No matter how hard we try to care for our children and keep them safe, the average toddler, preschooler, and school-aged child inevitably gets cuts, scratches, or scrapes from time to time. Parents and other caregivers know when and how to seek medical help
Injuries that require medical attention include:
- those who continue to bleed;
- those large or deep;
- Wounds caused by objects that may be contaminated, such as fingernails.
Take Care of the Wound
Use pressure first. Press firmly on the area with clean gauze or cloth for 5 to 10 minutes to stop the bleeding. If bleeding persists even after applying pressure, you should contact your child’s doctor.
Clean the wound. Once the bleeding is controlled, rinse the injured area under cool or lukewarm water for a few minutes to wash away any small debris, then gently wash the wound with soap and water. You should avoid scrubbing too hard (which is painful and can do more harm than good) and also avoid using iodine, alcohol, or other antiseptic solutions on open wounds, as they can make your child uncomfortable. You can take acetaminophen or ibuprofen by mouth as needed to control the pain. Aspirin should always be avoided because, among other reasons, it may promote bleeding.
Apply antibiotic ointment. After cleaning the area, apply an antibiotic ointment and then use a nonstick bandage or dry gauze. Change the bandage every day or whenever it gets dirty or wet. Once the area appears to be healing well, the bandage can be removed and the area left open for healing. Contact your healthcare provider if your child has a fever or if the wound site is red or oozing. These signs may indicate an infection and may require prescription antibiotics.
In the Emergency Room
A deep laceration is a linear tear or cut of the skin that requires treatment by a medical professional. Most often, this is done in an emergency room or urgent care clinic.
What can you expect if your child needs this type of medical care? First, the area is usually numbed with some form of topical or injectable medication so that there is no pain. The wound is then cleaned, usually with a syringe spraying cold water into the area, to remove any small debris.
The doctor will then decide on the best way to close the wound. One way is to use sutures. These sutures may be absorbable (which does not need to be removed) or non-absorbable (which need to be removed). It is usually removed after 5 to 12 days. A newer treatment can be used for wounds that are not too large or too deep, without significant skin tension, and involves the use of tissue adhesives. Apply this substance to the edges of the cleaned wound and seal it up, like a super glue to the skin. The advantage is that it is fast, there is no need to remove stitches, and there are no marks on the skin. Unfortunately, tissue adhesives cannot be used on all wounds. Steri-strips, which are narrow adhesive bands that are placed over the incision to keep the incision closed, are another possible option for smaller incisions.
Healing and Scar Management
Here are some guidelines to promote healing and reduce the appearance of scars.
Keep the wound covered in the early stages of healing. This will help speed up the growth of new skin.
Be sure to protect your child’s skin from the sun. Damaged skin is more likely to have permanent discoloration due to sun exposure.
If possible, keep your child relatively inactive during recovery. Ask her to avoid aggressive exercises, especially contact sports, to reduce the risk of further wound damage.
Control pain with acetaminophen or ibuprofen to reduce stress and promote healing.
Make sure your child is getting enough nutrition. Many vitamins, minerals, and trace elements are important in the wound healing process.