Wash your hands. Rinse the wound with normal saline or water, apply more benzoin to the outer edges of the skin (not to the wound), allow to air dry and you can apply a new dressing.
 

Should I apply Bacitracin, Neosporin or other antibacterial ointment to the wound?

With non-stick pads or Telfa, yes, I give more details above. With Tegaderm I usually do not use anti-bacterial ointment. Sometimes with a bad wound that is deep, I will apply the smallest dot of ointment to prevent infection. But it usually makes the Tegaderm dressing fall off quickly, so the amount has to be very small, about the size of 1-2 sesame seeds. Skin Tac or Benzoin helps the dressing stay on. If it falls off, put the next one on without antibacterial ointment because some of the ointment will have remained in the wound and that is enough. The Tegaderm keeps out dirt, acts like a layer of skin and allows the body to heal naturally, so the body's immune cells will fight off infection. Some people are sensitive to benzoin, so if you notice redness where you have put benzoin, see if it gets better if you stop using it. Some people also have sensitivity to Tegaderm. If that is the case, please use a non-stick or Telfa pad. Best of luck with your wound care and I hope you heal up soon. If you have any questions, please consult with your health care provider.

Author: Sandy Summers, RN, MSN, MPH, biography.
The views expressed herein are solely my own, are not medical advice, and are not a replacement for advice from your health care professional. Nor do they necessarily reflect the opinions of the Board Members or Advisory Panel of The Truth About Nursing.