Clinical Reference Systems: Pediatric Advisor 10.0
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Description

Most contaminated wounds that are going to become infected do so 24 to 72 hours after the initial injury. Keep in mind that a 2- to 3-millimeter rim of pinkness or redness confined to the edge of a wound can be normal, especially if the wound is sutured. However, the area of redness should not spread. It is also normal for there to be some pain and tenderness, but the pain and swelling should be greatest during the second day and then become less after the second day.

Home Care

Do not wash the area for 24 hours after the suturing. Then begin washing it gently with warm water and liquid soap one or two times a day. Apply an antibiotic ointment after you wash the wound to keep a thick scab from forming over the sutures. Swimming and baths are safe 48 hours after the suturing.

Suture Removal

Sutures are ready for removal at different times, depending on the site of the wound. The following table can serve as a guide.

 
         Area of Body                  Number of Days 
         --------------------------------------------
         Face. . . . . . . . . . . . . . . .  3 to 4 
         Neck. . . . . . . . . . . . . . . . . . . 5 
         Scalp . . . . . . . . . . . . . . . . . . 6 
         Chest or abdomen. . . . . . . . . . . . . 7 
         Arms and backs of hands . . . . . . . . . 7 
         Legs and tops of feet . . . . . . . . .  10 
         Back. . . . . . . . . . . . . . . . . .  10 
         Palms of hands or soles of feet . . . .  14 
         --------------------------------------------

Your child's stitches should be removed on the correct day. Stitches removed too late can leave unnecessary skin marks or even scarring. If any sutures come out too early, call your child's physician and in the meantime reinforce the wound with tape that pulls the edges together or with butterfly Band-Aids. Continue the tape until the date when the sutures are due to be removed.

Protection

After removal of sutures:

• Protect the wound from injury during the following month.
• Avoid sports that could reinjure the wound. If a sport is essential, apply tape to the wound before playing.

Scars

A sutured wound will develop a scar. All wounds heal by scarring. The scar can be kept to a minimum by taking the sutures out at the right time, preventing wound infections, and protecting the wound from being injured again during the first month after the injury. The healing process continues for 6 to 12 months. Only after this time will the scar assume its final appearance.

Call Your Child's Physician Immediately If:

• An unexplained fever (over 100 degrees F, or 37.8 degrees C) occurs.
• There is a red streak or red area that spreads from the wound.

Call Your Child's Physician Within 24 Hours If:

• It looks infected (for example, pus or a pimple).
• A stitch comes out early.
• You have other questions or concerns.