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The first step in allowing the wound to start the natural healing process is to clean the area. Be sure there are no unwanted materials lodged inside the injured area that could lead to infection.  Use soap and water. Gently wash the area with mild soap and warm water to clean the injury. Use clean, dry materials to apply pressure to stop the bleeding. Avoid using hydrogen peroxide to clean the area. As your body starts to immediately produce new skin cells, the peroxide destroys those new cells and increases the chances of a scar beginning to form in the early stages of treatment. Examples of wounds that may need medical attention include those that were caused by an object that deeply punctured the skin; wounds that continue to bleed freely; are deep; involve a broken bone; have visible internal tendons, ligaments, or bone; are on the face; involve an animal bite; have layers of skin that are torn or jagged; or have caused an existing wound to re-open.  Depending on the severity of the injury, stitches or sutures may be needed. Actually, sutures may help to reduce the risk of scarring. Once you have ruled out the need for medical attention and/or stitches, proceed with taking care of the wound at home. If you have an injury on your face, you may wish to have a plastic surgeon do the sutures, as she will be particularly capable of using techniques that will minimize scarring. Petroleum jelly keeps the injured area moist, promotes healing, and prevents the formation of a scab. Petroleum jelly does not interfere with the natural healing of the injury. In fact, it can speed up the process.  If a scar does form, using petroleum jelly can minimize the size of the scar as the tissues heal. Scabs are the body’s natural way of forming a protective covering over a fresh injury; however, just beneath the scab is where the scar is starting to form. As your body heals itself, collagen is brought to the surface of the skin to reconnect the broken and damaged tissue. Then a temporary crusty covering, the scab, forms above the collagen. As the collagen works to mend the broken tissue, it also starts the formation of the scar just beneath the scab. Some evidence suggests that hydrogel sheets or silicone gel can reduce scarring. These dressings provide moisture to the injured tissues during the healing process and help in reducing the formation of scars.  Hydrogel and silicone gel dressings work by supporting the natural fluid exchange between your healthy tissues and the injury. They are pressure dressings that keep the tissues moist, thereby assisting in the prevention of scars. Follow the directions on the packaging if you choose to use one of these products. They are available without a prescription. Product manufacturers have recommendations of use specific to their products. Similar products are available at a reduced cost. Ask your doctor or pharmacist about recommending over-the-counter scar therapy cosmetic pads. Continue the use of moisture/pressure dressings for several weeks or even longer to reduce the formation and size of scars. The use of petroleum jelly is not needed if you choose to apply hydrogel, silicone gel dressings, or the less expensive alternatives, as long as they provide adequate moisture to the wound. Examine your wound daily to determine their effectiveness in your specific situation. Consider changing your dressing materials if the tissues are not moist and scab tissue is forming. Use a bandage that is appropriate to the size of the area, provides protection to the wound, keeps the area closed, and covers the injury completely. Exposure to air does not interfere with healing but it also does not help with scar prevention. In fact, you may be more likely to develop a scar if you leave the injury uncovered and unprotected.  Exposure to air encourages the injury to dry out and leads to the formation of scabs. Scabs act as a barrier that contributes to the formation of a scar. If you have skin that is sensitive to adhesive, use dressing pads that are non-adhesive and use paper or medical tape to secure the edges. Use butterfly wound closures if needed. This type of bandage pulls together areas where the skin is split. Be sure to use closures that are long enough to allow for the petroleum jelly without compromising their ability to adhere to the surrounding skin. Even with butterfly closures, you still need to cover the area with gauze or a dressing pad large enough to cover the entire area to reduce the risk of infection or further accidental injury. Clean the area each day, check for signs of infection, keep the injury moist by re-applying petroleum jelly, and cover it back up.  If the butterfly closures are secure and there are no signs of infection beneath them, then you can leave them in place. Continue to examine the injury daily for improvement, or possible signs of infections, as you clean the wound, change the dressings, and re-apply the petroleum jelly. Once you see that new skin has grown together in a healthy manner, which may take as many as seven to 10 days, you can extend the time between your dressing changes to several days as long as you keep the area moist. Discontinue your treatments once the area is fully healed. Change the dressing daily, clean the area with each dressing change using mild soap and water and clean materials, and check for changes that may indicate an infection. Even the best cared for wounds can develop an infection.  See your doctor as soon as possible if you notice signs of an infection. He or she may recommend that you proceed with the use of topical antibiotic products or may prescribe an oral antibiotic to take for a period of time. Signs of infections in a wound include redness or swelling in the area, warmth to the touch, red streaks protruding from the skin around the injury, pus or fluid accumulating under the skin, near the wound, or draining from the wound, an odor coming from the wound, throbbing or unusual tenderness in the area, and having chills or running a fever.
Clean the wound. Determine if you need medical attention. Apply petroleum jelly. Use hydrogel sheets or silicone gel bandages. Cover the injury. Change the dressings every day. Monitor for infection.