Lacerations / Cuts
Laceration occurs frequently in children as they are curious and active and accidents happens. You may be worried when your child sustained a cut and unsure on how you should manage the injury.
What should I do now? First aid treatment
These are some immediate first aid management you should institute:
- Rinse the wound with water or antiseptic solution (if available) to keep it clean and to wash out the dirt and debris.
- If the wound is still bleeding, you can apply some direct pressure over it for several minutes with a clean towel or gauze.
- If the wound is still bleeding after 5 minutes of direct pressure, you should seek medical help.
- Do keep the wound covered with adhesive gauze / tape.
Learn more about wounds
Clean cut laceration
The mechanism of the wound will affect the type of the laceration. A sharp and clean cut will heal better and have better cosmetic outcomes.
With crush injuries, more energy is delivered to the surrounding tissue, and it is often injured with associated abrasions or degloving of the tissue.
Laceration with jagged edges and surrounding abrasion and crush injury which will need to be refashioned.
Biological wounds like human or animal bite are more contaminated and have increased risk of infection.
The wound has to be evaluated for the tissue layers involved. This can extend down from the epidermis, dermis, subcutaneous tissue and muscle down to the underlying bony structure.
Also, certain areas, particularly over the face, hands and fingers, may have more specific concerns. For example, vision if the laceration is near the eyes. Accurate alignment and precise matching of key landmark features of the face like the lips, eyelid borders and eyebrows as well as underlying tendons of the hands and feet.
Wound Management
Management of a laceration is based on the location and structures involved, the type and extent of the wound, as well as the age of the patient. The laceration can be managed under local anaesthesia in the emergency department if your child is able to cooperate. Otherwise, sedation or general anaesthesia is required. For more extensive wounds, sedation or general anaesthesia may also be required.
There may also be a need for tetanus booster injection if the wound is highly contaminated or a booster dose is due.
When should I call my child's doctor?
Specialised treatment for laceration should be managed by a doctor. Please contact your child's doctor for lacerations and cuts that are:
- Bleeding heavily and continue to bleed after 5 to 10 minutes of direct pressure
- Deep or long
- Located near critical structures like the eyes
- Puncture wounds, especially if they are caused by dirty or rusty objects
- Embedded with debris such as gravel, dirt or stones
- Jagged edges
- Caused by a human or animal bite
- Showing signs of infection such as redness, warmth, discharge of pus
It is also recommend to call your child's doctor if:
- Your child has not had a tetanus vaccination within the last 5 years, or if you are unsure when your child's last tetanus shot was given
- if you are concerned about the wound or have any questions
Is it common for children to receive stitches
for lacerations / cuts?
Yes, it is very common for children to undergo stitching of their laceration / cuts. Many children who are calm and cooperative are even able to have their stitches performed in the Emergency Department under local anaesthesia. For larger and deeper cuts or children who are younger or are afraid, these stitching can be performed under sedation or general anaesthesia in the operating theatre.
Post-operative Management / Wound Dressings
The repaired wound will be covered with a dressing for several days to allow optimal conditions for healing, to prevent infection and provide comfort to the patient. The type of dressing material used will depend on the underlying wound conditions. An appointment will be provided for the after care and management of the subsequent scar.
Medications will be provided to reduce infection, swelling and discomfort.
If you encounter this and are unsure what to do, do feel free to contact us.
Frequently Asked Questions about Lacerations and Cuts
Paediatric lacerations is covered under accident insurance or hospitalisation insurance, do check with your insurance agent for your insurance coverage.
Yes, steristrips and tissue glue are alternative management for more superficial type of lacerations.
An open wound that is left untreated may continue to bleed and cause discomfort. Furthermore, the risk of infection may also potentially increase.
The two edges of the wound may be mismatched and leave a scar that is irregular in configuration or broader than it should have been.
A laceration that is being surgically repaired will generally heal within one week. During this one week period, it is most ideal to have the wound protected with waterproof dressings.
Following this, the scar will need to be supported, as it gradually regains its original skin quality.