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What's the best way to treat my child's cut or scrape?
- Wash your hands well – and then take a look.
- If the wound is bleeding, apply direct pressure with a clean bandage or towel until the bleeding stops. Raise the wound above the level of your child's heart, if possible. (Put his arm or leg up on a pillow, for example.)
Safety note: If the bleeding doesn't stop after 10 minutes of direct pressure, head for the emergency room.
- After the bleeding stops, check for glass, dirt, and other foreign materials in the wound. If you see anything, try to flush it out with cool running water. If that doesn't work, use tweezers to carefully lift out the debris.
Safety note: If something is deeply imbedded or something large is stuck in the skin, don't remove it. That can cause more bleeding. Instead, take your child to the emergency room
- Gently wash the wound well with soap and warm water, and carefully pat it dry. If your child strenuously objects to washing, try having him soak the wounded area in the bathtub.
Safety note: Blowing on the owie may make your child feel better temporarily, but it's not a good idea because it can introduce additional germs.
What's the best way to bandage a cut or scrape?
After washing and patting it dry, cover it with an ordinary adhesive bandage or other sterile dressing. Don't use rubbing alcohol, hydrogen peroxide, or iodine. Not only will they cause more pain – they may also slow healing.
If you're dealing with a cut, position the bandage so that it gently pulls the edges of the skin together. Make sure the bandage isn't so tight that it cuts off circulation.
You can also apply ointment. Antibacterial ointment reduces the risk of infection and helps keep the wound moist and the bandage from sticking. You want the wound to stay moist, not dry, as it heals.
If that seems to contradict what you've always heard, it's not surprising. Common thinking used to be that letting a cut or scrape develop a scab, keeping it dry, and airing it out from time to time was ideal. But numerous studies have shown that wounds heal better and faster if they're kept moist.
Some doctors still recommend the older method, but the American Academy of Pediatrics says, in Caring for Your Baby and Young Child, "Scabs actually slow the healing process and can lead to more scarring. Treat large or oozing scrapes with an antibiotic ointment and then cover them with a sterile … dressing."
Also consider "liquid bandages." These waterproof adhesives keep germs out and moisture in. They're applied on the top of the skin, to hold the cut together. There are brush-on and spray-on options, and some advertise that they don't sting. Ask your pharmacist to help you choose one, if you're interested.
Avoid placing a bandage on babies and toddlers in a spot where they can take it off and put it in their mouth. You might instead wrap a finger in gauze, for example, or even leave a minor cut or scrape without a bandage rather than risk your child choking.
How do I care for the bandaged wound?
Remove and replace the bandage daily – or whenever the bandage gets wet or dirty – and examine how the wound is healing. Do this until the wound is fully healed.
(A liquid bandage doesn't need to be removed. It will wear off in five to 10 days.)
Call the doctor if you notice any signs of infection (redness, pus, oozing, or swelling), or if the wound is warm to the touch.
How can I ease the pain?
If you think your child is in pain, consider giving him the proper dose of acetaminophen or (for kids 6 months or older) ibuprofen. (Call your doctor before giving anything to a child younger than 3 months.)
Never give your child aspirin. It can cause Reye's syndrome, a rare but potentially fatal condition.
When should I call the doctor?
Call the doctor right away if:
- The wound is on your child's face. All but minor cuts to the face can result in visible scarring.
- Your child has been bitten by an animal or another child and the skin is broken – those wounds require special treatment.
- For deep puncture wounds or cuts caused by dirty objects. The doctor will need to make sure your child's tetanus shot is up to date.
- You notice any signs of infection – like redness, pus, oozing, or swelling – or if the wound is warm to the touch. An antibiotic may be needed to treat the infection.
Take your child to the emergency room if:
- You can't stop the bleeding within 10 minutes with firm pressure. (Keep applying pressure and elevate the wound above your child's heart, if possible.)
- You think your child needs stitches.
- The wound is embedded with debris (dirt or gravel, for example) that you can't get out.
- Something large is stuck in your child's skin.
When does a cut need stitches?
Cuts need to be stitched to stop bleeding and for cosmetic reasons. Your child is likely to need stitches for:
- Cuts that look deep and open, especially if they have jagged edges.
- Cuts longer than 1/2 inch.
- Cuts on the face (even if they're only 1/4 inch long) and in areas that are taut or that stretch with movement, like the palm side of the hands and fingers.
For best results, stitches should be done within eight hours of being cut – and preferably sooner, to avoid the risk of serious infection and to help prevent scarring. If you have any doubt about whether your child needs stitches, have a doctor examine the wound.