Minor wounds can be cleaned gently with soap and water to remove any foreign materials and then properly bandaged. A thin layer of plain petrolatum can be applied to the damaged skin surface before applying a nonadherent bandage. Topical antibiotics can be used for wounds that are in locations that have increased risk for secondary infection such as the perineum or major skin folds. Topical antibiotics such as neomycin and bacitracin have activity against gram-positive and selected gram-negative organisms but may lead to contact allergy. Mupirocin is effective only against gram-positive organisms, with little risk of contact sensitivity, although bacterial resistance is increasing.
Minor cuts and scrapes should be cleaned gently with soap and water, irrigated if necessary to remove any foreign material, and dressed with a bandage. If a cut extends into the dermis and is more than a puncture, it should be sutured together. Small cuts can be glued together with topical skin adhesive. Areas with increased tension (across the knee) are best sutured.
Burns may be caused by a multitude of agents including chemical, thermal, electrical, and ultraviolet light (Figure 63). Thermal burns are assessed based on the amount of surface area of involvement, depth of burn, and specific area involved. Grading of burns is seen in Table 15. Estimating the body surface area involved is based on the rule of 9s. The head and neck represent 9% body surface area, each arm is 9%, each leg 18%, the anterior trunk is 18%, the posterior trunk is 18%, and the genital region is 1% of body surface area. Minor burns in areas of low risk for infection with a small body surface area of involvement can be treated with gentle cleansing and application of a sterile dressing with petrolatum. Wounds prone to developing infection may be best treated with a topical antibiotic in addition to the sterile dressing.