LACERATIONS (CUTS) OF THE SKIN |
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DESCRIPTIONLacerations are open wounds in the skin. The wounds sometimes extend to underlying tissue and muscle. Appropriate health care includes closure of large and bleeding lacerations by a physician. Most cuts and scrapes heal well without sutures.
SIGNS & SYMPTOMS
Pain at the lacerated site.
Heavy bleeding in lacerations of the child's scalp and forehead.
Swelling, redness, and tenderness around the laceration (sometimes).
CAUSES
Direct blow with a sharp or blunt object (knife, athletic equipment, stick, etc.).
RISK FACTORS
Contact sports; auto, motorcycle, or bicycle racing; uneven terrain for a playing field.
PREVENTING COMPLICATIONS OR RECURRENCEYour child should wear protective padding and equipment appropriate for a sport.
BASIC INFORMATION
MEDICAL TESTSX-rays of bones adjacent to severe lacerations to rule out fractures.
POSSIBLE COMPLICATIONSExcessive bleeding; allergy to local anesthetics; wound infection due to bacterial contamination of the child's laceration. If infection complicates healing, fever, pain, and edema (collection of fluid) around the incision will occur. The edema may cause the child's sutures to become tighter and break; scarring and disfigurement (sometimes).
PROBABLE OUTCOME
Lacerations usually heal in 2 weeks if they are sutured properly and do not become infected.
TREATMENT
HOME CAREFor your child's minor cuts:
Hold the wounded area under running water and clean with mild soap.
Pat the skin dry.
Hold the edges of a shallow straight cut together with tape stretched across the laceration.
Apply a sterile dressing.
For your child's serious cuts and brisk bleeding:
Cover the injured area with a cloth or your bare hands, if no cloth is available.
Apply strong pressure directly to the laceration for 10 minutes while awaiting an ambulance or transportation to an emergency room.
If direct pressure doesn't control extremely heavy bleeding and bleeding is from an arm or leg, use a light tourniquet. Make a tourniquet from a length of cloth or similar material. Note how long the tourniquet is in place so emergency medical personnel will know. Don't leave the tourniquet on longer than 20 minutes.
For wound care without brisk bleeding:
Clean the child's wound carefully with soap and water.
The wound will be cleaned again and sutured in the doctor's office or an emergency medical facility, usually under local anesthesia.
Keep the wound covered with a bandage and moderate compression for 2 days to help prevent fluid collection under the sutures.
If the bandage gets wet, replace it and apply non-prescription antibiotic ointment.
If bleeding occurs after suturing, control it by applying firm pressure to the child's wound with a facial tissue or clean cloth. Hold the pressure for 10 minutes.
Prevent tetanus by having the child get a booster dose of tetanus toxoid or human antitetanic serum.
Protect a child's laceration with extra padding during contact sports until it heals.
MEDICATION
Inquire regarding the need of a tetanus booster for your child.
Your doctor may prescribe:
-- Pain relievers. Don't give your child prescription pain medication longer than 4 to 7 days. The child should use only as much as needed.
-- Antibiotics to fight infection.
Use non-prescription drugs, such as acetaminophen, to relieve minor pain.
ACTIVITY
Your child should avoid vigorous exercise for 1 to 6 weeks after suturing.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?Yes, after treatment is complete.
CALL YOUR DOCTOR IF
Pain, swelling, redness, drainage, or bleeding increases in the child's wound area.
Your child develops signs of infection: headache, muscle aches, dizziness, or a general ill feeling and fever.
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