Kids get into accidents all the time. But what happens when it's your niece or nephew - and their in your care?

The good news is that most scraps and abrasions can be treated with good cleaning with soap and water getting rid of all debris.  Wounds heal best in a closed moist environment with antibiotic ointment (such as bacitracin) and a Band-Aid or sterile gauze dressing.  This helps protect the wound from water loss and infection.  If redness, warmth, pus, or increasing pain develops, then your niece or nephew should see their doctor.

Unfortunately, it's not always that simple. So if the full thickness of skin is cut, bleeding continues despite appropriate pressure. Suturing of the laceration with stitches may be necessary.

The process is relatively simple. The area is anesthetized (numbed) with local anesthesia or in severe cases, general anesthesia is used. The wound is then cleaned and repaired.  In sensitive areas (frequently the face), a plastic surgeon may be consulted for the repair.  The laceration may be closed with absorbable (dissolving) sutures, non-absorbable (ones that need to be removed), staples, dermabond (“glue”).  Depending on the location, stitches stay 4-14 days.

Getting burned

Most burns suffered by infants and young children are hot-liquid scalds burns.  The extent of the burn needs to be assessed by a physician -  as well as the cause. Unfortunately,  as many as 15% of scald burns may be due to child abuse!

Large burns and certain areas of the body may require hospital admission to a burn unit.  Fortunately, most burns are superficial and can be managed as an outpatient.  Treatment includes rinsing the burns with saline solution and light cleaning with mild soap-and-water solution, then applying silvadene or bacitracin and non-adherent dressings. Blisters may be debrided by the doctor.  Close physician follow-up is necessary to rule out the possibility of poor healing or infection.

Burns of the ears and hands require special attention to prevent scarring or deformation that could limit function. A plastic surgeon should be called into consultation for burns on these vulnerable.  Remember - a plastic surgeon’s goal is to give the best scar possible, but a scar is the bodies’ way of healing that depends on genetics and the location and orientation of the injury.

We hope your niece or nephew never has any cuts or burns!