Summer is that glorious time of reckless abandon when adults and children manage to sustain all manner of punctures, lacerations and abrasions.

So, as summer is upon us, what guidelines can I offer to the wounded? Well, first of all, if you aren’t sure about your wound — however you sustained it — see your doctor right away or come to your local ER or urgent care center. The wounds I see that need sutures (also known as stitches) or staples typically are large enough that they simply fall open and stay open, are all the way through the skin, are in places where they will be repeatedly reopened by motion (hands and various joints), involve the face and eyes, or won’t stop bleeding. Deep wounds, crush injuries, amputations partial and complete (of course), and joint punctures or lacerations are some of those that automatically require a physician to evaluate.

In addition, wounds that have evidence of loss of function (for instance, difficulty moving hands, feet, fingers or toes) may suggest injury to tendons or nerves. A wound in which the extremity beyond is cool and pale may suggest an injury to the artery that supplies oxygenated blood. Some wounds, such as those that penetrate an unknown depth, or that penetrate the neck, chest or abdomen, may have very significant injuries underneath them, and evaluation should not be delayed at all. This is why the ER is open around the clock!

Wounds generally need to be sutured within 24 hours, after which closure increases the risk of infection. If not closed, healing will usually occur but may take longer. Also remember that tetanus is still out there, so you may need a tetanus immunization booster if it has been more than four or five years since your last. If you believe your wound is not likely to need sutures, wash it copiously with soap and clean water, cover, clean daily, and let it heal.

There are times when antibiotics are indicated. Wounds that are infected display redness, persistent pain, swelling, warmth, occasional systemic fever and sometimes exhibit yellow-green drainage. Sometimes, these infections spread through the tissues adjacent to the wound and produce what’s called cellulitis. Red streaks up the offended extremity can signify a more rapidly advancing infection and require more aggressive care. Scrapes (abrasions) are sometimes infected as the skin barrier is broken down and bacteria enter.

Finally, some wounds have bits of rock, glass, metal, stingers or wood inside. While some are visible and can be removed easily, others are deceptive. Some signs of a retained foreign body may be persistent pain at the site and/or evidence of infection (as described above). In this case it is important that you see a physician as soon as you can. Such objects, if not easily found and removed, may require further exploration of the wound.

If you end up with a laceration or some other wound, don’t worry. These are the “bread and butter” of life in medicine. Wounds, at least the non-infected variety, heal quickly, and before the victim realizes it, five to 14 days will have passed and the stitches can be removed easily.

Just be careful not to turn the “lazy, hazy, crazy days” into the “wounded, bleeding, oozing” days of summer!

— Edwin Leap is an emergency physician and writer who lives with his wife and four children in Walhalla. Read more at EdwinLeap.com.