An abrasion, commonly known as a scrape or graze, is a superficial open wound where the top layers of skin have been rubbed or torn away. These injuries are almost always contaminated with dirt, debris, and bacteria, making immediate and thorough cleaning necessary to prevent infection. The primary goal of initial wound care is to mechanically remove foreign material and reduce the bacterial load. Clean, running tap water is usually the most accessible and effective medium for this process in a home setting. When this readily available resource is not an option, approved substitutes are necessary to ensure the wound is properly cleansed.
Approved Liquid Substitutes for Cleaning
The most effective alternative for wound cleansing is a sterile saline solution, often available in pre-packaged wound wash spray cans or small plastic containers. Saline is the preferred choice because it is an isotonic solution, meaning its salt concentration is similar to the body’s fluids and cells. This compatibility ensures the solution cleans the wound without causing irritation or damaging the healthy tissue beginning the healing process.
Clean, bottled drinking water is an excellent substitute when sterile saline is unavailable. Research shows that clean water is as safe and effective as saline for cleansing acute traumatic wounds, provided the source is reliable. Since the main purpose is the mechanical flushing of debris, clean water performs this action without introducing harmful contaminants. If the only water available is of questionable quality, such as from an untreated source, it must be boiled for at least one minute and then cooled to room temperature before use.
Proper Irrigation Techniques for Abrasions
Effective wound cleansing relies on applying a sufficient stream of fluid to physically dislodge contaminants from the wound bed. Simply dipping or soaking the wound is inadequate, as this does not create the pressure needed to flush out embedded particles. The recommended pressure range for safe and effective wound irrigation is between 4 and 15 pounds per square inch (PSI).
You can approximate this pressure at home using a clean, new syringe, or by filling a clean plastic bag and snipping a small corner to create a forceful jet. Pouring the cleaning solution from a height of about six to eight inches above the wound can also generate helpful force. Irrigation should continue until all visible dirt, gravel, or other debris has been washed away from the abrasion surface.
If larger pieces of debris remain after flushing, carefully remove them using clean tweezers. Remaining small particles can sometimes be gently scrubbed away with sterile gauze or a clean, soft washcloth. Once the wound is visibly clean, gently pat the surrounding area dry using a clean towel or sterile gauze, taking care not to rub the open wound itself.
Common Substances to Never Use on Open Wounds
Certain common household items often mistakenly used for wound care can be detrimental to the healing process. Hydrogen peroxide is a prime example; while it foams and appears to be cleaning, its strong oxidizing nature is cytotoxic. This means it indiscriminately kills bacteria but also damages healthy skin cells, fibroblasts, and white blood cells necessary for tissue repair and fighting infection.
Rubbing alcohol should also be avoided because its strong chemical properties cause severe pain and irritate exposed tissue. Like hydrogen peroxide, alcohol can damage the cells responsible for wound healing, potentially leading to a prolonged recovery time. Additionally, harsh bar soaps should be kept away from the open wound bed, as their chemical components can be irritating and leave behind residues.
Antiseptic solutions like povidone-iodine are generally reserved for use by medical professionals, as they can be toxic to tissue if not properly diluted. For simple abrasions, the mechanical action of flushing with a neutral solution like saline or clean water is the most important step. Introducing harsh chemicals is counterproductive because the goal is to remove foreign material, not to kill microorganisms at the expense of healthy tissue.
Next Steps: Dressing the Wound and Seeking Medical Attention
After the abrasion has been thoroughly cleaned and gently dried, the next step is to protect it from further contamination. A thin layer of an over-the-counter antibiotic ointment can be applied to the wound surface to help prevent infection and keep the area moist, which promotes healing. Cover the wound with a sterile, non-stick dressing or bandage.
The dressing should be changed daily or whenever it becomes wet or soiled, and the wound should be checked for any developing signs of trouble. You should seek professional medical attention if:
- The wound will not stop bleeding after applying firm pressure for several minutes.
- The wound is very deep, gaping, or if you suspect a foreign object remains embedded beneath the skin.
- Signs of a developing infection appear, such as increasing redness, swelling, warmth, pain, or the presence of pus.
- The injury was caused by a dirty or rusty object, requiring a check of tetanus shot status.