Wound Care, Bites, Lacerations, and Burns

Also: Bites, Burns, Lacerations, Cuts

Most minor wounds can be handled at home easily and safely.  The first important step in managing a cut, scrape, or bite is to control bleeding. Please call us if constant, firm pressure for ten minutes fails to stop bleeding.

After bleeding has stopped, clean the wound by irrigating with clean tap water for five minutes.  If bleeding restarts, apply pressure again once wound cleaning is completed.  The irrigation phase is a good time to inspect the wound more closely for length, depth, and the presence of foreign bodies.

If a cut is more than a ¼” deep and tends to gape open, there is a reasonable chance that it will need stitches.  Obviously, cuts in cosmetically significant areas such as the face are more likely to be sutured than are others.  Foreign bodies that cannot be removed also warrant medical attention.  The sooner stitches are placed, the less likely a wound will become infected and the more likely it will heal successfully.  Twelve hours is generally considered the safest window in which to close a wound.

For cuts and scrapes that do not require a doctor’s attention, keep the wound clean, dry, and covered with a bandage for the first 24 hours.  Use of an over the counter antibiotic ointment will help to prevent infection but will not substitute for proper wound cleaning.  Once the wound has scabbed over, bandaging is no longer necessary.  Check to ensure that your child has received a tetanus vaccination in the last five years.

Please call our office in the following situations:

  1. Bleeding that won’t stop with ten minutes of pressure.
  2. Wounds that reveal underlying structures like tendon, bone, or fat tissue.
  3. Wounds that cause numbness, weakness, or tingling.
  4. Wounds that develop painful swelling, spreading redness, or discharge of pus.

Bites

Animal bites are handled in the same general fashion as cuts and scrapes.  Special attention should be paid the following situations. (Please call us for assistance.)

  1. Bites from animals without documented rabies immunization.
  2. Animal bites to the hand or face.

Insect Stings

If the stinger is still embedded, remove it with a scraping motion of your fingernail or a credit card.  Don’t pull on the stinger.  A cold compress on the area can relieve pain.  Diphenhydramine, (Benadryl), can be given to alleviate itching and swelling.  We should be notified if you notice hives, paleness, weakness, nausea, vomiting, or difficulty breathing.  Ticks can be removed with tweezers placed close to the head.  Apply gentle, continuous traction.

Burns

Burns are divided into three categories, according to their severity.  First degree burns are the mildest and cause redness and slight swelling of the skin.  Second degree causes blistering and considerable swelling.  Third degree burns appear white or charred, and are often painless.  Third degree burns cause serious injury to both the surface and the deeper skin layers.

Burn Treatment

  1. As quickly as possible, soak the burn in cool water.  Do not use ice.  
  2. Remove any clothing from the burned area unless it is stuck firmly to the skin.  In that case, cut away as much as possible. 
  3. Do not burst intact blisters.  Apply antibiotic cream twice daily to any open blisters.  Do not put butter, grease, or powder on a burn. 
  4. For anything more serious than a superficial burn, call our office. All electrical burns, and burns of the hands, mouth, or genitals should receive immediate medical attention.
  5. When treating a burn at home, watch for any increase in redness or swelling, or the development of a bad odor or discharge.  These can be signs of infection, which will require medical attention.

Injury to the Teeth

If baby teeth are knocked out or broken, apply a clean gauze to control bleeding.  If a permanent tooth is knocked out, rinse off any dirt and insert it root first into the socket or put it in a cup filled with milk or the child’s saliva.  Do not touch the root.  If a tooth is broken save the pieces. Call your dentist ASAP.