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When spring arrives, the winter overalls are put away and the children are running around on gravel pitches and lawns in their shorts and t-shirts. As predicted, our plaster supply is growing at a furious pace. Is this the same in your household? I thought I should offer a short course on abrasions or grazes in children and how I use fixomull on grazes.
An abrasion is a wound caused by damage to the skin. This can be superficial and only affect the epidermis (or top) layer. This causes minimal bleeding and scarring. However, abrasions affecting the dermis layer may lead to scarring. An abrasion is also known as grazes or scrapes.
So, what do you need to do?
1. Clean the wound!
This is so important. A clean wound will heal nicely and often without scarring. A dirty wound triggers the immune system’s defense response and hinders the body’s own healing process. Abrasions are not that deep but they are always dirty with gravel, asphalt or soil.
All visible dirt must be cleaned away!
This part hurts. Abrasions cause pain immediately. Children are often scared and sad when they bleed. And it’s often more scary when the parent comes along and begins scrubbing away at the site. When you’re cleaning the wound, you may feel like a horrible person inflicting pain on your child. But by cleaning the wound, you are, in fact, a great parent taking responsibility for your child’s health.
How do you clean an abrasion?
If you are used to cleaning wounds or giving medicine to your child, and you have a child who cooperates to some extent, you can clean the wound yourself. To do this, you may need to keep a firm grip on the affected body part with one hand and wash with the other.
If you are not so used to doing this, or have a very sensitive child, I suggest that two adults get involved. Preferably two parents, if possible. One can hold onto the child and the other can wash. The best way approach this is by being resolute and determined.
Soap and water
Soap and water on a washcloth work well to get rid of visible dirt. But clean it properly! Sometimes you may need to brush the abrasion with a soft toothbrush or a soft nail brush and soap, to remove all the gravel. Sometimes you may even need to pull or pick out the dirt with tweezers.
If the child agrees, you can put a wet washcloth over the wound for 10 minutes to dissolve the dirt that has dried in. Or you can dip their whole hand or foot in lukewarm water.
You can use a local anesthetic gel, xylocaine gel, which is available without a prescription at the pharmacy. Do not use it on children under one and a half years of age, and follow the dosage instructions carefully. High doses of xylocaine absorbed through the skin and into the blood can affect the heart rhythm.
It is you as a parent, and partly the child, who must decide whether to use local anesthesia before wound cleansing. If your child, for one reason or another, is very afraid of being held, has painful experiences, or will need to be subjected to very planned medical care in the future, local anesthesia may help even when the wounds are not so dirty.
On the other hand, if you and the child are confident with wound cleaning, and you want to get rid of the dirt as soon as possible, you can very well clean it without local anesthesia.
If the wound is very dirty and you are not able to clean it, go to the medical health center. There, you can get help with wound cleaning, with or without local anesthesia. At the health center, you decide, in consultation with the nursing staff, whether local anesthesia should be given.
When the wound is completely clean, wash it a little more and rinse thoroughly with water. Then soak a washcloth with chlorhexidine solution (available at the pharmacy) that is bactericidal and bathe the wound in it. Allow to dry. Now you have killed all the bacteria that are on the skin, around the wound and in the wound. You have also given the body the best possible conditions for wound healing. There are also ready-made wet wipes available with chlorhexidine in it. These may be good to take with you on a trip.
If the wound is bleeding excessively, it is a good idea to use a clean washcloth and apply pressure to the wound for a while before putting on a bandage. This can decrease the bleeding.
Patches or dressings
When you have come this far and the wound is clean, it is time to apply bandages or plasters. What you choose depends on the size of the wound. I like plaster rolls because I can cut out the right size. I always have non adhesive dressings at home so I can cut it to suit the wound size, and wound adhesive (Fixomull) to secure the dressing. The wound pad or dressing should cover the entire wound and the tape must be secured on to the undamaged skin.
Cuddles and praise and rewards
The wound is clean, the patch is on. Now it’s time for the child’s body to heal. And for you and the child to relax. Do something cozy! Give the child a little reward if you want. No matter how much screaming and arguing there has been, praise the child for being so brave and for letting you take care of the wound so that the bacteria doesn’t have a chance against the child’s strong wound healing powers.
Has your child been vaccinated against tetanus?
Tetanus is a bacterial infection caused by soil bacteria in dirty wounds. If the child has followed the general vaccination program and is over 6 months old, they are protected against tetanus. If the child has not been vaccinated against tetanus, you must go to the pediatric emergency room to get injections of ready-made antibodies against tetanus as soon as the child has an abrasion.