Pediatric Lacerations (Minor Trauma)

What is a laceration?

A laceration is tear or opening in the skin caused by an injury. Lacerations may be small and need only minor treatment at home, or may be large enough to require emergency medical care.

What are stitches?

Stitches, also called sutures, are special types of thread that hold wound edges together while they heal. Stitches help to stop bleeding, reduce scarring and decrease the chance of infection in the wound.

What are Steri-Strips?

Steri-Strips are special adhesive bandages that can sometimes be used on shallow wounds instead of stitches. Steri-Strips perform the same functions as stitches.

How do I know if my child's cut needs stitches?

Lacerations that involve the face, are longer than 1/2 inch, are deep, or are bleeding heavily, may require stitches.

First-aid for lacerations requiring stitches

• Calm your child and let him/her know you can help.
• Apply pressure with a clean cloth or bandage for several minutes to stop bleeding. If the bleeding is profuse, hold pressure for five to 10 minutes without stopping to look at the cut. If the cloth becomes soaked with blood, put a new cloth on top of the old one. Do not lift the original cloth.
• Once bleeding has stopped, wash your hands and then wash the area well with soap and water, but do not scrub the wound. Remove any dirt particles from the area and let the water from the faucet run over it for several minutes.
• Cover the area with an adhesive bandage or gauze.
• Call your child's physician, or if bleeding is severe, call 911 or take your child to the emergency room for further care.

When should I call my child's physician?

Specific treatment for lacerations that require more than minor treatment at home will be determined by your child's physician. In general, call your child's physician for lacerations that are:

• Bleeding heavily and do not stop after five to 10 minutes of direct pressure
• Deep or longer than 1/2 inch
• Located close to the eye
• Large cuts on the face
• Caused by a puncture wound or dirty or rusty object
• Embedded with debris such as dirt, stones or gravel
• Ragged or have separated edges
• Caused by an animal or human bite
• Excessively painful
• Showing signs of infection such as increased warmth, redness, swelling, or drainage

Also call your child's physician if:

• Your child has not had a tetanus vaccination within the past five years, or if you are unsure when your child's last tetanus shot was given
• You are concerned about the wound or have any questions

Treatment

If your child's physician or an emergency department physician needs to place stitches or use Steri-Strips to close a laceration, you will be given specific instructions for how to care for the stitches. Treatment at home will be based on the location and size of the laceration, type of stitches used and any special needs noted by your child's physician. Antibiotics may be given to help prevent infection in the wound.

Some stitches dissolve and do not need to be removed while other stitches require removal. Your child's physician or the emergency department physician will let you know when to return to have stitches removed. Do not try to remove your child's stitches yourself.

Some general guidelines for caring for lacerations with stitches or Steri-Strips include the following:

• Keep the area clean and dry
• Carefully follow the physician's instructions for care of the wound
• Make sure your child avoids any activity that may cause him/her to re-injure or open the wound
• Observe the wound for signs of infection such as increased warmth, swelling, redness, drainage, or pain
• Observe the stitches to make sure they are intact and keeping the wound edges together
• Return for follow-up care, as advised by your child's physician
• Once the wound is completely healed, use extra sunscreen on sunny days to help protect the area of new skin