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Deep Cuts, Lacerations, and Slivers (Oh My!)

Cuts & Lacerations


Two Minor Surgical Procedures You Can Probably Do At Home

Ever since I got a letter from a woman who wanted instructions for doing her own thoracic surgery by correspondence, I have more truly realized the need for absolute clarity in writing a section like this one. So here it is: I am not utterly opposed to using the valid skills of well-trained medical professionals. Get a physician’s opinion first. There are limits to what you can do. (By the way, I told the woman to see a surgeon. I considered suggesting that she also see a psychiatrist.) Yet there are many things we can do for ourselves, as well and arguably better, than a harried, hurried, hired practitioner.

I offer for your consideration (as Rod Serling would say) one or two of my more delightful childhood medical dramas, or should I say, traumas:

As kids, we were always building something in the woods behind my parents’ house.  After we built our tree fort (as differentiated from a mere tree house, mind you), we practically lived there as well. So, disdaining work gloves, we were prime candidates for picking up frequent slivers of wood under our skin, especially in our hands.

My first line of treatment was my father. He was, after all, the one who always patched up our old tomcat (“Tony,” named after a famous but more peace-loving tiger). Tony’s nocturnal avocations resulted in his coming home with substantial portions of his fur, skin and ears missing. We went through many a bottle of A&P hydrogen peroxide on that cat, since vets were for rich kids’ pets. 

For wood splinters in our skin, Pa used the tried and true Army approach: sterilize a sewing needle (the bigger the better, it would seem) and unceremoniously dig the splinter out.  This form of frontal attack worked, and of course it hurt. Once I had a sliver way up under a fingernail.  Even Dad backed away from that one.  I was delighted when my folks sent me to our family doctor.  There, I was certain, I would receive the adept and painless ministrations of a sympathetic healer.


The doctor sat me on his all-purpose examination table, and painted my finger orange with lots of mercurochrome (23% mercury in a colorful solution). Then, he turned to his little white cabinet of goodies, and calmly produced a large pair of black-handled office scissors.  These are formidable-looking blades to see coming at your little fore-fingertip.

Without a word, and without any anesthetic, the doctor began cutting away my fingernail.  I was so surprised I could barely yell… for a moment, anyway.  In a few agonizing minutes, he had removed over half the fingernail, and the splinter along with it.  I decided that the mercurochrome’s real role was to hide the color of the blood, which it very nearly did.  But the pain of a forcibly removed fingernail is more suited to prisoner-of-war torture stories than to a doctor’s office. 

It was almost immediately afterwards that I decided that not only could my father have done as well, I could have done as well myself.  After all, we had a pair of ten-inch paper shears at home that were almost as big as the ones the doctor used.

The next time I had an under-the-finger sliver, I had the inspired idea to perhaps avoid the needle, or the scissors, or the battle ax, or whatever they might throw at me.  I had some experience with “black drawing salve” (ammonium bituminosulfonate; I think the brand of the day was Ichthammol).  Black drawing salve is so-called because it is black (duh) and because it helps “draw” pus out of a wound or boil.  I wondered if it would physically draw out a sliver of wood.

So I applied a small glob of it, covered it with gauze, and did nothing.

The next morning, enough of the splinter was protruding from under my fingernail for me to simply grab it with tweezers and pull it out.

No pain. No blood. No skill needed.

Equipment list: black drawing salve (available at any discount drug store), your mother’s eyebrow tweezers, and one band-aid.

Let's now up the ante somewhat and consider deep cuts and lacerations. How can we close them without stitches? With butterfly bandages, available at any pharmacy or discount store.

Butterfly bandages look like doll-sized white paper bow ties. They are narrow in the middle, hence the name, and have a strong adhesive on the back. To use them properly, you first must staunch the flow of blood so you can see what you are doing, and ensure that they will stick. Pressure on or above the wound will usually to this. With a clean cloth or gauze, blot and dry the area as best you can.  Do not use “Kleenex” or toilet paper, as these paper products will disintegrate when dampened and make a mess. Paper towels are OK. Remove the plastic adhesive-protecting strip from one side only of the bandage. This is easiest if you have an assistant help you. Then apply the bandage, like a bridge over troubled tissue, to hold the cut together. THE TRICK IS TO PUT A STRETCH INTO IT.  To do so, you have to place the first side of the butterfly bandage further away from the cut than you’d think.  When you pull it over, it will close the wound. Hold it, remove the adhesive-cover on the remaining side, and press it down to complete the maneuver.  You can pre-remove the adhesive-covers from both sides in advance if it works better for you, but this is the way I do it.

Expect to make a schlock job of it the first time. Have at least half a dozen butterfly bandages on hand and do not worry if you have to scrap a few and try again. Keep the wound area as dry as possible, though, and you are likely to get it right on the first few tries. 

Even if the first closure works well, I usually use apply a second butterfly bandage. I do this even if the wound is a small one. I put the second one on at a slight angle to the first, to contact different skin and increase the likelihood of success. This results in an “X” shaped appearance that impresses children a great deal. Then, I cover the “X” with a fairly large, one inch wide band-aid. This helps lock the butterflies in place and to a moderate extent keeps them from getting wet. Children, and adults, invariably manage to get a wound wet no matter how careful you want them to be to avoid doing so. Wet bandages lose their stick and come off sooner. Better the outer ones than the butterflies, though, for it is easy to slap on a plain band-aid or two any time, any place. Ideally, you do not want to remove the butterfly closures for several days to a week, depending on the severity of the cut. This gives the skin a chance to knit together deep down as well as on the surface, and makes it unlikely that the wound will reopen.

On a long laceration, you can repeat the “bridging” process with a series of butterfly bandage crosses. There is a limit to how far you can go with this, so use uncommon sense and get medical assistance whenever you need it.

Here’s a hint: As the skin heals, it will tend to dry and “pull” and itch. Dropping some natural vitamin E, simply squeezed from a capsule onto the wound, will help. Do not do this too early, for 1) vitamin E is oily and will completely ruin and bandage adhesive and 2) applied too soon, vitamin E’s modest anti-coagulant properties will delay surface clotting. Wait a few days to a week until you can see that the wound is solidly closed and you are ready to let the bandages come off anyway. As a side note, I might mention that if you want to spare your kids the pain of removing a bandage (slow or fast, it sure does hurt if there is hair under there), try this vitamin E technique. You will never hear an “ouch” again, for the bandages will gradually come off on their own.

In addition, healing is likely to be uncomplicated (no infection, scarring or keloid formation) if you keep putting a tiny but of vitamin E on the wound twice a day. Again, be sure the wound area is dry. Vitamin E oil and water don’t mix. You can apply vitamin E to a conventional line of sutures, too.

Bleeding is nature’s way of cleaning a wound, so antiseptics and antibiotics are needed only rarely.  If the wound is less than perfectly clean, I apply some iodine tincture to it, BUT NOT RIGHT AWAY, because it hurts!  Wait until you see slight redness, giving it a couple of days, before using an antiseptic. Iodine tincture is less disruptive of bandage adhesive than vitamin E oil, and may be applied sooner, but sparingly. (You will need to carefully remove the outer covering bandages to do this, of course, but you will want to see how the wound is coming anyway.)  No need to remove the butterflies; just touch the iodine applicator to the exposed edge of the wound and it will be drawn in by itself. One or two applications is usually enough if you then follow up with the vitamin E treatment as mentioned above.

In summary:
1. Pressure to stop blood flow.
2. Dry the wound.
3. Butterfly bandage(s) applied with a stretch.
4. Cover with band-aid(s)
5. Add topical vitamin E after healing is well underway.

I may know how to do all this, but I confess that I still hate buying band-aids. This is because as a parent, I know all too well for whom I am buying them.  I especially grimace when buying butterfly bandages. The only good thing about them is that they work as well or better than the alternative: stitches. I have only rarely had to use butterfly bandages on each of my children. Once my daughter fell in primary school and cut her chin. She had a band-aid on when she got off the bus. When we removed it, we saw that the cut was deep enough to expose yellow-orange fat. That is a deep cut. I very carefully applied a pair of butterfly bandages which held the skin tightly together. After four or five days we started applying vitamin E to the site. Healing was so successful that you cannot find what otherwise surely would have been a scar should she have had the several stitches that the school nurse recommended. When I had a chin laceration of my own some years before, I had stitches. Aside from the interminable waiting room session, I have a scar to this day (which I hide nicely under my beard).

I have personally observed children getting stitched up in an emergency room.  It is a scene to be avoided.  In my daughter's case, it was.  A laceration was effectively closed without needles, without the pain they necessarily cause, and without the stress of going to and waiting for assistance.  I don't relish the task, but I'd prefer to be the one delivering care to my own kids.  I think they greatly prefer it as well.

If it is a question of competence, then we must become competent, for even emergency room personnel might not be.  "Many U.S. emergency rooms are staffed by doctors who were never taught how to treat a heart attack, resuscitate a child or treat bleeding," says an article in the Rochester, NY Democrat and Chronicle (1994, September 8).  According to "Dr. L. Thompson Bowles, president of the National Board of Medical Examiners and chairmen of a group of 38 health care authorities who studied the issue... many (emergency room doctors) lack training and adequate experience in any aspect of primary health care." 

Look, if you really need an ambulance, call one!  Major traumatic injuries and some other situations absolutely demand medical technology.  Even if the medical residents are not experienced, chances are the nurses and paramedics are.  I submit, however, that we can increase our self-help territory, reclaiming a significantly larger part of healthier than most doctors would allow, and by simpler steps than most doctors would admit.  I actually learned how to use the butterfly bandage from a friend over the phone, and by reading the directions on the package.  It was time well spent to save my little girl from added pain and a facial scar.

For further reading:

Richardson, J. G. et al (1904)  Medicology.  New York: The University Medical Society. 

The pharmacological information in this huge (1,400 page) volume is way out of date. On the other hand, the instructions for how to set a fracture (p 674-679), and how to employ water therapy, herbs, massage and homeopathy seem as if they were written this morning.

Werner, David (1977) Where There Is No Doctor.  Hesperian Foundation, 1919 Addison Street, Suite 304, Berkeley, CA 94704.  ISBN 0-942364-15-5 

This book is a favorite of mine. How to make your own butterfly bandages is on page 98. How to suture a wound is on page 99.  Setting fractures is illustrated in pages 111-114. Incidentally, how to deliver a baby: pages 300-315.  I do not recommend self-deliveries.

Copyright C 2007 and prior years Andrew W. Saul.

Andrew Saul is the author of the books FIRE YOUR DOCTOR! How to be Independently Healthy (reader reviews at ) and DOCTOR YOURSELF: Natural Healing that Works. (reviewed at )

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Andrew W. Saul


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