Wound Care Do’s and Don’ts for Kids (Pedcast)

 

 

Today we are going to talk about minor scrapes and cuts. By minor I mean only surface injuries without injury to underlying structures and wounds less than an inch in length.  A lot more kids get hurt than sick so parents and pediatricians spend a lot of their time caring for bruises and cuts.  Over time, parents need to become experts in minor wound care so today I thought it might be useful to talk about the important topic of broken skin care in children.

Before we start, it is important to remind you that any wound, new or old, large or small that you have concerns about should be discussed with a pediatrician or other medical provider. Take advantage of their experience.

Here are some instances where health professional’s advice is aways needed;

Larger lacerations

Injuries with lots of blood loss

Injuries in vital areas such as near eye, nose or mouth

Injury from animal bites

Head injuries with a change in consciousness, repeated vomiting, or a severe headache

Penetration injuries that may have injured more than the surface skin or have foreign bodies still inside

among others

 

With that said, for our purposes, let’s assume your child has a scrape or a cut that doesn’t need sutures or formal medical attention, just a parent’s loving care. How do you care for these boo boos? Well, here is a way to remember the steps; just recite your ABCD’s

A-Assess the level of injury and make sure it is a home care situation.

B- Stop any Bleeding. Ice can help here or a cool clean rag with some steady pressure.  If bleeding cannot be stopped in 15 minutes, I think you need to consider getting some help from a medical professional.

C-Cleanse. This is probably the most important step since if dirt and debris are left in the wound, it will probably get infected in a few days greatly complicating healing. If there is a foreign piece of wood or material still in or under the skin, it must be removed because infection will surely follow. When cleaning wounds, think lots and lots of water. Tap water is fine. Studies show that cleaning with tap water is just as good as sterile water. Experts that I read no longer recommend that wounds be cleaned with iodine solutions, peroxide, or solutions that contain alcohols or anesthetics like benzocaine or lidocaine. These solution do kill bacteria but they cause tissue damage to healthy tissues as well and are thought to slow down healing.  You know that Doc Smo pearl; Often time less,  is more when it comes to medical therapies.  A mild soap or antibacterial disinfectant on the other hand… these can be very useful, especially if there is any grease or road tar in the wound during the initial cleansing and all subsequent washings for that matter.

D- Stands for Defend the wound from the outside world. Certainly, if you watch TV, you would think that applying an antibacterial cream or ointment like Neosporin or Bacitracin  and covering with bandaids is essential to proper wound healing.  In my experience, this is not true. Many wounds heal fine without any covering.  I think a covering does reduce the amount of dirt and bacteria that are able to get into a wound but this can often be done with a thin layer of vaseline. Many children are allergic to some of the ingredients in antibiotic ointments or the adhesives in bandaids and the use of these products can actually slow down healing.   Now here is something that comes as a surprise to many parents when we discuss wound care; after the surface skin has grown back to cover the cut or abraded skin, sunscreen should be applied daily for at least 6 months so that complete healing is not slowed down by daily sun damage.

 

So, the next time one of your children falls on the driveway and breaks some skin, don’t for get your ABCD’s of skin care. And remember that sunscreen after healing, even in the winter, especially if the area is a high sun area like the face. This will minimize scarring that can happen and make very thick scars called keloids less likely. If you enjoy learning pediatrics the pedcast way, take a moment and subscribe to my blog on iTunes or at www.docsmo.com. This is Doc Smo hoping that when your kids get cuts, these boo boos won’t drive you nuts. Until next time.

 

 

 

 

 

Smo Notes

Acute wound management: revisiting the approach to assessment, irrigation, and closure considerations

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047833/

2 Comments

  1. Peggy says:

    Hey Dr. Smolen. You are still the Genius
    That you have always been. I’m so glad that I can still ask you stuff and I know I will get the best and most practical advice. I know of a family that has three precious little girls under the age of
    Four. It seems like they are always sick.
    She has always made lite of not liking to bathe them. I on the other hand am a germophobe and put them in the tub before the greetings have finished. Maybe I’m old school, but with as many
    Cuts and scrapes and boo boos that they always have, oh and bug bites…. Shouldn’t they take a bath every night???
    They enjoy it at our house but she says she just doesn’t like giving baths. Drives me crazy. I love these people. Help

    • DocSmo says:

      Dear Peggy,

      This is one of the age old questions. I did a podcast on this subject that you might want to check out. My dermatology consultants tell me that children need a bath when they start to smell badly! We over bath in this part of the world. Yes, this keeps us very clean but it also removes much of the oils and healthy bacteria that our skin needs to stay healthy. Bathing in room temperature water without soap is probably Ok daily but not with antibacterial soaps and hot water like so my families do. I hope that helps and make sure you check out podcast on the subject.

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