Cuts and Scrapes: How to Manage Skin  Injuries

Cuts and Scrapes: How to Manage Skin Injuries

No matter how much we try to watch over our children and ensure theirsafety, it is inevitable that the average toddler, preschooler, andschool-aged kid will get a cut, scratch, or abrasion from time to time. Itis vital that parents and other caregivers understand whento seek medical attention and how to care for minor skininjuries.

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

Start by using pressure. Stop the bleeding by applying firm pressure with clean gauze or cloth overthe area for 5 to 10 minutes. If bleeding continues even after applyingpressure, you should contact your child's doctor.

Cleanse the wound. Once bleeding has been controlled, place the area under cool or lukewarmrunning water for a few minutes to flush away any small debris, and gentlywash the wound with soap and water. You should avoid overly aggressivescrubbing (which is painful and may do more damage than good) and alsoavoid using iodine, alcohol, or other antiseptic solutions on open woundsbecause they can be uncomfortable for your child. You can control the painby giving acetaminophen or ibuprofen by mouth, as needed. Aspirin shouldalways be avoided because, among other reasons, it may encourage bleeding.

Apply antibiotic ointment. After the area has been cleansed, apply an antibiotic ointment followed bya non-stick bandage or dry gauze. Change the bandage daily or whenever itbecomes soiled or wet. Once the area appears to be healing well, thebandage can be removed and the area left open to heal. Should your childdevelop a fever or the wound site show redness or oozing, contact yourhealthcare provider. These signs may indicate an infection, which mayrequire a prescription antibiotic.

In the E.R.

Deep lacerations, which are linear tears or cuts of the skin, need to betreated by a medical professional. Most often this is done in the emergencyroom or urgent-care clinic.

What can you expect if your child needs such medical attention? Forstarters, the area will usually be anesthetized with some form of topicalor 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 removeany small debris.

The doctor will then decide on the best method of closing the wound. Onemethod is to use stitches. These might be absorbablesutures, which do not have to be removed, or non-absorbable sutures, whichdo need to be removed, generally 5 to 12 days later. A newer treatment,which can be used in wounds that are not too large or deep in locationswithout significant skin tension, involves the use of a tissue adhesive. This substance is applied to the cleansedwound edges and seals them like a super-glue for the skin. The advantagesare that it is fast, there are no stitches to remove, and there are nomarks left on the skin. Unfortunately, tissue adhesive cannot be used forall wounds. Steri-strips, which are narrow adhesive stripsplaced over a cut to keep it closed, are another possible choice forsmaller cuts.

Healing and Scar Management

Here are some guidelines for promoting healing and minimizing theappearance of scars.

  • Keep the wound covered during the early stages of healing. This willhelp speed the growth of new skin.
  • Be sure to protect your child's skin from the sun. Damaged skin is morelikely to become permanently discolored due to sun exposure.
  • If possible, keep your child relatively inactive during the healingperiod. Have her avoid aggressive sports (especially contact sports) todecrease risk of further damage to the wound.
  • Control pain with acetaminophen or ibuprofen to decrease stress andincrease healing.
  • Ensure that your child is receiving adequate nutrition. Many vitamins,minerals, and trace elements are important in the wound-healingprocess.

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