No matter how much we try to watch over our children and ensure their safety, it is inevitable that the average toddler, preschooler, and school-aged kid will get a cut, scratch, or abrasion from time to time. It is vital that parents and other caregivers understand when to seek medical attention and how to care for minor skin injuries. Injuries that require medical attention include:
those that bleed continuously;
those that are large or deep;
wounds inflicted by possibly contaminated objects such as nails.
Caring for a Wound
In the E.R.
Preventing or Limiting Scars
Caring for a Wound
Start by using pressure. The initial goal in the care of all wounds should be to stop the bleeding. This usually can be accomplished by applying firm pressure with clean gauze or cloth over the area for five minutes. If bleeding continues even after applying pressure, you should contact your child's doctor.
Then cleanse the wound. Once bleeding has been controlled, the wound must be cleansed. Place the area under cool or lukewarm running water for a few minutes to flush away any small debris. You should avoid overly aggressive scrubbing, which is painful and may do more damage than good. Also avoid the use of iodine, alcohol, or other antiseptic solutions on open wounds because they can be uncomfortable for your child. You can control the pain by giving acetaminophen or ibuprofen by mouth, as needed. Aspirin should always be avoided because, among other reasons, it may encourage bleeding.
Apply antibiotic ointment. After the area has been cleansed, apply an antibiotic ointment (such as Bacitracin, which is available over the counter) followed by a non-stick bandage. Avoid antibiotic ointments containing the ingredient neomycin; there is a high risk of an allergic reaction to this ingredient. Change the bandage daily or whenever it becomes soiled or wet. Once the area appears to be healing well, the bandage can be removed and the area left open to heal. Should your child develop a fever or the wound site show redness or oozing, contact your health care provider. These signs may indicate an infection, which may require a prescription antibiotic.
In the E.R.
Lacerations, which are linear tears or cuts of the skin, need to be treated by a medical professional if they are deep. Most often this is done in the emergency room or urgent-care clinic. What can you expect if your child needs such medical attention? For starters, the area will usually be anesthetized with some form of topical or injected medicine so there is no pain. The wound will then be cleansed, usually with cool water squirted into the area with a syringe, to remove any small debris.
The doctor will then decide on the best method of closing the wound. The standard method is to use stitches, which are generally removed in one to two weeks. A newer treatment, which can be used in wounds that are not too large or deep in locations without significant skin tension, involves the use of a tissue adhesive. This substance is applied to the cleansed wound edges and seals them like a super-glue for the skin. The advantages are that it is fast, there are no stitches to remove, and there are no marks left on the skin. Unfortunately, tissue adhesive cannot be used for all wounds.
Preventing or Limiting Scars
Most wounds in children are minor and heal well. Unfortunately, even with the most diligent of care, scarring may develop after a skin injury. At this point, there are no known ways to completely eliminate the risk of scarring, but it can be minimized. Here's how:
