When your child has a wound, it can be stressful for both of you. Your child may experience stress related to pain, physical limitations, and body image concerns during the healing process. Depending on what the wound is related to — surgery, trauma, etc. — a good deal of stress may be attributed to coping with what has happened. As a parent, it can be incredibly stressful caring for a child with a wound for many reasons, including feeling helpless about their discomfort, a lack of confidence in managing the wound, and fear or anxiety about what the future holds. Here is a comprehensive overview of wound care management for children to help put your mind at ease.
At Alaska Pediatric Surgery, our skilled surgical team makes every attempt to minimize surgical wounds and scars that are created. We can help you and your family cope with and care for wounds, as well as perform wound debridement and scar revisions if necessary. We will also ensure that you are well prepared to manage your child’s surgical wounds prior to discharge — it’s part of our commitment to quality patient care.
Wound Care Instructions
If you do an internet search for wound care instructions for kids, you will undoubtedly be overwhelmed by the tens of thousands of articles and ads offering assistance, creams, salves, and other advice. Some of this advice will be helpful and others are just gimmicks to make a buck off of worried parents. It can be hard to know the difference. For simple scratches, scrapes, bruises, bug bites, and minor burns, we will leave it up to you as soap, water, and a thin layer of triple antibiotic ointment paired with the tender touch and a parent’s comforting kiss is usually enough. The care and management of major wounds including surgical wounds, stomas, burns, and traumatic wounds, require a little more.
Whatever type of wound your child has suffered, if you seek medical attention, your providers will develop a personalized wound care plan and provide patient education to you. Instructions should be followed as closely as possible and will include instructions about dressing change, medication, and infection prevention. While the specifics may change for your child’s wound, there are some general wound care management tips that apply to all wounds.
Keeping Dressing Dry
Depending on what type of dressing, where it’s located, and how active your child is, keeping the dressing dry may be difficult. However, it is very important. Bacteria love dark, warm, moist areas and a wet wound dressing is a perfect spot for bacteria and other microbes to take refuge. If you notice the bandage is saturated, either from wound discharge or external sources, check your wound care instructions for guidance on performing a dressing change. Avoid getting the dressing wet by covering it when moisture is not avoidable and educating your child about how to keep it dry.
Protect the Wound
Protecting the wound may seem natural when pain is present. However, there are many things that you and your child may not even think about, especially when pain is minimal. Healing wounds are active sites for cell activity of all types. To encourage cell regeneration, healing, and tissue growth, avoid bumping, scraping, scratching, direct sunlight, moisture, and contaminants from assaulting the new and healthy cells. This may require additional clothing at bedtime, altered play habits, and lots of reminders.
Encourage a Healthy Diet
There are few things more important to health and recovery than nutrition. Healing wounds need plenty of vitamins and nutrients, protein, and hydration to help aid in the healing process. Processed sugars and fats aid in breeding infection and slowing healing. Encouraging your child to eat a high protein diet can help expedite the recovery process and reduce the risk of infection. Meat, dairy, fruits, and vegetables should be the main staples, along with plenty of low-sugar fluids and whole grains. We understand that it may be tempting to give in to the snack requests of a child in pain, but it is important to remember that a healthy diet, packed full of nutrients, will help them recover quicker.
Dressing Removal and Changes
Dressing removals and changes should be done following your provider’s instructions. Dressing change instructions will include frequency, supplies, and the steps to changing dressings. Every time dressing changes are completed, you should be looking at the wound for signs and symptoms of infection and healing. When you change the dressing, be sure not to damage the skin around the wound with the tape or bandage adhesive. When in doubt about how or when to conduct dressing changes, contact your provider or nurse line for clarification.
There are some wound care situations that may require special care. For instance, for port implantation, you will be caring for a clean surgical incision, but paying special attention to reactions to the new port as well as caring for the port itself.
For a new stoma or ostomy, refer to our previous post for the care and management of the fresh stoma as well as long term care.
If your child’s wound includes stitches, it is important to keep a special eye on them and prevent snagging them. For dissolvable stitches, check for wound healing and allow the stitches to dissolve on their own, never pull them out. For non-dissolvable stitches, ensure they are not healing into the wound. If the stitches come out and the wound opens up, be sure to call your medical provider.
For surgical glue and steri-strips, keep the area clean and dry. Don’t use creams or ointments and avoid rubbing, scrubbing, and scratching. Even when the edges of the glue or strips begin to peel, let it fall off naturally without tugging at it.
For burns, wound care is similar, but heat and exposure should be prevented. Keep the area cool and out of direct sunlight, heat sources, and hot water. Do not over moisturize the area.
For more information on wound care management for special situations, check out these online resources:
Infection prevention is an important element of wound healing. Infection prevention focuses on reducing microbe access to the wound. Some critical elements of infection prevention include:
- Hand washing
- Using a clean technique during dressing changes
- Preventing and changing wet dressings
- Keeping the wound covered and protected
- Avoid exposure to unnecessary bacteria — hands, sweat, baths, pools, mud, rugs, etc.
- Taking all medications as prescribed
When to See a Doctor
It is normal for a wound to appear beefy red, swollen, and/ or have blood or clear fluid on it. These are all normal symptoms of the healing response and are good things to see. For surgical wounds, the edges of the wounds should come together like a seam, with no gaps. For traumatic wounds, edges of the wounds should appear red or white. You should contact your surgeon or pediatrician if you notice any of these signs or symptoms:
- Increased pain
- The wound is hot to touch or your child develops a fever
- The wound has a smell
- There is increased discharge of any color or there is a change in color of discharge
- There is yellow or green discharge or dried crust on or around the wound
- The skin around the wound becomes red and warm
Wound Care Management Resources
For severe wounds, your child may have regular visits to their pediatric surgeon, pediatrician, wound care clinic, or have regular visits from a regular wound care home health nurse. To get you set up with the right services, talk with your provider and case manager.
At Alaska Pediatric Surgery, we are dedicated to optimizing positive surgical outcomes and reducing complications and scarring. Our pediatric surgical team will take every measure to set you and your child up for success after any surgical procedure. Contact our office for more information or to schedule your consultation today.