Recently our family had an outing to visit Martin Luther King’s house here in Atlanta. Graeme and I were excited to be at a historic location on a historic day (we went on MLK day!) and were distracted by taking pictures. When we weren’t looking, 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 to avoid an infected cut. I felt like a horrible mother and I worried that the abrasions would result in a horrible scar.
Irrigation (cleaning the skin abrasion with lots of clean water or normal saline) is the best way avoid an infected cut. This is because irrigating will help to remove any bacteria or debris that have become enmeshed in the skin cut.
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 cut, 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.
Children have the benefit of having young healthy skin tissue with a lot of collagen (a protein that helps to strengthen the skin) as well as good blood and nerve supply. This is good for toddlers. When toddlers get a skin abrasion, when the steps are taken to ensure the abrasion is clean, they are less likely to get an infected cut or scar. As we age, our skin tissue becomes thinner; we lose collagen and our nerve and blood vessel supply to the skin also decreases. As a result, wounds heal slower and less effectively as we age.
Sure enough, within a week and a half all of the abrasions on Madi’s face were gone, and she never suffered from an infected cut, and she never developed a scar. I felt reassured after speaking with many mom friends that falls and cuts are sometimes unavoidable in toddlers. If your child has a cut that is very deep and won’t stop bleeding, they might need stitches so taking them to a doctor is a good idea.
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- Stevenson TR, Thacker JG, Rodeheaver GT, et al. Cleansing the traumatic wound by high pressure syringe irrigation. JACEP 1976; 5:17.
- Rodeheaver G, Pettry D, Turnbull V, et al. Identification of the wound infection-potentiating factors in soil. Am J Surg 1974; 128:8.
- Fernandez R, Griffiths R. Water for wound cleansing. Cochrane Database Syst Rev 2012; :CD003861.