Laceration Care, Child

A laceration is a cut or lesion that goes through all layers of the skin and into the tissue just beneath the skin.

TREATMENT

Some lacerations may not require closure. Some lacerations may not be able to be closed due to an increased risk of infection. It is important to see your child's caregiver as soon as possible after an injury to minimize the risk of infection and maximize the opportunity for successful closure.

If closure is appropriate, pain medicines may be given, if needed. The wound will be cleaned to help prevent infection. Your child's caregiver will use stitches (sutures), staples, wound glue (adhesive), or skin adhesive strips to repair the laceration. These tools bring the skin edges together to allow for faster healing and a better cosmetic outcome. However, all wounds will heal with a scar. Once the wound has healed, scarring can be minimized by covering the wound with sunscreen during the day for 1 full year.

HOME CARE INSTRUCTIONS

For sutures or staples:

  • Keep the wound clean and dry.

  • If your child was given a bandage (dressing), you should change it at least once a day. Also, change the dressing if it becomes wet or dirty, or as directed by your caregiver.

  • Wash the wound with soap and water 2 times a day. Rinse the wound off with water to remove all soap. Pat the wound dry with a clean towel.

  • After cleaning, apply a thin layer of antibiotic ointment as recommended by your child's caregiver. This will help prevent infection and keep the dressing from sticking.

  • Your child may shower as usual after the first 24 hours. Do not soak the wound in water until the sutures are removed.

  • Only give your child over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • Get the sutures or staples removed as directed by your caregiver.

For skin adhesive strips:

  • Keep the wound clean and dry.

  • Do not get the skin adhesive strips wet. Your child may bathe carefully, using caution to keep the wound dry.

  • If the wound gets wet, pat it dry with a clean towel.

  • Skin adhesive strips will fall off on their own. You may trim the strips as the wound heals. Do not remove skin adhesive strips that are still stuck to the wound. They will fall off in time.

For wound adhesive:

  • Your child may briefly wet his or her wound in the shower or bath. Do not soak or scrub the wound. Do not swim. Avoid periods of heavy perspiration until the skin adhesive has fallen off on its own. After showering or bathing, gently pat the wound dry with a clean towel.

  • Do not apply liquid medicine, cream medicine, or ointment medicine to your child's wound while the skin adhesive is in place. This may loosen the film before your child's wound is healed.

  • If a dressing is placed over the wound, be careful not to apply tape directly over the skin adhesive. This may cause the adhesive to be pulled off before the wound is healed.

  • Avoid prolonged exposure to sunlight or tanning lamps while the skin adhesive is in place. Exposure to ultraviolet light in the first year will darken the scar.

  • The skin adhesive will usually remain in place for 5 to 10 days, then naturally fall off the skin. Do not allow your child to pick at the adhesive film.

Your child may need a tetanus shot if:

  • You cannot remember when your child had his or her last tetanus shot.

  • Your child has never had a tetanus shot.

If your child gets a tetanus shot, his or her arm may swell, get red, and feel warm to the touch. This is common and not a problem. If your child needs a tetanus shot and you choose not to have one, there is a rare chance of getting tetanus. Sickness from tetanus can be serious.

SEEK IMMEDIATE MEDICAL CARE IF:

  • There is redness, swelling, increasing pain, or yellowish-white fluid (pus) coming from the wound.

  • There is a red line that goes up your child's arm or leg from the wound.

  • You notice a bad smell coming from the wound or dressing.

  • Your child has a fever.

  • Your baby is 3 months old or younger with a rectal temperature of 100.4° F (38° C) or higher.

  • The wound edges reopen.

  • You notice something coming out of the wound such as wood or glass.

  • The wound is on your child's hand or foot and he or she cannot move a finger or toe.

  • There is severe swelling around the wound causing pain and numbness or a change in color in your child's arm, hand, leg, or foot.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your child's condition.

  • Will get help right away if your child is not doing well or gets worse.