Skin trauma (cuts, scrapes, bruises)

In general

While growing up, a child will get many kinds of injuries to different parts of his/her body. Most of these injuries will be cuts and scrapes that do not require the attention of a doctor.

The only wound care that is usually needed is to clean the area thoroughly to avoid infection. Large wounds and any wound that is dirty could need the attention of a doctor in order to clean it well. Occasionally, stitches will be necessary to help stop the bleeding and to avoid unsightly scars.

Complications

The most common complication of a wound is infection.

Bacteria that are normally present on the skin may enter the wound to cause an infection. Other times, bacteria from outside the body enter the wound at the time of the injury.

Puncture and bite wounds are at particularhigh risk for infection because the opening in the skin is often so small that it closes quickly, trapping bacteria inside. infection.

When infected, a wound will appear red and inflamed with the surrounding skin swollen and painful to the touch. Discharge or pus may run out of the wound. 

Home treatment

• Wash your hands thoroughly before you begin to care for a wound. 
• Wash small wounds thoroughly. Begin by washing around the wound with warm soapy water. Then wash the actual wound in order to remove any trapped particles such as soil, sand, gravel or asphalt dust. Irrigation with a large amount of water or saline is especially effective in cleaning a wound. 
• Dry the wound carefully using a clean towel, apply a topical antibiotic ointment, and cover the wound with gauze or an adhesive bandage. 
• For deeper wounds that are bleeding freely, rinse the area briefly with water, then stop the bleeding by pressing a compress (piece of gauze or clean cloth) against the wound. Don't let go to look at it for at least 5 minutes. This may be repeated if the bleeding does not stop after the first treatment. 
• To minimize the bleeding, elevate the injured body part above the level of the heart (unless there is any possibility of a fracture). 
• Apply a new, clean bandage to the wound after the bleeding has stopped. If the wound is deep, do not remove the first bandage; simply place a new one on top. Taking off the original bandage may re-start the bleeding.

When to seek medical advice

See the doctor immediately or call 911 if:

• The trauma is major; or a body part is partly cut off. 
• There are signs of arterial bleeding (the bleeding is bright red and pumping in spurts). 
• The bleeding does not stop with appropriate pressure. 

Make an appointment with your doctor if:

• The wound is longer than 1/2 inch (1 cm) or the edges of the wound are separated. Such wounds should be assessed for stitching within 6-8 hours. 
• The cut occurs on the face or neck. 
• If the wound is very dirty and you cannot clean it completely. The wound will need to be cleaned and it may be appropriate for the child to receive a tetanus vaccination.
• If you suspect damage to a nerve, tendon or ligament -- for example, with a deep cut on a finger or at the wrist. If not treated correctly, movement or sensation may be affected permanently. 
• For wounds caused by a human or animal bite. It may be appropriate for the child to receive antibiotics to help it heal or a vaccination.