When Madi was two years old, I was distracted from taking pictures and Madi tripped and fell on the cement. Madi’s nose was bleeding and she had multiple small cuts on her nose and cheeks. I panicked but fortunately, Graeme remained calm. He picked her up and applied pressure to her nose to stop the bleeding. He cleaned her face with some bottled water and wipes. I felt horrible and worried that abrasions would result in a horrible scar.

Irrigation (cleaning the skin abrasion with lots of clean water or normal saline) will help remove bacteria or debris inside the wound.   

Clean Tap water and Normal Saline (salt water) are both effective to clean cuts

There have been 5 large studies, 3 involving adults and 2 involving children, which found no clinically significant difference in wound infection rates when skin cuts were cleaned with clean tap water vs normal saline. 

Luckily children heal very quickly with minimal scarring from abrasions. 

If your child does get a cut, these are the steps you can take to help the wound heal as quickly as possible:

• Rinse the cut or wound with lots of clean water or normal saline to ensure you have a clean cut and to avoid an infected cut. 
• When you are sure you have a clean wound, apply pressure with a clean cloth or sterile gauze if it is available.
• Keep applying pressure to the skin abrasion until the bleeding stops. If the skin cut is on a limb, you can raise the limb above the head to slow blood flow to the area.
• When the bleeding stops, apply a bandage.  If blood soaks through the bandage, replace it with a clean, fresh, new bandage as necessary.

Younger skin tissue is healthier because it has a lot of collagen, a protein that provides strength to the skin as well as plenty of oxygen and blood supply. Almost all toddlers will have a skin abrasion at some point. If you take the right steps to keep it clean, they are less likely to get an infected cut or scar. As we get older our skin tissue gets thinner – we lose collagen and nerve blood supply and this makes us more prone to getting an infected cut or scar. As a result, wounds heal slower and less effectively as we age.

Did Madi get a scar?

Sure enough, within a week and a half, all of the abrasions on Madi’s face were gone, and she did not get any infections or a scar. I felt horrible for 2 weeks but was reassured after speaking with many mom friends that falls and cuts are sometimes unavoidable in toddlers. 

If your child has a cut that is deep or won’t stop bleeding, they might need stitches so taking them to a doctor is a good idea.

This post was co-authored by Suzanne Black, MD, BSc, and Stephanie Liu, MD, MSc, CCFP, BHSc.

References

1. Reddy M. Skin and wound care: important considerations in the older adult. Adv Skin Wound Care 2008; 21:424.
2. Fore J. A review of skin and the effects of aging on skin structure and function. Ostomy Wound Manage 2006; 52:24.
3. Stevenson TR, Thacker JG, Rodeheaver GT, et al. Cleansing the traumatic wound by high pressure syringe irrigation. JACEP 1976; 5:17.
4. Rodeheaver G, Pettry D, Turnbull V, et al. Identification of the wound infection-potentiating factors in soil. Am J Surg 1974; 128:8.
5. Fernandez R, Griffiths R. Water for wound cleansing. Cochrane Database Syst Rev 2012; :CD003861.