It’s almost impossible for an active child to avoid some scrapes and cuts. An article in healthychildren.org has some advice on how to manage these occurrences.

With a small cut or scrape, almost all active bleeding can be stopped by applying direct pressure with a clean gauze or cloth over the site for five to 10 minutes. The most common mistake is interrupting the pressure too early in order to peek at the wound.

Once the bleeding is stopped, gently wash the wound with soap and water for five minutes. If your child persistently objects, try soaking the wound in the bathtub. Cleaning the wound will decrease the chance of infection and prevent dark spots caused by dirt trapped in the skin. After cleaning, apply a small amount of ointment, such as Vaseline, to keep the wound moist, and cover with dry gauze or a bandage until healed.

Cuts that go all of the way through the skin may benefit from stitches. Any cut that’s gaping open with visible dark red muscle or yellowish fat should probably be closed, even if it’s small. If the gaping cut is more than a half-inch it probably should be stitched.

Small cuts that aren’t gaping may not require actual stitches, but may benefit from steri-strips or skin glue. Steri-strips are narrow adhesive strips placed over a cut with a bit of tension to keep the cut closed. They should stay in place for at least three days. Skin glue is applied by rubbing it over the cut as it’s held closed. It’s a good choice for straight cuts and is quick and painless, but isn’t good for wounds that have tension from muscle usage as over a joint. If the cut is in a cosmetically sensitive place such as the face, call your health care provider for advice about stitches.

Most cuts can generally be closed as long as 24 hours after injury. Some cuts should be closed sooner. Don’t let the cut dry out. After washing, wet some gauze pads and tape them over the cut until you can get to help.

If there’s uncontrolled bleeding, call 911 and act quickly to control the bleeding. Expose the wound to find out where the bleeding is coming from and apply firm, steady pressure to the bleeding site with both hands if possible. If the bleeding doesn’t stop and you have a commercial tourniquet, place it as high on the leg or arm as possible above the wound and make sure it’s tight enough to stop the bleeding. They don’t recommend homemade tourniquets.

To lessen scarring, use good sun protections for at least six months. No sunscreen until after two weeks from the injury, so use sun hats and clothing to prevent darkening of the scar. Scar massage and silicone sheets may also help.

Sally Robinson is a clinical professor of pediatrics at UTMB Children’s Hospital. This column isn’t intended to replace the advice of your child’s physician.

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